Drugs for COPD…

Another response to what others are looking for here, and not finding. Obviously, I can’t recommend drugs for COPD beyond my own experience, but I can tell you what I take, and tell you a little about them.

First, the tablets/capsules:-

The mainstay of my meds is Phyllocontin Continus (aka Aminophylline SR – a bronchodilator). I take 2 225mg tablets every twelve hours (05.00 and 17.00). The timing is vitally important with this drug, as the difference in blood plasma levels between ineffective, the effective dose and toxicity is very small (ditto with toxicity, too), and every 12 hours is the optimum period. Side effects for me are nil, but I have very few problems with drug side-effects – but see ** and the Update, below. My advice, though, for any drug, would be to not go looking for problems, and don’t check on side-effects before you take the drug, otherwise you’ll find yourself looking for problems where there aren’t any, and maybe creating them. If they make you feel odd, or ill, then you can check, but bear in mind that your body will adjust to the drug, and many side-effects are temporary. NOTE: It is vital that the patient is maintained on the brand of Phyllocontin Continus on which they were first stabilised – the literature is very insistent on this.

I also take Angitil SR 180 (Diltiazem), a 180mg sustained-release capsule, again every 12 hours, at the same time as my Phyllocontin. Note: sustained release, and modified release mean the same – the drug is released at a controlled rate over a period. Angitil is a smooth-muscle relaxant often prescribed for angina, but it also has very beneficial effects on the smooth muscle of the respiratory system, and it’s a very useful drug in COPD – I’d be a whole lot sicker than I am without it, as I found out, recently, when I ran out.

I take all my morning meds at five in the morning. This is so that, when I finally get up, around 08.00, they’re in my system and I’m ready to go.

Finally, I take a PPI (Proton Pump Inhibitor – a drug that inhibits the production of gastric acid). This is Pantaprozole, 40mg, prescribed to treat Gastric-oesophageal Reflux Disease (GORD), a problem that is very often associated with COPD. I take this once a day, at 21.00, thus the effect, which lasts for 12 hours, will take me safely through the night, when GORD is at its worst. You may find you’re advised to take PPIs in the morning – if you have COPD, ignore that, and take it in the evening. Sleeping on a bed wedge, to raise the upper part of your body, also helps with GORD.

Inhalers:-

Salbutamol aka Ventolin - a short-acting bronchodilator, taken at need – it is almost impossible to overdose on this inhaler (compare the vastly bigger nebulised dose if you doubt that). I would have said totally impossible, but there are too many idiots in the world! Two puffs, on rising and whenever I need it. At home all my inhalers are used with a spacer device, for more efficient administration. IMPORTANT NOTE FOR UK READERS: Generic salbutamol inhalers are NOT as effective as Ventolin, and I don’t care what NICE claims – some chemists still dispense Ventolin because of this, and are worth seeking out (and, of course, in hospital pulmonary function labs, the gold standard is Ventolin, not some shite generic imported from Romania for 3p!). May cause an elevated heart rate, but otherwise no problems.

Ipratropium bromide aka Atrovent - a long-acting bronchodilator that also takes time to kick in – 2 puffs 4 times a day, on rising and approx. every 6 hours. No problems.

Beclomethasone dipropionate aka Becloforte** – high-dose inhaled steroids. 2 puffs 4 times a day, as above – note that at this level, systemic problems, as with oral steroids, will occur, so carry a steroid card and try to watch your weight or, as I have, you’ll balloon! Do not believe your GP if you’re told there are no systemic problems – GPs don’t know everything and the literature is quite clear on the subject; you can check it out for yourself. Becloforte, which contains CFCs, is currently being replaced with Clenil Modulite – same drug, same dose, no CFCs.

**Now CFC-free, the current equivalent is Clenil Modulite 250.

Salmeterol xinafoate aka Serevent -another long-acting bronchodilator. NOTE: when prescribed this inhaler it is vital NOT to stop taking your inhaled or oral steroids – deaths have resulted among people who have. Again, not all GPs are aware of this; hospital clinics are, though. 2 puffs every 12 hours, or as close as I can get – it’s not critical. 4 times a day at need.

Odds & Sods:-

Codeine linctus – cough suppressant. This is the only cough suppressant that actually works! You used to be able to buy it OTC until the junkies discovered it – now you can’t, so if you rely on it, as I do, make sure you never run out. 10ml as needed. Constipating.

Amoxyl aka Amoxycillin or Amoxicillin- antibiotic, 500mg every 8 hours, round the clock for 7-10 days, as needed. I have been buying my own Amoxyl for over 8 years now, and my respiratory health has never been better. This is because it’s impossible to get an infection flare-up treated promptly these days, without submitting a sputum sample to be cultured – which takes a week, which I spend getting worse. Then I’m likely to be prescribed whatever drug is in favour that week – depends which rep has been to the hospital. Some of the modern antibiotics, while arguably more effective (they’re usually described as cleaner, whatever that’s supposed to mean), are more likely to affect me adversely and, as has happened, put me in hospital.

The antibiotics I find most effective and least harmful are Amoxyl, obviously, Septrin, Augmentin, and Erythromycin. Ciproxin at a pinch – it makes me feel crappy, but it’s not dangerous.

To be avoided at all costs – it’s put me in hospital twice, and a third time left me with gastric problems that took months to clear up – is Distaclor MR. The drug itself, Cefaclor, is harmless, so it must be something in this particular formulation which, maybe, reacts with something else I’m taking (I take over 20 drugs in all, not all for COPD, so the risk of interactions is always there). You may ask why I keep taking the bloody things – good point. It’s because my GP is an idiot – I keep telling him how dangerous it is, he makes a note and then forgets and, the last time he prescribed it I was completely out of it and didn’t realise what I was taking. Now, I have the information sheet on the wall, so I don’t forget!

You may want to consider some form of analgesia, too, as COPD can be painful – not a lot of people realise that. Paracetamol is OK, but 30/500 Co-codamol is better (that’s 30mg codeine, 500mg Paracetamol – prescription only, though you can buy 8/500 OTC). Anything containing codeine is constipating, and in my experience products like All Bran make the problem worse. A few pints of beer twice a week works well, and is far more fun… NOTE: The maximum dose for Co-codamol, either strength, is 2 tabs 4 times a day – this is governed by the Paracetamol content. The maximum dose for codeine is 200mg a day,  and as codeine can seriously depress the respiratory system, it’s not wise to exceed it.

NB: May 8 2013 – analgesia now Tramadol, 100mg 4 times a day, plus Paracetamol.

As far as side-effects are concerned, those I’ve mentioned are those I am aware of. The problem is that I have had moderate to high levels of meds for 62 of my 68 years** – I’ve never known what it is to be drug free – so it’s quite possible I may be experiencing side-effects and not know it. I have no basis for comparison. Of late, due to dramatically worsening health, I have had to re-evaluate my view of side effects. Taking all my meds into account, I am now of the opinion that I might not have ME/CFS at all – everything under that heading can be laid at the door of my medication’s side-effects. That would also account for the reason I found it impossible, for 10 horrendous years, to be taken seriously. The question of why it didn’t occur to anyone to point this out to me remains unanswered.

** At the age of 2   I developed severe asthma and bronchiectasis, the result of almost simultaneous whooping cough and measles, either of which, on its own, was capable of doing a number on my lungs – both together and, to use a technical term, I was fucked. I’ve never had more than about 50-60% lung function, even with my meds maxed out. It hasn’t stopped me leading an active life, though, until the last few years (and it’s my legs that have failed, not my lungs) – and were it not for the sometimes high levels of activity (even damaged lungs can be strengthened) I’m pretty sure I’d be a lot worse than I am – my doctor says I should be, anyway. NOTE FOR DAILY MAIL-READING PARENTS – get your kids vaccinated and stop being bloody stupid! Measles and whooping cough screwed up my life, caused me to miss about 30% of my schooling and lose almost every job I’ve had as a result of excessive sick leave – is that what you want for your kids?

With COPD, and its precursors, like chronic asthma or bronchiectasis (I’ve little sympathy for smokers who have caused their own COPD here and, who, of course, have contributed substantially to mine, until they were stopped last year), a decent sex life can be problematic. Women, and girls in my yoof, find constant coughing, wheezing, and hawking up pounds of crap a turn-off. The latter, of course, is unavoidable, and should always be done in private – coughing and wheezing you’re stuck with. Ah well… I wonder if women have the same problem with men?

One final thought – some GPs believe that one or two bronchodilators should be enough for anyone, which is rubbish. The action of each of these is subtly different; they’re not all doing exactly the same thing in the same way. The above regime was arrived at after a long and arduous 3-day trip through the Pulmonary Function Laboratory at the local hospital, and all of it is necessary. I’m alive and functioning only because of this high level of medication, a fact that’s brought home to me if I ever run out of just one component.

Some docs also believe you can get by on inhalers alone. I think this idea is wrong-headed in the extreme. Obviously, people vary in their response to drugs, but I believe that main medications should be oral – Phyllocontin and Angitil in my case – with inhalers as adjuncts. I’ve tried the alternative – inhalers only – and it doesn’t work. Not for me, anyway.

For COPD-related depression (and in other respiratory illnesses, see this post.

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40 thoughts on “Drugs for COPD…

  1. hi ron how are you i have just recieved the letter that i have to go to a tribunal about dla i have copd could you advice me i feel i drserve this benifit as i suffer so mush at times i am 62 is it worth going to this tribunal

  2. hi i take 7.5 steroid tabs pregnilisone and aminophline 2 aday also seritde 2 puffs twice aday ventolin inhaler 2 puffs 3 times aday and when required which i take alot i hve 4 every 2 weeks also singular 10 mg 1 aday andlansoprazole 15 mg aday and folic acid 1 aday and no i dont smoke i tryed it once years ago but it nearly killed me and i am constantly coughing and put loads of weight on due to the steroids i have been on steroids since october last year i was on 8 aday but am in the process of reducing them bye for now gina

    • Hi Gina,

      My first thought, based on what you’ve told me, is that you’re under-medicated (and that could have affected your DLA claim – they look at your meds and think, Hmm… not a lot wrong there!). Your base level meds, given how badly affected you are, should be Aminophylline (is that Phyllocontin Continus?), 2 twice a day, exactly 12 hours apart (and that matters, as timing does with all your meds), and you build on that with inhalers. Right now you have too much emphasis on inhalers (but inhalers that, to my mind, are inadequate), but with no foundation of a long-acting bronchodilator to build upon, which you’d get by taking your Aminophylline twice a day (if it’s Phyllocontin – if it’s not, see below).

      If your Aminophylline isn’t Phyllocontin Continus then changing would be a good move, as it’s better tolerated and more effective. The standard dose for Aminiphylline is 100-300mg 3-4 times a day, so you’re way down on that, and are you taking your 2 tabs a day in one dose or two?

      Ventolin is fine, but at that level your GP should be thinking about a nebuliser, which is more effective. You also need a long-acting bronchodilator inhaler, like Serevent (below), and/or Atrovent. Oh, and all inhalers are more effective when taken with a spacer device, like a Volumatic.

      I think you might be better with two inhalers – Serevent and Clenil Modulite, a steroid, instead of Seretide (which contains Serevent and a steroid, fluticasone propionate). Using two inhalers will deliver more of each drug and it will also enable you to tailor your meds to your needs. I’m not a fan of combination inhalers, as they’re too inflexible. You need to be able to maximise your meds when you’re bad, but reduce them when you improve – you can’t do that when you have the bronchodilator and steroid in one inhaler. And one very important point about Seretide – dry powder inhalers can aggravate asthma (they certainly do with me – they get coughed straight out again), so if you’re taking the powder version you will almost certainly benefit from changing to the aerosol version. You’ll benefit a whole lot more by switching to the two I suggested.

      The Clenil Modulite will also give you more benefit than low-dose oral steroids, with fewer side-effects. I won’t touch Prednisolone unless my life is actually in danger. I maxed out at 80mg a day a few years ago and swore that once I recovered I wouldn’t touch them again because, frankly, they’re dangerous, especially long-term. I do accept, though, that for some people not taking them isn’t an option. And all drugs are dangerous to some degree, it’s a case of balancing the benefits against the risks, but long-term steroids can really mess you up.

      Lansoprazole, of course, is for acid reflux (GORD), which often goes hand in hand with COPD, but what’s the folic acid for? It has no benefits in asthma.

      Based on that, you really do need to get a Pulmonary Function Laboratory assessment ASAP. I really mean that.

      By the way, if you tell any of that to your doctor, there’s a very good chance he’ll tell you to sod off! I hope not, because I’ve made it my business over many years to know at least as much, and often more, about my condition, and its medication, than my GP does (by their very nature, GPs can’t be expected to know everything about every illness). It’s a lot to take on trust, I know, but I do know what I’m talking about.

      Ron.

  3. hi iam taking phyllocontin 1 in morn and 1 at night know one told me about 12 hr interval and as for nebuliser i have got to buy my own they wont give me one to use iam at doc this morn and going to ask again when last in hospital in january they put me on ventolin and actrovent and it was great and by the way folic acid i take is for b12 defiancy by for now
    gina

    • Hi Gina,
      Just a quickie, I’m on the way out.
      Most hospitals have a few nebulisers for loan to patients. Have you checked that out? Atrovent, by the way, is excellent, and available as a normal inhaler. If it helped in hospital surely it should be part of your meds?

      If you have to buy one, I’ll see if I can find you a good one for as little as possible (you can pay amazingly high prices if you’re not careful). If I don’t get back to you on this tomorrow, do remind me.

      Phylocontin – timing is critical. The effective level of the drug in the system is very close to the toxic level, and if you take it too soon after the previous dose it can make you feel sick (though you’re on a low dose, so that’s not too important). Thing is, though, that it’s a sustained-release preparation which lasts for about 12 hours (actually, a little more than that), so taking it earlier than that serves no purpose. Also, taking your drugs on a regular timetable is far more effective than just taking them when you remember (which is what most people do!).

      Might be worth talking to your doc about increasing your Phyllocontin to 2 twice a day – sounds like you need it.

      And Gina, what you need for a B12 deficiency is B12! Seriously. Although unless you have pernicious anaemia, you’re very unlikely to have a B12 problem, and if you DO have PA, then folic acid won’t help.

      Ron.

  4. docs have put me on atrovent inhaler 2 puffs twice aday and got some cough medicine codene linctus what you told me about they wont change anything else till i go hospital again on the 16 th may been ofered a nebuliser for 40 pounds but the docs say i have to talk to specialist first before he will prescribe stuff to go in it is it okay to have second hand ones and i do have pernicious anaemia bye for now gina

  5. also been put on antibiotics called co-amoxiclav 250 one three times aday as really been struggling over the weekend bye gina

    • Co-amoxiclav is good. As I’ve said, COPD needs antibiotics. When you go to the tribunal make sure you tell them about the changes.

  6. hi think i will bye the nebuliser then and thanks for your replys i feel better talking to someone who nows what it is like bye gina

    • Hi Gina,

      Would it be better to make sure your doc will prescribe the nebules for it first?

      Anyway, whatever you do, don’t forget to tell the tribunal about the changes to your meds – it should help your case, especially if you present it as “My COPD is getting worse, so my doctor has added Atrovent to my medication.” And the nebuliser, too, if you’re using it by then.

      Ron.

  7. Hi Gina (and everyone),

    Just realised I’d spelt Atrovent wrong, so I’ve fixed that.

    This website is well worth a look for anyone with COPD

    http://www.goldcopd.com/index.asp?l1=1&l2=0

    And this one, too
    http://www.papapoo.com/ not least because it confirms what I said in my Can you stop COPD from Getting Worse post:-

    Diagnosis of COPD is not necessarily a death sentence!
    There are options for the COPD patient!
    The COPD patient can make the difference!

    In other words, how well you manage your COPD makes a huge difference.

    It’s an American website, so some gadgets they mention aren’t available in the UK. You’ll see Papapoo mentioned here and there – that’s the site’s originator, Bill Powell, who has since died.

  8. any ideas why i havnt had a medical i rang them and they didnt know just told me to turn up to the tribunal docs sent them a letter explaining what is wrong with me and that i struggle on a daily basis everything has to be done slowly as i get out of breath and i get terrible back and chest pains sometimes it like a belt is round my chest been pulled tighter my hubby had to have a medical years ago and they came to our house and did his so i dont know i will just go and see what happens gina

    • Hi Gina,

      Sounds like a bit of a cock-up. Have you tried to find a benefits advice centre? It’s probably worthwhile.

      Yeah – a lot of people don’t realise how painful respiratory problems can be. The tight feeling is probably your asthma, but coupled with the pain it might be a good idea to get your heart checked out (also, if you get in the system, it’s more ammunition to take to your tribunal, even if you don’t get an appointment in time). And it still looks as if you’re under-medicated. Have you asked about doubling your Phyllocontin? I’m certain you’d be a lot better.

      I can understand, in a way, why you’re on a low dose at your age, because 4 a day is the maximum, and if you take that now, then reach the point where that’s not enough, as I have recently, then things get difficult. I don’t think that’s a valid reason, though, as that point is probably a long way in your future, if it arrives at all.

      There have been no new drugs since Phyllocontin – except Serevent, and that works in a different way – and that’s nearly 30 years, so we’re long overdue for a new drug. There’s been lots of tinkering, and combining drugs in inhalers, when what’s really needed is something as ground-breaking now as Phyllocontin was then. No sign of it, though.

  9. i have taken phyllocontin for 24 years 2 aday and i think i should be taking more they tried to take me of it about 4 yrs ago and put me on qvar inhaler in stead but it didnt work i was put back on them i wasnt happy coming of them the doctor at hospital told me that in 5 years he dosnt now were i will be if i didnt do as he says life style and everything i have always been outgoing and active but the last 12 months have been terrible i am tired all the time and if i do go out iam a sleep and i swell up specially my feet and this face rouding caused by steroids makes me look awfall i have never been really thin but i have never been like this my doctor told me i look like a addict he said i look like steroid taker , to day we went to leicter hospital t my hubbys check up he as got to have operation now so dont now what we going to do just have to plod on as normal sorry to tell you all this just nice to talk to someone gina

    • First point – your doctor doesn’t get to dictate to you – healthcare is a partnership, and the days when doctor knew best are long gone.

      A consultant once tried to get me to stop Phyllocontin, and rely just on inhalers – that almost never works because inhalers have relatively short-lived effects. The whole point of Phyllocontin is that – as I said – it creates a base on which you can build with inhalers. Inhalers alone are inadequate. I tried it for 48 hours and – surprise! – it didn’t work.

      You have Cushing’s Syndrome by the sound of it (that’s the round face), which should go when you get off the steroids and your own system kicks in again. You also have fluid retention (me too), another reason to get your heart checked. It’s probably nothing but best to check. Once you’re off the steroids, you can take diuretics to treat the fluid. You can’t take them with steroids, they cause nasty complications. Your doctor sounds like a stupid sod, by the way.

      I’d tell you not to worry about things you have no control over, but I know you will anyway. Do try not to, though – you can’t change anything by worrying.

      By the way, would you like to switch to email? It’s more private – you’ve got my address on the DLA info I sent.

      Ron.

    • Hi Gina,

      Yeah, not too bad, thanks. Hoping to get out in my new chair tomorrow, but heavy rains forecast – we’ll see.

      Ron.

  10. its my tribunal on thursday morning just hope it goes well never been any where like it before.iam a bit nervous but got to go any more advice would be great gina

    • Good luck with that, Gina. Take a friend, if you can – might make you feel better, and did you talk to a benefits advice centre as I suggested? Best advice I can give is not to let them rile you, just relax and go with the flow. Remember that, although these people aren’t your friends, they’re not your enemies either, so try not to take anything they say personally. At the same time, don’t take any crap – if they keep asking the same question, repeatedly – and they often do by all accounts – don’t be afraid to tell them you’ve covered that and they should move on. Other than that, specific advice is impossible, as there’s no way to know how it’ll go.

      Ron.

  11. okay thanks will let you now how it goes i am taking a friend with me anyway i started at a health centre gym last week it was good go tomoz doc sent me i slept all afternoon after see you gina

  12. hi been hospital today he put me on another drug called spiriva to take in a morning long acting have you heard of it gina

    • Hi Gina,

      That’s pretty similar to Atrovent in make-up and in action, but you take less of it; you should be OK. Standard dose is two puffs once a day. Did they tell you how to set up the inhaler for use? It’s a lot more complicated than normal inhalers. There’s lots of information here

      http://emc.medicines.org.uk/document.aspx?documentId=20134#PRODUCTINFO

      It’s a fairly new drug, and is being closely monitored in case of problems, so if you feel you have undesirable side effects from this, you MUST tell your doctor. This doesn’t imply a problems with this drug – all new drugs are closely monitored. New drugs are marked with a black triangle, as this is, to show that they’re being monitored.

      I still don’t understand you doctors’ obsession with inhalers, though, I really don’t. I mean, they’re fine – I have 4 – but your base-level medication is being ignored (start with a long-acting oral bronchodilator, like Phyllocontin, twice a day, and build on that base with inhalers (and with a decent dose of Phyllocontin in your system, you may actually be able to reduce some of your inhalers, with care). That, as far as I know, is still standard practice, but you seem to have fallen in with doctors who think inhalers alone are sufficient, and they very rarely are.

      On the plus side, when you reapply for DLA, you have an extra drug to include, and if it were me I’d hint very strongly that I have the extra drug because my condition is deteriorating! Logically that makes sense – you wouldn’t need more meds if you where still the same…

  13. hi ron had to do that spiro thing i hate doing that it about kills me specially when they shout at you to keep blowing i just cant do it it makes me choke and go dizzy but they do insist my mate was with me and i scared her as couldnt stop coughing she never seen me like that but not to worry how are you doing any way bye for now gina

    • They shouted at you? Bugger that – you’re supposed to give it your best shot and, and they’re supposed to encourage you, that’s all. You don’t blow til you’re dizzy. Sadly, though, coughing does rather go with the territory.

      I’m pretty frazzled, getting ready for the move on Monday. I’ll be glad when it’s all over!

  14. I have had COPD for quite a few years now and been prescribed various inhalers ,currentley I am taking Spiriva 18mg and Symbicort 400/12 as well as Salbutamol, have you any experience of Symbicort 400/12 as I have only just started with it, I was prescribed Symbicort 200/6 for a couple of months prior to going onto the 400/12.

    • Hi Michael,

      I’m not familiar with Symbicort, I’m afraid, but I disapprove of combination inhalers entirely. In my view they take flexibility of treatment away from the patient. With some patients this is probably a good idea, but it presupposes that every patient is too dumb to modulate their treatment according to need. Doctors are probably happy with that; I’m not.

      When I’m bad I take two puffs each of Clenil Modulite, Serevent and Atrovent 4 times a day, plus Ventolin (Salbutamol), at need. That’s the level set by the Pulmonary Function Lab. I treat those three doses as maxima, though, and when I’m having a good spell, I go down to three times a day, especially if I’m just sitting at home doing nothing more active than blogging. This is especially important for the steroid inhaler, as at 4 times a day it generates the same systemic side-effects as oral Prednisolone (something not all GPs are aware of, though it’s in the literature).

      This means that when I hit a bad patch, I have something in reserve to deal with it immediately. With combination inhalers, I wouldn’t have that flexibility, and for that reason I won’t use them.

      I’ve never been convinced by dry powder inhalers either, I’m afraid. Not only do they make me cough, so much of the dose is expelled immediately, but a significant amount of it ends up on the oral mucosa anyway (this happens with aerosol inhalers, too, but to a much lesser degree).

      This comment, from the smartasthma website, worries me:-

      What is the difference between Symbicort SMART and my existing therapy?
      Previously you would have probably used two or more inhalers to treat your asthma including:

      * A preventer inhaler (usually brown or orange) to take every morning and at night.
      * A symptom controller (usually green) to take every morning and night.
      * A reliever inhaler (usually blue) to relieve symptoms as they occurred.

      Symbicort SMART does all these things in one inhaler.

      That is a clear implication that you don’t need Salbutamol with Symbicort, and that’s simply not true – Formeterol (the non-steroid ingredient), is akin to Salmeterol, NOT Salbutamol. Unfortunately, that disinformation is all over the Web, and though I haven’t been able to track it back to Astra-Zeneca, I think they’re behind this dangerous claim.

      That reminds me of the early days of Serevent (Salmeterol), when quite a few patients died through being told – or just deciding for themselves – to stop their steroid inhalers. These days the standard instruction is that Salmeterol is always to be taken with pre-existing steroid inhalers. Mind you, if patients routinely did what I do when offered a new drug, and ask “Is this as well as or instead of? that may not have happened.

      Clearly, Michael, your doctor hasn’t been taken in by this, as you still have your Salbutamol. Make sure it stays that way.

      Ron.

  15. Thanks for the info Ron,I will monitor it closely over the next two weeks and as you say ensure that the Salbutamol is continued. So far it seems to be ok especially seems to lessen the coughing on exertion.I am pleased to have found your site and encouraged to read about the other medications that are available which I wasn’t previously aware of. Also your site has made me more aware that I should probabley try for DLA Mobility element as I struggle a lot more these days with walking any great distance especially trying to keep up with anyone.

    • Yep, by all means apply for DLA. You apply for the whole package, by the way, then wait to see what you get. When you’re ready to apply, get back to me – how you fill in the form matters almost as much as what you tell them, as does the form of words. Get them right and it really enhances your chance of success. You can download a form to complete on your computer here http://www.direct.gov.uk/en/DisabledPeople/FinancialSupport/DG_10011925 A good idea as you can fiddle with it until you get it right, plus you have a copy of it for yourself.

      Incidentally, if coughing is a problem, see if your GP will prescribe codeine linctus. It’s the only thing that works. Officially it’s available OTC, but most pharmacists won’t sell it now as junkies have discovered it gives them a buzz (never done that for me!).

      Ron.

  16. Thank you for your investment of time and energy and research which is magnificently displayed throughout your web. I have recently been diagnosed at 63 with the curse, I quit smoking over 30 years ago so am not sure the origin of my troubles, I am scheduled to see a Pulmonologist next week. I feel I am much more informed and armed with information from your writings, thank you very much, God bless.

    • Thanks, Daryl – always nice to be appreciated. The bad news – the damage smoking does can still get you, even after 30 years; the good news – if you hadn’t stopped you’d almost certainly be a hell of a lot worse by now, so stopping was a good move in that respect.

      Once you get your meds sorted out, the most important thing to do – and you’ve probably seen this already – is to work out a timetable and stick rigorously to it.

      Good luck next week.

      Ron.

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