This is one of my favorite (not!) answers when I ask one of my patients why they come to class wheezing and barely able to breathe. I have to pause before I figure out how to tactfully ask the question: You know you need your inhalers, so, how could you not know you were running low?
And then the REAL question: if this person refills regularly, every month, then how is it they ran out?
Er, have you been using your inhalers ‘as needed’ more often than usual?
This happens to many patients. You are going along fine, 2 puffs 4 times a day, then the weather changes. Or you get a mild cold. Or something stressful starts happening. Next thing you know, your inhaler is empty and you have another 5 days before you can get a new inhaler.
Everyone takes extra ‘rescue’ puffs once in a while. But it’s important to keep track of how many of these extra puffs you are taking in a day, and why. With asthma, we divide the diagnosis into ‘controlled’, ‘poorly controlled’, and ‘uncontrolled’.
This goes for COPD as well. I had one patient who was taking one puff every hour. That is not a symptom-control strategy!
If you find that the inhaler regimen you have been prescribed just isn’t covering you and keeping you symptom-free, it’s time for a medication review with your doctor.