Most children with asthma using inhalers incorrectly

Expert shares top ten mistakes

DENVER – Experts say most children who rely on inhalers for their asthma are using them incorrectly.

Ten-year-old Amanda Grabel's asthma had gotten so severe, it was life-threatening.

"I just couldn't breathe. My face turned blue, and I was gasping for breath," Amanda said. "So my dad called 911."

Desperate for a solution, her parents took her to see several doctors.

"It was very frustrating, and they just kept throwing more medicine, and none of it, and none of it helped," Amanda said.

"She was afraid to go to sleep at night because she was afraid she was going to die," said Rori Grabel, Amanda's mother.

Finally, the Grabels found Dr. B.J. Lanser, a specialist at National Jewish Health in Denver.

Lanser discovered Amanda had the right medicine. She was just taking it in the wrong manner.

"We see children who just don’t know how to use it at all, and so they take breaths in a totally different way that doesn’t help get it into the lungs, which is where the medicine needs to go," Lanser said. "Someone like Amanda, in particular, she was trying, right?  She was using her medicine twice a day, every day. She was taking it. She was trying. She just wasn’t getting it where it needed to go.”

Nearly 6.5 million children in the United States suffer from asthma, and most use an inhaler to help keep their airways open. But experts say most children are making mistakes that can dramatically affect how well their medication works.

Lanser said the biggest mistake is not using a spacer. Without it, about 80 percent of the medicine settles in the mouth and never gets into the lungs. Lanser also says many children don’t realize that exhaling is just as important as inhaling.

"Take some normal breaths and then a big deep breath to fully exhale, so that you then have empty lungs to take a nice big, deep breath to get all the medicine deep into the lungs," Lanser said.

Other common mistakes involve how the inhaler is positioned. Lanser said a child should stand up straight with her head in a neutral position, not tipped back. Aim the inhaler at the back of the throat and close the lips tightly around the mouthpiece.

Experts say it's important for parents to have a doctor evaluate their child's technique for using the inhaler.

"If their asthma is being very difficult to control or has changed, you know to take that step back and go to the doctor and make sure that the technique is good before necessarily adding a bunch of new medicines or jumping way up to the highest dose," said Lanser. "If we can use the right medicine at the lowest dose
possible and be effective with how we’re using it, that certainly can prevent some of the side effects as well.”

Amanda practiced and perfected her inhaler use, and her asthma is now under control.

"I don't have to worry about everything, and I'm just, I feel like I don't have asthma anymore. I do, but it feels like I don't," she said.

"It's like we have a new Amanda, who's just joyful and happy and loving, and she can fully engage now," Rori Grabel said.

Click here to view the top ten inhaler mistakes.