Labored breathing

[chally]

Last pulmonary testing I had the nurse tech allowed me to recline in my pwc to do test. Then after the test were done she gave me a breathing treatment w/ Albuterol in a nebulizer.
Then did some of the test again to see if there was a change.
When we left my cals noticed I was breathing better and voice was stronger. I think the breathing treatment had some thing to do with the change.
Question : anyone else doing breathing treatments?
Hospice just got me the nebulizer and Albuterol just wondering others opinions on this.
Also nurse hospice says that morphine can help with breathing so I got talked into that too but don't plan on using it unless I really can' t get a breath.
My trilogy is good but still feel like 50 lbs on my chest most times. Any way, like to hear others experiences espically PALS.
Love ya all chally

 

[soonerwife]

My PALS went for a pft at the hospital 6 months ago. They also did this type of test but his breathing was not helped by the treatment. Kinda makes me wonder if maybe you have something else going on with your lungs as well? I hope it makes you feel better!

 

[KimT]

Chally,

Are you a former smoker? I have a feeling that since the treatment helped, you might have something more than ALS affecting your breathing. I'm glad the Albuterol helped.

Morphine helps with breathing in an entirely different way than Albuterol. It actually suppresses breathing but helps fight off air hunger.

Albuterol is a bronchodilator. It works in the airways by opening breathing passages and relaxing muscles and is often prescribed for asthma and COPD. My dad had COPD caused from years of smoking and Albuterol helped him for two years.

Laurie will be the expert on this. I'm just glad the treatment helped.

 

[lgelb]

Albuterol and its cousins is an emerging area. Results in ALS have been mixed. As Kim points out, your lungs are more than ALS.

I would start low, go slow, monitor your BP, appetite and pulse and have a pharmacist review it along with your other meds. I hope it works out and continues to help.

Best,
Laurie

 

[affected]

Morphine in low doses doesn't suppress breathing, but in high doses it will.

In low doses it will relax the person so that they tend to be able to breathe a little more deeply.

If there are no other lung conditions, the airway opening medications don't usually make much difference. In early stages of breathing problems they can help a little, but breathing works by the muscles pulling the lungs outwards and pulling the air in, kind of like bellows. Certainly opening the airways can give a little help, but if the muscles are really weak, opening the airways further doesn't do anything really.

If there are underlying conditions narrowing the airways, then those medications can give some help.

That's how it was explained to me recently at a presentation by a pulmonologist talking about ALS and how it affects breathing.

 

[chally]

Thanks all, espically Laurie & tillie
I have not smoked in 30 yrs and before this nightmare came along my breathing was fine ,I ran marathons & triathlon.
I did the breathing treatment yesterday and did not get the same results as before at the pulmonary testing.
So not sure this has much merit but I will try it again.
Anything to not have to start up the morphine.
I feel it is in my diaframe muscles that are not working now as it feels like a lot of weight on my chest, which I think is described as starved for air. Hence low dose of morphine.
I feel as you do Duker but not sure if cals can do this .
Any way thanks again for shared experiences and I love ya all chally

 

[gooseberry]

Steve tried this as well. It did not work for him.

 

[swalker]

Thanks for sharing this, Chally.

Please let us know how it works out. I am very interested in this topic!

I don't want to take anything that will cloud my mind. If there is something that has the possibility of delaying the need for morphine, I would be quite pleased.

Steve

 

[lgelb]

Not to be repetitive, Steve, but the best recipe for delaying air hunger is ensuring optimal BiPAP settings, that likely change over time/situationally, and using it as much as needed.

 

[swalker]

Thanks Laurie. I don't mind be reminded over and over and over

Steve

 

[Duker52]

Chally, I have had asthma for years and used to be on a whole host of nebulizers. I was weened off of those and now only have albuterol for emergency asthma attacks. None of my air hunger episodes fall under that category. My hospice doctor said to use the morphine whenever I felt I needed it and not think that once you take it you have to keep taking it. Could it be that you also have asthma? Bill

 

[chally]

I won't rule that out Duker my grandson has asthma .
My hospice said about the same in regard to morphine.
Thanks Laurie for the reminder about proper settings on bipap or trilogy. I am getting a new setting from last testing . Hoping that helps. Love ya chally

 

[ehd42]

Hi Chally

Albuterol is a bronchodilator that affects the smooth muscles of the airway, which are not affected by motor neuron disease. Therefore, if the albuterol helped you breathe it is likely that you have or had some level of bronco constriction at the time that the albuterol was nebulized. Many patients who have bronco constriction (bronco spasm) have undiagnosed mild asthma or COPD.
If you feel that nebulized albuterol made it easier to breathe then I would continue to use it as long as your physician agrees. In any case, it should have no negative effect on the course of ALS.
To confirm the albuterol’s effect I would have the breathing test repeated about 30-60 minutes following a treatment to see if your FVC and FEV1 show significant improvement, and if it does, I would ask to be evaluated by the pulmonologist to determine whether you mght also benefit from an inhaled corticosteroid, which could also be nebulized (e.g., pulmocot respules). It's interesting that you say that you feel as if you have a 50-pound weight on your chest, which is the type of description given by many patients with bronchospasm. I imagine that most if not all of your shortness of breath is due to weak respiratory muscles resulting from of ALS, nevertheless PALS can have more than one problem affecting their breathing, so I think it would be worth exploring with your pulmonologist the reasons why you feel that the albuterol helped you breathe.

Best wishes

Eliot

 

[chally]

Thanks Eliot, that's good info and helpful, I appreciate everyone's input. Love ya chally

 

[Atsugi]

Tiny input: One time, when my wife complained it was difficult to breathe, the doctor ordered morphine. I objected. I wanted to speak personally with the doctor. We spoke. He told me that the low dose of morphine would relax the patient and make it easier to breathe. So we gave the low dose of morphine. About a minute later, my PALS was obviously breathing easier.