Frequently Asked Questions
Dr. Mahler answers “real” questions
often asked by his patients with COPD
![How To Clean Inhalers](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1710982579406-XR66958EV55E804184DZ/clean-inhalers.jpg)
How To Clean Inhalers
Dear Dr. Mahler:
I recently read that I should clean my inhalers to make sure that they work correctly and to prevent infections. However, I can’t find any information that describes how to do this. I use Symbicort inhaler and Spiriva powder every day and ProAir as my rescue inhaler. What do you recommend?
Gerard from San Juan, Puerto Rico
![Harmonicas for COPD: Provides Better Breathing](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1711034076542-KWF1NBLUPQPI813EWM26/harmonicas.jpg)
Harmonicas for COPD: Provides Better Breathing
Dear Dr. Mahler –
I recently read about a pulmonary rehab program that includes playing music on a harmonica in addition to usual exercises. What are your thoughts? I haven’t tried it, but it sounds like fun.
Claudia from Jackson, MS
![Nebulizer Therapy For COPD – Can It Help Me Breathe Easier?](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1711028514837-WROMRZ7LR5OLC2XI52WO/nebulizer-ex.jpg)
Nebulizer Therapy For COPD – Can It Help Me Breathe Easier?
There are four major reasons why your health care professional might prescribe nebulizer therapy: 1) cognitive impairment - such as a memory problem (dementia) or confusion; 2) problems with use of hands - such as arthritis of the hands and wrists or tremor; 3) difficulty coordinating release of the medication from the device, not inhaling correctly, and not holding your breath long enough; and 4) a low inspiratory force required to break up and then inhale powder particles out of a dry powder inhaler.
![Oral Thrush with Certain Inhalers](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1710981454047-NP267APOSKS0N0FFT38D/inhaler-thrush.jpg)
Oral Thrush with Certain Inhalers
Dear Dr. Mahler:
I am concerned about getting thrush. I was diagnosed with severe COPD, and have improved with Stiolto Respimat. My pulmonary doctor said that I am now in the moderate category. A nurse who works at a community college with me asked if I was rinsing my mouth with water after inhaling the medication. She said that I should do this to prevent thrush. Is that correct?
Sophia from Key Biscayne, FL
![Why is my COPD getting worse even though I quit smoking?](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1710979726482-3WYQF0KJCAXV2EAFAAIM/stop-smoking.jpg)
Why is my COPD getting worse even though I quit smoking?
Dear Dr. Mahler:
Why does my COPD seem to be getting worse? After my doctor pushed hard, I quit smoking 4 years ago. I have been doing pulmonary rehabilitation at the local hospital. However, my breathing seems to be getting worse and I have 1 – 2 chest colds each year, usually sometime between fall and spring. I take Advair and Spiriva regularly, and use ProAir 2 – 3 times a day when I am active. What do you think?
Hank from Appleton, WI
![Atrial Fibrillation and COPD](https://images.squarespace-cdn.com/content/v1/65d945c0879b6223a00add64/1710360076882-VKOIDTYHH7Y80GPDD3BQ/image-asset.jpeg)
Atrial Fibrillation and COPD
Dear Dr. Mahler:
My doctor told me that I have “severe” COPD, and I have been stable for years until one month ago when I had sudden breathing difficulty and I became lightheaded. The diagnosis was “afib,” and I am now taking a blood thinner medication to prevent clots from forming in my heart.
I am having a problem finding out about this heart condition. Thanks very much for your help.
Al from Grove City, PA