I spent much of Saturday shopping for a new nebuliser, as I noticed last time I was in hospital that mine’s running a bit hot. I need one because I’m still having bouts of pulmonary oedema, most recently Friday night/Saturday morning.
I can get it under control by megadosing using my Volumatic spacer. For those of you unfamiliar with it, it’s a big one (the trend seems to be for smaller ones, which is a bit pointless in my view). This is it, alongside a Salbutamol inhaler:-
You insert the inhaler mouthpiece in the bottom, trigger it, and suck out the resulting mist through the spacer mouthpiece at the top. The increased airflow carries the inhalant deeper into the lungs than it would without the spacer, and reduces losses due to deposition on the oral mucosa, a major cause of side-effects for many people, especially with steroid inhalers (pretty obviously, but worth mentioning, these are for use with aerosol inhalers only).
During a pulmonary oedema attack it allows me to put multiple squirts (a megadose), into the spacer (with my thumb blocking the mouthpiece so it doesn’t go straight through), and inhale them all at once. It’s effective, but if the attack doesn’t wake me in time, such an inhalation would be beyond me, and it’s hospital time. Which I’d rather avoid.
In hospital they stabilised me using a nebuliser with a combination of Salbutamol and Atrovent nebules, one of each per dose, and kept me on that until I was discharged.
So that’s what I want from my GP and, as it’ll almost certainly keep me out of hospital, he should have no objection, especially in his new-found spirit of co-operation. The only problem might arise because it’s not recorded in my discharge notes, not too surprising as Arrowe Park’s record-keeping is staggeringly, and probably dangerously, inept.
And every goddamned doctor I see there – based on no evidence whatsoever – gets the urge to meddle with my meds. If my GP paid any heed to the changes – he hasn’t so far, I think he’s overlooked them or, hopefully, recognised them for the danger that they are – there’s a good chance they might well kill me.
Apart from the unavoidable worsening of my COPD – not unexpected, just not thought about – and the onset of pulmonary oedema, I’m pretty stable on the current regime. And when you consider everything that’s wrong with me, that’s no mean achievement. I really don’t need some fuckwit consultant making changes for no better reason than because he can.
Anyway, I got this neb from Amazon, an Omron CompAIR NE-C801 (Omron link), 50% off, for £30, and its main feature is that it’s supposed to be quiet (most are noisy buggers – if you’ve even been in a chest ward at neb time, you’ll know exactly what I mean; it’s like a concerto for jackhammers!). So, because I’m likely to be using it in the middle of the night, I wanted something quiet.
I also wanted to see if it would power my existing neb,** an extremely low-loss device which delivers almost the entire ampoule and, importantly, at a rate at which I can actually inhale it. Most devices used in hospitals waste much of the dose as patients can’t inhale efficiently enough. Mine takes a lot longer, but it’s nearly all utilised.
**Most people assume that the entire assembly is the nebuliser. Not so. In the pic above, the cylindrical item on the left is the actual neb, the main unit is the compressor that powers it.
So, anyway, I connected my neb, just with cooled, boiled water, to see how it performed, and it’s fine.** The compressor is also extremely quiet, which is what I was hoping for. The specs say it’s 46db, but that means nothing to me in real terms – I had to hear it to put it in perspective.
**I now have three nebs – the one that came with it, my old one, and an NHS one left behind by the ambulance crew in August.
If you need a neb that’s small, light, and quiet, this one is perfect. How durable it will prove I have no idea as yet, but it’s guaranteed for 3 years so it should be fine.