Hi, Goodmorning Mr. Mitchell. My name is Naomi Gravel and I’m a student nurse from Champlain College Morning You have been prescribed medication that needs to be taken through these inhalers. These are to control your newly diagnosed asthma, correct? Yes, I hope this medication will work so that I can get rid of this disease Unfortunately, asthma is incurable, but the medication will work towards alleviating and preventing the symptoms that occur during your asthma episodes Ok, at least I hope this will allow me to do sports again I haven’t been able to play football with my friends in a week and can barely do any exercise nowadays You seem very eager to learn how to use the medication. I can see you miss doing your daily activities a lot Oh, yes, it’s been terrible, but I will do my best to fulfill the medication plan and get better I’m very glad to hear that. You seem like a rather knowledgeable young individual, may I ask where you attend school? Yes, indeed I attend Champlain college. I study science pure and applied. It is my second year and I can’t wait to go to university. Very good, and I assume your parents are very proud of you and support you a lot Yes, they are the best I love them so much That’s great. I would like to know do you have any pets at home? Will you come into contact with any allergens that may trigger your asthma, whether at school or at home? Oh, well, we’re doing some renovation in the basement. And I guess there’s a chance that dust and other particles fly my way. Yes, this may indeed be problematic in your situation. I recommend you to avoid that area of the house until it is clear of air pollution, as it can easily cause you to have asthma exacerbations, which in other words are asthma attacks Yes I understand okay, so now you will have to use your medication at the time prescribed by your doctor and you have You will also be able to use it during episodes of asthma to relieve your symptoms. I’m worried that I may forget to take the medications in the morning because I’m in a rush Yeah, perhaps you could ask your parents to remind you or prepare it for you in the morning so you don’t forget it Great idea My mom leaves work a bit after me and I will ask her whenever I’m in a rush if she can help me with it Ok, great. So, I will now show you how your inhaler works, and I’ll have you do it afterward as well to ensure you understand. I’ll explain it first and then we’ll practice it Sounds Good Alright, this device is called a metered-dose inhaler It has a certain amount of dose of medication that it can administer So first of all, you will shake it before using it and then you remove the cap And then you hold the inhaler upright And then you grasp with your thumbs and two fingers like this and then you will tilt your head back slightly and open your mouth Positioning the inhaler 3.5 cm away from it and then you exhale and then press down on the inhaler to release the medication as you breathe in slowly and deeply for 5 seconds. And finally, you hold your breath for ten seconds after which you will exhale using the purse lip technique and for this technique you will purse it in a way as if you were to blow into a bottle to make sound so like this This helps empty any air trapped inside your lungs Oh, that was a lot of information. I don’t know if I can manage Yeah, I know you’ll get the hang of it, we will practice it and if you still feel unsure we can write it down so that you may have the instructions with you Thank you. That sounds good. Do I put my mouth on the inhaler when inhaling? You’ve probably seen that as common practice but the best practice is to hold the inhaler away from your mouth. And this prevents the spray of the inhaler directly on your mucous membranes. If doing so is too difficult, we can give you a spacer device to put your mouth on to make it easier for inhaling. So this is the spacer device. I was talking to you about. So I will shake it first open the cap. Put my two fingers and then my thumb on top then exhale then push to the top with my thumb and I would breathe in for five seconds and hold it in for 10 seconds and after that Do a purse lip Great you did it perfectly! Now, you have the bronchodilator and corticosteroid inhalers prescribed right? You have to take a puff of the bronchodilator first and then wait 1-2 minutes before taking your second puff. For the corticosteroid, you have to wait 2-5 minutes after your last bronchodilator puff because it’s a different medication. Taking the bronchodilator first ensures absorption of the 2nd medication, which is the corticosteroid. Finally, after you take your corticosteroid, it is important that you rinse your mouth with water to avoid any oral fungal infections. Yeah, I definitely will write this down. And to check when it’s empty, I just shake it right? Actually, I have a print out of the instructions right here that I can give to you. And no, shaking the inhaler won’t accurately tell you if it’s empty or not. In fact, you have a specific amount of doses in each inhaler. Both of these have 200 puffs each. So you will have to calculate how many puffs you take and subtract it from the total amount. You can note the date down in a calendar or write it down with a permanent marker on the inhaler to help you remember when to get a refill. Okay great So what do you expect to come out of you taking this medication? Well I hope to no longer have issues with asthma anymore and that it won’t prevent me from doing the activities I want to do. Yeah, you are correct, however, you need to keep in mind that for your asthma to be controlled, it must not occur all that often. As such, you should try to avoid the triggers as much as possible. Your asthma is well controlled when episodes occur less than 4 times a week and are relieved through the use of the inhalers. That should be your goal I understand I hope I will reach it. I am prepared for this and will do my best to avoid allergens and use my medication properly when needed. I think you have gotten most of this down. Share what you learned with your parents to ensure they help you. I’m sure you will be enjoying your activities soon. Yes, thank you so much nurse!