Zenhale

[Deleted]

Hi Everyone. New today. I was diagnosed 4/5 years ago and am doing well on spiriva. I go to the gym everyday and walk 1 km, treadmill, weights, row, bike and misc. classes. I can keep up with the able bodied folk. My doctors seem to think that, according to my test results that I must be breathless all the time. In fact, I am never breathless. My last Fev 1 a couple months ago was 46. They are suggesting I start Zenhale. Is anyone familiar with it. I know it is approved for asthma, not sure about COPD. Can it be prescribed for COPD if it not approved for that treatment? Anyway, I don't feel that I need it but they I get the feeling that they think I am in denial. I think I do well because I exercise so much. Any opinions?

[Deleted]

I have COPD and was on Spiriva and Symbicort. Last week the doctor prescribed a trial with Zenhale as an alternative to Symbicort.

So it is being prescribed to COPD.

So far it seems to be working okay.

I am a bit surprised to hear that you were not on something like Advair, or Symbicort (which contains a Corticosteroid) from the beginning.

[Darcy]

I found out that Zenhale is prescribed for asthma, chronic bronchitis and emphysema. All 3 are part of COPD.

You say you are never breathless but what about your oxygen levels? Perhaps you should buy a Pulse Oximeter to test your levels during your workouts or walking. Start with a baseline by using Pulse Oximeter while seated and relaxed.

BTW They cost about $50 - $100

[Blossom/Jackie W.]

Hi Dogwalker; and welcome!

Couple of quick things for now....
Back in January Zenhale came up.... there's a few posts on it here....
philns.proboards.com/index.cgi?board=questions&action=display&thread=9892

And..... you're bang on as to why you're not breathless all the time. Exercise. And; you've an FEV 1 that is still very, very workable. I was a fair lower than you when I was diagnosed, but I was very active. Hills of course were a big challenge and doing any degree of swimming BUT; other than that, I got on pretty well...

So..... you just keep on doing what you're doing!

[Deleted]

Hi

Another thing about Zenhale is that Ont. drug plan doesn't cover the cost of $134./2 months supply unless the Dr. signs a form stating that 2 other medications have been tried on the patient without any improvement being noted. The Dr. couldn't sign as it didn't happen. My only inhalers are not steriod (Spiriva and salbuterol).
I get the impression that the Dr. is not believing that I am doing OK with Spiriva and is pressuring me to start a steriod treatment. I don't want to take a steriod unless I really need it and expect it will come to that at some time.

[sandy07]

If you are doing well then leave things as they are. If you need something later then check out your options then. I'm thinking the doctor is used to seeing much more advanced COPDers. No need to rush with the steroids.

[respeducator]

Good afternoon, all!
Dogwalker - first off, WOW! You're doing a great job with your level of physical activity - don't ever stop, the benefits to your lung function are incredible.
My two cents here - in working in a Respiratory Clinc with a Family Health Team (referrals to me come from a group of 12 physicians) - some physicians strictly follow the Canadian Respiratory Guidelines in determining appropriate treatment. With an FEV1 of 46%, this would be considered 'moderate' severity COPD - in which combo inhalers such as Zenhale (or Advair, or Symbicort) may then be appropriate to add in. One thing that often determines IF it is time to add in the combo inhaler, is the number of 'flare-up' or exacerbations you are having per year. If none - I too would say your symptoms are quite well managed with Spiriva plus your fast-acting inhaler as a reliever. If your COPD progresses to a point that you are having 1-2 or more exacerbations per year, the addition of the combo inhaler could be considered.
Over all - YOU are the patient. If you feel your symptoms are well managed and you are staying healthy with your current medications, then the goal should really be managing your symptoms with the least amount of medication possible.
(the physician may argue the combo inhaler will help 'prevent' flare-ups...this is why I ask about any flare ups/exacerbations).
Keep up your great efforts - you're seeing the benefits!!

Maria

[Deleted]

Maria

So glad to get your views. I have not had even a cold for 4 years so preventing flare-ups is not the goal here. I might try to find the Canadian Respiratory Guidelines and check it out. Thanks.

[chrisw]

You can find the highlights of the Canadian COPD Guidelines at www.respiratoryguidelines.ca/sites/all/files/CTS_COPD_Highlights_2008.pdf

[Deleted]

chrisw

Thanks for the link. Interesting reading-learned a lot.