Frequently Asked Questions

Dr. Mahler answers “real” questions
often asked by his patients with COPD

How To Use My Inhaler?
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How To Use My Inhaler?

Dear Dr. Mahler:

It is confusing to me how to use the different inhalers prescribed for my COPD. I was diagnosed a few years ago, and my primary care started me on ProAir as needed and Spiriva HandiHaler in the morning. They helped my breathing, but I was still short of breath walking from my car to the grocery store.

I was referred to a pulmonary doctor who recommended adding Symbicort and replacing ProAir with Combivent Respimat for “rescue.” Unfortunately, the nurse who does inhaler teaching was not in the office that day. This morning, my husband watched me use the inhalers, and suggested that I wasn’t inhaling the right way. I got mad at him and told him to “Shut up.”

After I calmed down, I thought about his comment and realized that I really wasn’t sure about how to inhale correctly. It seems so simple, but I not getting the relief that I want. Please help me.

I have been quite inactive during the current COVID pandemic. I retired two years ago working as a secretary in the school district office.

Many thanks.

Karen from Carson City, NV

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My COPD Inhalers Are Expensive: What Can I Do?
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My COPD Inhalers Are Expensive: What Can I Do?

Dear Dr. Mahler:

I was diagnosed with COPD a few years ago and stopped working in 2020 as a cook at the local diner because it closed due to COVID. When I was working, the owner of the diner covered my health insurance and I paid $25 – $40 as co-pays for my two inhalers.

I am 66 years old and receive Social Security payments each month. I have Medicare parts A and B insurance, but part D is too expensive. My doctor has given me samples of the once daily inhaler on occasion, but he does not have albuterol samples.

I feel desperate now because I really can’t afford the two inhalers on my fixed income. Do you have any suggestions?

Ken from Sacramento, CA

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Platelet Rich Plasma For COPD: Does It Work?
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Platelet Rich Plasma For COPD: Does It Work?

Dear Dr. Mahler,

A friend recently told me that he received a platelet rich plasma injection into his shoulder to try to repair damage to the rotator cuff muscles. He then mentioned that someone in the waiting room at the treatment center was using oxygen and told him that he was getting the same treatment for COPD. Can you tell me whether this works for COPD?

I am 71 years old and have had COPD for at least 15 years. My breathing has gotten worse and I find it difficult to even walk 30 yards before needing to stop to catch my breath. I am very frustrated because I can’t do things that I enjoy such as walking my dog on a nearby trail, and have to pay someone to do outdoor yard work on our property. I use Stiolto in the morning and ProAir several tiems a day when I feel short of breath. My oxygen level at home ranges form 91 to 93% when I do activities, and I haven’t had a flare-up in the past few years.

Should I consider platelet rich plasma treatment? I asked my lung doctor about this, but she did not know anything about this topic.

Andrew from Mt. Airy, NC

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Should I Use A Spacer With My Inhaler?
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Should I Use A Spacer With My Inhaler?

Dr. Mahler:

The pharmacist at the local drug store told me that I should use a spacer with my inhalers. I am confused because Bevespi and ProAir inhalers, which I take for my COPD, seem to be working fine. I asked my nurse practioner about it, and she said that it wasn’t necessary. What are your thoughts?

Judy from Chattanooga, TN

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How To Clean Inhalers
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How To Clean Inhalers

Dear Dr. Mahler:

I recently read that I should clean my inhalers to make sure that they work correctly and to prevent infections. However, I can’t find any information that describes how to do this. I use Symbicort inhaler and Spiriva powder every day and ProAir as my rescue inhaler. What do you recommend?

Gerard from San Juan, Puerto Rico

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Oral Thrush with Certain Inhalers
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Oral Thrush with Certain Inhalers

Dear Dr. Mahler:

I am concerned about getting thrush. I was diagnosed with severe COPD, and have improved with Stiolto Respimat. My pulmonary doctor said that I am now in the moderate category. A nurse who works at a community college with me asked if I was rinsing my mouth with water after inhaling the medication. She said that I should do this to prevent thrush. Is that correct?

Sophia from Key Biscayne, FL

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