The Essential and Affordable Accessory for the Asthmatic: Philips Respironics Optichamber

An essential accessory for the Asthmatic

What is an asthmatic without the obligatory 'inhaler.' Used by physicians for many decades, these portable devices have delivered life-saving medications at the moment that the medication is needed. Sprayed directly into the mouth, timed precisely with inspiration, and after significant practice, the asthmatic might get it right.

The Philips Respironics Optichamber

There is a simple device, remarkably inexpensive, that takes much of the worry out of timing the 'squeeze.' Teaching a child to do it right is very difficult, expensive if you consider the waste of medicine that is involved in 'practicing.'

The Philips Respironics Optichamber makes it very easy to administer the bronchodilator and increases the amount of medication delivered to the lungs by around 60%. I have patients that are able to get by with one puff instead of two on their Ventolin, saving more than a few dollars by reducing the frequency of inhaler refill.

Respironics Optichamber Spacer

I found that you can get these with a detachable mask, something that might be worth having around, but it works very well if you place the mouthpiece directly in your mouth.

The Inhaler, mine is Ventolin (albuterol, Ventolin is the better of the generics) attaches on the opposite side of the chamber.

1. Attach your inhaler mouthpiece to the opening in the spacer.

2. Shake the inhaler, before each use.

3. Exhale and just as you begin to inhale slowly, you actuate the inhaler into the chamber.

4. Precise timing is not essential as it is without the Spacer. This device is equipped with a high volume whistle that fires if you inhale 'too fast.' Perfect feedback, actually.

My First Impression

I was admitted in January 2023 with asthmatic respiratory failure after a two week long bout of pneumonia (Mycoplasma Pneumoniae.) I had been doing well, I thought, working full time in the clinic. One Thursday afternoon, however, I was escorted out of the office and ended up in the hospital.

Antibiotics, oral steroids and 3 days later, I had a discussion with the respiratory therapist who was giving me my nebulizer treatments. He looked at my inhalers and asked: "Hey, Doc, where are your spacers?" Well, it is not my field of expertise, but I know better now. The spacer makes the inhaler work like a champ.

The Test

Being a bit skeptical, I needed to be convinced. The RT suggested that I try two puffs without the spacer, and see how well I'm breathing. He was withholding the nebulizer, I might add.

Then, he told me to take one 'hit' on with the spacer. I did as I was told, and moments later, the effect was unlike any I had previously experienced with the albuterol. I did not take a second inhalation, as it was entirely unnecessary.

The principal advantage to the spacer is efficiency. The principal disadvantage is bulk. It does not fit neatly in my trouser pocket. It is the Essential Accessory for the Asthmatic.

The spacer increases the efficiency of the inhaler by 40 to 60%

The device is probably a reasonable device to carry in a purse, folio or whatever the garment that men are seen carrying through the airports.

I bought three of them, leaving one at the office, one in my bathroom and one in my car.

I have been a physician for 42 years, and I rarely pick up pearls of wisdom as I did from that Respiratory Therapist.

It is now a frequently used piece of armamentarium in the treatment of my patients with asthma and chronic bronchitis.

Philips Respironics Spacer

I provided a link to an Amazon page where you can see the instructions for use.

I chose not to use the facemask, for my own situation.

David S Klein MD FACA FACPM

David S. Klein, MD, FACA, FACPM

Stages of Life Medical Institute

1917 Boothe Circle

Longwood, Florida 32750

Pregnenolone: The Misunderstood Wonder Hormone. Important for Memory, Cognition and Sexual Health

Pregnenolone is an Adrenal Hormone, essential to life as the root hormone for all other Adrenal Hormones. It is converted directly from cholesterol, then it is converted to progesterone and on to DHEA, Cortisol, Testosterone, Estriol, and Estradiol, just to name a few.

A hormone is a chemical entity that acts directly a class of signaling molecules. Inducing or inhibiting a gene to produce a protein, to cause a cell or tissue to behave in a predictable manner, or after having been secreted by one tissue, it would cause a tissue in a remote portion of the body to have a change in physiology or behavior.

Little understood as a primary hormone, low pregnenolone levels are often seen in patients with Adrenal Insufficiency, low levels may be present in patients receiving 'statin' drugs to lower cholesterol. Additionally, low levels occur in patients who receive oral, injectable and inhalational corticosteroids.

This Misunderstood Wonder Hormone is Important for Memory, Cognition and Sexual Health

Of note, low levels of pregnenolone may be associated with memory impairment and cognition, low levels of sex hormones and may be associated with dementia.

At Stages of Life Medical Institute, we have been testing our patients over the age of 60 for pregnenolone levels, and using a device called a "Cognivue" to assess cognitive impairment. Over the past 2 years, we have found that low levels of Pregnenolone were associated with mild to moderate cognitive impairment, and with treatment with pregnenolone, the cognitive impairment measured on the COGNIVUE improved in a matter of a few months.

Additionally, the use of oral pregnenolone can increase progesterone levels in women who have post menopausal hypogonadism, that is low estradiol and progesterone.

Pregnenolone 60 mg 60 count bottle

We monitor pregnenolone levels most commonly, twice yearly. It is an inexpensive blood test and yields a tremendous amount of value.

We typically start our patients on 60 mg twice daily, but it should be taken concurrently with a fish oil. The reason for this is that pregnenolone is oil soluble and the stomach is a water environment. Pregnenolone will not absorb well unless it is taken concurrently with an easily absorbed oil.

David S. Klein, MD, FACA, FACPM

Stages of Life Medical Institute

1917 Boothe Circle

Longwood, Florida 32750

Tel: 407-679-3337

www.suffernomore.com

Healthy and Tasty Smoothies from the Kitchen of the WMD. Fruit & Vegetable, the 'Birdie Basic.'

We would like to help our patients find a way to introduce themselves to the wonderful world of healthful snacking and simultaneously getting a good dosage of essential carbohydrates (ECH).

Advertised on television, almost 8 to 10 times an hour, "Vegetable and Fruit" supplements are more prevalent now, than ever. Many of these products will cost between $45 and $110 per month. If you want to check out 'Garden of Nature,' you can use this link. I think you can save a significant amount of money and get additional nutritional benefit from doing this one, yourself.

Convenience in a can, capsule or tablet, I think that you can do better, by making your own smoothie in the kitchen or at work. There are a few simple tips from my "WMD." She is not weapon-of-mass-destruction, but more like:

"Wife of the MD."

The WMD, my wife, is better known to the grand children as "BIRDIE." So, for our first of many smoothie recipes, we will start with:

Birdie's Basic Smoothie

1/2 banana (FROZEN)

1/2 cup plain Greek yogurt. Sugarless is best

1 cup low fat milk or rice milk

1 cup of frozen fruits and greens, e.g. berries, kiwi, spinach, kale, pineapple, mango

Add a few ice cubes, if your banana or fruit was not frozen.

Use your Ninja TWISTi Blender on high-speed.

It comes out tasty enough for the Doc to enjoy. Like so many men, I would rather clean the gutters than eat Kale, but this smoothie is entirely different.

Note Well: Use frozen fruit, but the frozen banana is what makes it nice and creamy.

Ninja Smoothie Maker

David S. Klein, MD, FACA, FACPM

Stages of Life Medical Institute

Stages of Life Medical Institute

1917 Boothe Circle

Longwood, Florida 32750

407-679-3337

www.suffernomore.com