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Inhaling more quickly
- Question
- Our daughter is whining and crying each time during the therapy because she is bored. She does not want to do her therapy and this is really troubling our everyday life.
Therefore, my partner had the idea to mix the drugs to make inhalation quicker. She needs Colistin and Pulmozyme® (Dornase alfa).
What do you say?
- Answer
- Dear parents,
Unfortunately, you do not write how old your daughter is since physiotherapy and inhalation therapy change a lot depending on the various age groups.
My first recommendation is, thus, to discuss the problem with your attending physiotherapist who should be trained in the special techniques for physiotherapy and inhalation therapy in CF. If you are not in contact with such a physiotherapist so far you can find many addresses of qualified therapists on the website of the Mukoviszidose e.V. (www.muko.info) [German patient organisation; if you are from another country, please ask the patient organisation of our country if they can provide you with contact details; www.cfww.org/members ].
Furthermore, I would like to reassure you that many children do not like to inhale. However, it is possible to perform inhalation therapy in a way that makes the situation more relaxed. Depending on the age one can involve the children more and more in the therapy, e.g. one can let them hold the nebulizer themselves, keep them at it by reading a picture book or having them inhale while sitting on a Pezzi ball. The gentle hopping on the ball calms the little ones and usually allows them to cooperate in the inhalation pretty well.
Unfortunately, Colistin and Dornase alfa cannot be mixed (see: Inhalationstherapie im Kindes- und Jugendalter, Wildhaber, Kamin Uni-Med Verlag 2008; Update Mukoviszidose, Hirche, Wagner, Thieme Verlag 2010). Moreover, the amount that would have to be nebulized would not be smaller either.
First, the Dornase alfa should be inhaled with a powerful compressor (e.g. Pari Boy SX) and after that the Colistin should be inhaled.
Is the situation not getting better and is your daughter so little that she can only inhale with a mask it would also be okay to inhale with her while she is sleeping.
I hope to have been helpful.
Best regards,
Birgit Dittmar
Physiotherapist - 08.05.2012
