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Family Webicine

with Rod Moser, PA, PhD

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Wednesday, July 6, 2011

Homemade Asthma Nebulizer: A New Use for Recycled Water Bottles

My wife and I recycle nearly everything: cans, glass, aluminum, plastic, and paper/cardboard. We have a huge compost pile for leaves, lawn trimmings, twigs, and pine needles. Of course it is highly-enriched when we clean the chicken coop.

We are on well water and fortunately, our deep well produces an adequate amount of cold, fresh, and untreated water. My only guilt is that I love ice-cold bottled water in those plastic bottles. I find them perfect to partially freeze and find them convenient when traveling. Since my bout with kidney stones, I am forced to drink a gallon or so of water per day. Working outside, I find it easier to grab a few cold bottles from the fridge and bring them with me to the garden.  I can’t drink out of the hose, since this is untreated, irrigation water.

We don’t throw away the plastic water bottles. I envision a time when I will refill them from our well water (assuming they are not dirty), and just use them over and over. At this time, most of these bottles just go in the plastic recycling bins.

We had a crew of tree-trimmers at our home recently, removing the mistletoe that was slowly killing the oaks, and a few precarious, oak branches that, if they snap, would surely kill me. These guys use recycled gallon milk bottles for their water, which became warm to hot from sitting outside all day. Unless I was dying of thirst, my choice would not be to drink warm water. As a child in Pennsylvania, we would walk miles to a spring that was bubbling out of the ground. This water was soooooo cold that your hands would freeze when you cup them together to drink your fill. If I had a cold spring on my properly, I would never move.

I have a lot of asthmatic patients — mostly children. In order for kids to use a hand-held MDI (multi-dose inhaler) for albuterol or inhaled corticosteroids, they must have a spacer — a chamber-like device where the medicine is sprays, and the child can easily inhale it without having the coordination to time their inhalations with the spray.

Most insurance companies will pay for asthma medications, but a surprising number of them will not pay for a medical spacer. These can cost $30 or more, depending on the type. Someone without health insurance (many), or those with really crappy insurance (most of us), may not have the extra income to buy the least-expensive spacer. What happens is that they try administering the medication without it. Inhaled asthma medications are not effective if they don’t make it to your lungs. When I ask parents to demonstrate how their children are using the inhaler, I finally understand why they are not improving. The kids are just getting the medicine in their mouths, not their lungs.

I have a cleverly-hidden hoard of pharmaceutical company supplied spacers that I give out for free for families who do not have the resources to buy them. In the spring, when allergies are the highest, my supply runs out quickly. Either that, or my wife who uses my office on my day off, has found my stash.

Years ago, I would cover the private practice of an elderly physician so that he could get a little vacation. He was nearly 90 years old and still practicing. He would have his asthma patients save the empty toilet paper tubes to use as an inhaler. They would work for a time, but since they were made of paper, they would bend, wear out, or be discarded if seen lying around. This gave me an idea.

Every year or so, our state medical conference holds a contest called “Two Minutes; Two Slides, Two Questions” where the participants are limited to a two-minute lecture, using only two PowerPoint slides, and answer only two questions at the end.  I have won for about three years in a row. I would like to share one of my entries with you: The Water Bottle Spacer.

Supplies Needed:

  • Discarded, but clean, small plastic water bottle
  • Roll of duct tape
  • Sharp knife

Steps:

1. Carefully cut the bottom off of the water bottle, as well as part of the mouth piece.
2. Using strips of duct tape, cover the sharp edges where you have cut
3. Take more duct tape and create a smaller opening at the mouth end — an opening or even a slit that will temporarily and snugly fit the inhaler. If you have an old nebulizer mask, you can attach this with duct tape instead.
4. Hold the bottom end around the mouth (or over the mouth and nose); spray the proper dose of the asthma medication, and just inhale. The bottle may even collapse a bit confirming a proper inhalation.

 

For this entry, I won a $50 gift certificate at a book store, and upset another clinician who challenged my personal ecology for using plastic water bottles in the first-place. Her entry lost; she was just a sore loser.

Photos: Rod Moser

Posted by: Rod Moser, PA, PhD at 11:56 am

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