Kid friendly spacer devices for asthma

It's now been almost 6 years since the little miss has been diagnosed with asthma. As any parent with an 'asthmaticky' kid knows, your life is ruled by allergies and drugs, colds and infections. Every tiny sneeze or cough has the potential of turning into a major production of hospital visits and machines etc etc. And sometimes, you never know what causes the first little cough. But before you know it, the first ominous signs of a full blown attack appear... Hack, hack, hack...wheeze, wheeze... Panic all around. It's times like that that I'm glad I have my spacer devices. After all, studies have shown that if you put 2 puffs into the spacer chamber (manufacturers will say the devices are not meant for this so I leave it up to your discretion) it works as well as having a nebuliser. Obviously, they are referring to pure salbutamol nebs alone and not the ones that mix atrovent or pulmicort in. (disclaimer: if your child is having a bad attack, they need to be seen in emergency. I certainly don't advocate sitting at home giving them puff after puff while they turn blue).

In any case, what I've realized is that if it is truly possible to avert an acute attack, very often it will be if I can get the inhaled salbutamol into her before the symptoms get too bad. Obviously, once we get home we have to do major allergy management... Meaning she gets tossed straight from the car into the shower for a massive wash down, maybe antihistamines and inhaled seretide to follow. It all depends on our initial management of the first cough and how bad the subsequent attack gets.

So... In the last 6 years, we have tried 3 devices. The first one I won't bother talking about since it was an infant device and pretty impractical for toting around being about 18 inches long. The other 2 are the Able Spacer by Clement Clarke and the AeroChamber by Boehringer Ingelheim.

Able Spacer

This is manufactured by Clement Clarke and marketed by LifeTronic Medical Systems in Bandar Sunway. Priced at RM70 + RM40 for the mask. It's not widely available in KL and I had to email the head office to get the details of their local distributor. I got my first unit in Singapore when I forgot to pack kiddo's spacer on what I thought was a short 2 day holiday (smack upside the head for an 'I should have know better' moment). My wonderful uncle rushed us to Mount Elizabeth and this is what they gave us. We elected to have it without the mask as kiddo is almost 8 and quite capable of holding her nose and breathing through her mouth. The inhaler fits neatly into the body of the spacer device and is amazingly compact. Fits my handbag and her school bag with no worries about squashing the mask or having the canister fall out somewhere. It is also very streamlined on the inside which makes washing less of a worry. My concern is that the canister being stored inside will scratch the sides and cause the salbutamol particles to stick to the walls and reduce efficacy per puff, but so far, there doesn't seem to be any appreciable difference in the effect on kiddo during an attack using either device. The big plus point for me is that kiddo goes to school with it in the bottom of her bag and I know that if she needs it, both device and canister will be in the same place. No worries about squashing the mask, and since it's in a zip lock bag, dust either. Recommended that devices are changed for new when the silicone parts appear aged.

AeroChamber

This is manufactured by Boehringer Ingelheim. Priced at RM82 at last check today with the pharmacy of a local hospital. One of the most widely available devices in Malaysia and Indonesia. Comes with attached mask. This is the device kiddo has grown up with. Not massively large though a bit cumbersome to fit in regular handbags, and great for kids who can't yet control breathing just through their mouths. So in an acute attack, when coordination is not great, this little fellow is wonderful. It has more intricate parts though, so cleaning can be a bit tricky for obsessive moms like me. I can't stick a bottle washer in at risk of scratching the insides, nor can I completely dismantle it to clean all the itty bitty parts. Also the silicon face bit can get a tad tacky if dust gets on it. Generally recommended that devices are changed for new every 6 months or so depending on usage.

My take on the both of them...

Ease of usage : the AeroChamber is definitely easier as the kid can breathe normally through it without holding her nose.

'Tote-ability' : for now, the AbleSpacer definitely wins out. It is so incredibly compact and easy to carry. As kiddo gets older and her hours away from home longer, one of my bigger worries are what would happen if she gets an attack in school. Getting a call from school and having to rush her inhalers there while I know she is struggling to breathe is one of my greatest nightmares. I firmly believe in making my child as independent as possible and this little device certainly does that. As the inhaler is stored within the device, the 2 items are always together and she doesn't have to waste precious moments scrabbling around for a missing part.

Usability : the AeroChamber is definitely the easier of the 2 to use. The child can breathe normally through nose and mouth. With the AbleSpacer, the child has to be coordinated enough to take a breath in, remove the device while holding their breath, breathe out, then take another breath through their mouth only.

Price : the AeroChamber is the cheaper all round option at Rm82 (with mask the AbleSpacer comes to RM110). Although without the mask the AbleSpacer is less.

All in all, I'm probably not going to give up kiddo's AeroChamber at home anytime soon, but the AbleSpacer (without mask) is a great device that the child can use into adulthood (since it has also been shown that spacer devices benefit adults too). In all pract

icality, the AbleSpacer is so compact that it's the only reasonable option for kiddo and myself. I find that I now carry it everywhere because it fits all my bags. So that means we no longer chance going out without her inhalers and rush home at the first sign of a cough, we ac tually treat immediately. Also, being a girl, she's going to be carrying a handbag one day, and if she's anything like me, she'll only carry it if it'll fit her evening purse :)

Photos to follow. My iPad doesn't allow me to load photos to my blog weirdly enough...

Here they are:

First off, this is a comparison of what will be going into your mummy bag... Top device is the AeroChamber and accompanying inhaler. Bottom device is the neat little AbleSpacer with inhaler inside.

Here's the AeroChamber and inhaler stuffed into my bag. Now that I don't need a diaper bag anymore, I prefer smaller totes. This is a problem as I sometimes (often actually!) elect to leave the device at home. I know, I know... bad mommy!

Here is the AbleSpacer. Isn't that nifty?! Slots into a tiny corner of my bag. Most days I don't even notice that I've gone out with it when kiddo is not with me. I was looking for that effect actually. For it to become so much a part of my bag that I would unconsciously carry it everywhere...

So there you go. My 2 cents worth on spacers. I'm all for finding the perfect balance between my kid's needs and my own. Trial and error!