Now, I’m not one for going to or listening to Doctors, so I possibly wasn’t paying attention but…

A couple of years ago I was diagnosed with EIB after two chest infections exaggerated by turbo training in cold weather.  I can’t remember the conversation but was offered a Brown inhaler, refused it yet accepted a Blue one.  This year, I haven’t needed it but last year I had a few puffs before a race as a precaution.

I’m sitting here with Bronchitis and have been given all the bells and whistles because the Locum I saw got scared of “onset pneumonia”. She told be off because I’m “asthmatic” and hadn’t used a blue inhaler during my bouts of coughing, potentially damaging my lungs and causing things to be worse.   She condemned me to using the Brown Inhaler daily – forever – and the Blue one if I have any coughing or breathing issues and told me I should be carrying the blue one with me everywhere.

My question is, is this over cautious/zealous of the locum?  Or once diagnosed with EIB – which I thought wasn’t very serious – do I need to be treating my repository system with a bit more care?

Brown one is a preventer (probably Clenil Modulite)

Blue one is a reliever, Salbutamol

If you take the brown one every day you, shouldn’t need the blue one.

Do it for a period of time and your GP will review your situation periodically.

It’s not forever

Seems like sensible advice to me. You can damage you lungs in this way.

Blue inhaler is worse for your heart. It’s better for you to use the brown inhaler every day in order to avoid occasional use of blue inhaler.
This is the message I got.

While you have bronchitis it seems sensible to use the brown inhaler, but remember this takes days/ weeks of using every day to actually get up to full strength.

When your fully better you can get off it and see what the difference is like as to if you want to keep using the brown. My vote is this is better than reacting each time with the blue.

If your interested use a ‘peak flow’ meter to measure how your lungs are doing (prescription or £10 on web).

Also when using the brown inhaler I also recommend using a ‘spacer’ (mine is called an aero chamber), I did not do this for years but now do and it’s much better with it. Easier on the throat and gets more medication in to your lungs. Again on ‘script or £10 online.

I have a yearly asthma check at the GP. Their advice is to keep up the brown inhaler on a low (2 puffs a day) dose most of the time. When I get a cold or the hay fever kicks in then I’m supposed to double or even treble toe daily dose to keep things getting bad on my chest.

Seems to work to be honest. I rarely use my blue inhaler.

(However, as an aside, it does seem that my early (I’m 42) cataracts are probably due to long term steroid use. And the only steroids I’ve ever had are the brown inhalers.) Net result: I don’t get wheezy often but I can’t see shit!

If your interested use a ‘peak flow’ meter to measure how your lungs are doing (prescription or £10 on web).

Also when using the brown inhaler I also recommend using a ‘spacer’ (mine is called an aero chamber), I did not do this for years but now do and it’s much better with it. Easier on the throat and gets more medication in to your lungs. Again on ‘script or £10 online.

Yes the doc gave me those, thanks.  Ok, so the Brown one I’ll continue with.  At the moment I’ve only use the blue one once each night after I awoke to a horrendous coughing fit.

I kind of thought it was a bike related / sports thing rather than a permanent ailment and didn’t treat it seriously.  A bit worrying as my Dad suffered from pneumonia before he died, so I’d better wise up a bit.

When I was diagnosed with Asthma at about 45 they wanted me to start using the brown inhaler. I was a bit reluctant so they gave me a chart to plot my peak air flow for a month while taking the inhaler to see if there was any benefit. After a fortnight the peak air flow from my lungs, which had been low and all over the place, began to stablise and rise. After the month the graph was more or less a straight line. I was convinced. My fitness improved, my constant colds disappeared and my lung capacity rose. I have gone from a peak air flow of around 480 to over 600. I still have a few puffs on the blue inhaler before serious exercise, but have not had any sort of desperate asthmatic attack. I guess I have now only had 1 good cold/flu in the past 8 years

You should get the annual check with a nurse at your GP practice,  it’s all personal so the brown inhaler may not be forever.  If you routinely use both blue and brown inhalers then ask the nurse about seretide, which is both in one inhaler.  After being an inhaler use all my life i havent touched one since having to go gluten free!

I was convinced. My fitness improved, my constant colds disappeared and my lung capacity rose. I have gone from a peak air flow of around 480 to over 600.

Oh now this gets very interesting.  I don’t recommend you read my near tantrum in the Doldrums thread, but this year of suspiciously low performance coincides with what I said above about not using Salbutomal since at least last October.  I’ve always had this nagging doubt something physical was holding me back as if I was taking beta blockers…  Hmmm…

Peak flow was at 500 at the Docs, after 2 days use it was 600 today – I’ll keep measuring, and when I get back in training it’ll be it’ll be interesting to see if there’s a boost…

You should get the annual check with a nurse at your GP practice,

I’ve been ignoring the reminders… 🙁

You probably won’t get the brown inhaler on repeat prescription indefinitely if you don’t attend soon.

I was on the brown & blue inhalers for years then went onto Seritide with a blue inhaler for a few years then some white round thing that screwed my asthma back up and now on Fostair which has really got my asthma under control. The last asthma review I had I was told to ditch the blue inhaler and just use Fostair.

you really do need to see the asthma nurse.

Yes, stick to the brown if that’s the advice. It will reduce the need for the blue. 500 on a peak flow meter seems low for your size. My target is 600 and I am smaller than you. I’m on my brown daily now as the hayfever impacts on my asthma. But for large chunks of the year I don’t need it.

Personally I prefer to rely on anecdotal forum advice than professional medical advice…

So, I was diagnosed asthmatic as a kid and took loads of the daily ‘brown’ inhaler and never ever needed the :blue’ inhaler… Thirty years later and my kids get diagnosed similer. They never use either, never have a problem.

Take two sticks of licorice

Used inhalers for almost 50yrs. Mainly some version of ventolin/salbutamol. Can’t exercise without taking it before. Use the brown one to prevent.

blue. 500 on a peak flow meter seems low for your size.

Dont forget i currently have Bronchitis…

Pretty much as already covered, I use the brown daily although tend to drop off a bit in the summer months (need to sort that out really). One hit night and day, two if I’m feeling a bit wheezy generally in colder times.

Only need the blue when I get ill, but will occasionally use it before a race if I think the effort is going to be full on from the start (short crits) just to head things off a bit.

Brown is an inhaler corticosteroid. This damps down the immune response to allergens in the lung and is therefore a “preventer”. The blue is a muscle relaxant that opens up the airways for short relief and immediate prevention of say exercise induced bronchoconstriction.

The brown inhaler has a steroid that is broken down rapidly and very little enters the body. But when given by metered dose inhaler comes out very fast and a lot hits the back of the throat. This can give symptoms such as sore throat, due to local suppression. Hence a spacer can be used to improve delivery to the lung. The action in the lung can also increase lung infections, although the effect is very small.

Spent many years developing the grandchildren of both of these medicines and….

Medicines don’t work in patients that don’t take them.

That for all the advice here.  The one thing that stands out is

Medicines don’t work in patients that don’t take them.

I know its obvious but I treated EIB as if it were not a illness/condition as such, but something I needed to treat as and when it but IF it happened.  I haven’t felt like I need Salbutamol all year, hence havent used it.

Plenty of reading over the weekend and I’ve learned not only should I have been using an inhaler pre exercise, not doing so has likely led to to sub-optimal endurance and VO2max output all year.

You live and learn, I’ve another asthma test & appointment after the Bronchitis is done within which I expect to be told off.

I know its obvious but I treated EIB as if it were not a illness/condition as such, but something I needed to treat as and when it but IF it happened. I haven’t felt like I need Salbutamol all year, hence havent used it.

Ideally, this is the right approach. Reliever when required, preventer all the time.

You live and learn, I’ve another asthma test & appointment after the Bronchitis is done within which I expect to be told off.

I wouldn’t have thought so. You just need a preventer and to recognise when your asthma is not well-managed.

The one thing that stands out

Thanks. Sometimes they don’t work in patients that do take them as well. That’s all part of the day job 😉 . EIB is a thing, and people scoff at the peloton, but the action of training puts a burden on the immune system.

puts a burden on the immune system.

As I’ve found out, cough cough cough….

Well, lots of tests and I’ve been diagnosed as properly Asthmatic.  I spent an hour with the nurse who was very detailed and helpful, horrified that my GP turned down a flu jab last year, and feels that despite no attacks even slight broncho constriction may have been a limiter in my bike racing performance this year.  Ah well.

She’s going to swap me to a single combined inhaler in late September as she performs my flu jab for me as an alternative to x 2.

The good news is I went from a peak flow of 500 when I had Bronchitis to 675 today, on a target of 631, so thats good.

675? There’s nothing wrong with you!

Mine is currently hovering around the 500 mark on a good day.

@ronniebond … blue inhaler is worse for your heart.

Interested in that comment. What do you mean by worse and is there an evidence base for this? Genuinely interested – not meant sarcastically. I’ve been issued with a brown steroid one but never use it because I’m convinced it greatly increases my appetite – I just have a toke on my bluey, as and when.

675? There’s nothing wrong with you!

This after 2 weeks of the inhalers…  and remember one is an athlete 😉

and remember one is an athlete

How very kind of you 🙂

Mine is after about 20 years of the inhalers!

https://www.asthma.org.uk/

When I was having problems a few years ago(turned out to be my BP tablet!)My Then consultant strongly advised drinking water immediately after taking inhaler.

Haven’t the read whole thread but response to OP is: quit the denial and take the preventer**.

** Spoken from experience.