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If you had an alpha-1 antitrypsin deficiency (AATD) patient in front of you, would you prescribe inhalers? Perhaps the better question is which inhaler would you prescribe and for what issues? After thinking about such things during a long COVID-19 case, I have decided I would.

Yes, I am aware that inhalers may steal magnesium or bone strength from the rest of my body. There are many issues that inhalers can cause. But, I still believe that I can do my best to offset some of these effects.

You might wonder if I knew that certain common corticosteroid inhalers might have made COVID worse for me. I would understand your question, but I feel that inhalers have benefitted me in the long run.

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Why do I think this? I had a long time to think about this. I read an article that said inhalers like corticosteroids could cause issues with brain function.

I neither agree nor disagree with this point of view. Inhaled steroids probably did have an impact on how sick I got and how long it lasted. But in the long run, I am helped.

I feel these inhalers help me breathe at night and therefore provide a break in the cycle of difficulty sleeping. We all know this can trigger anxiety, which can keep a person from sleeping well the next night. All of this is a vicious cycle.

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If nothing is done to help me breathe at night, I will most certainly have anxiety when I am older because the same problem will be there. So, if I am going to have brain issues toward the end of my life, I can at least know I did all I could to get myself there.

Not too many months ago, someone asked me if I was worried about lung disease. I said “no” because I knew that I was doing as much as I could to protect my lungs.

That’s the key. To feel like I am doing a lot vs not knowing if I am doing enough assures me that I won’t get to the end of my life and ask myself, “Did I do enough to prevent these issues?” I know I won’t have to wonder if I did enough because I’m doing all I can.

It’s more of an emotional motivation than a logical one. I have heard that inhalers could be stealing bone density (something that runs in my family as a person ages). For years, I have made a point to take magnesium and vitamin D regularly, along with some calcium, for bone and overall health.

I have taken precautions and won’t be erring on the side of caution. I would rather err on the side of doing too much, because at least then I won’t be up late wondering what more I could have done.

I won’t have to ask, “What if I had done X, Y, and Z?” because I am doing those things. As complicated as lung problems are, there are things we can do now for those of us with AATD that will help us in the future. Many of us have learned to listen to our bodies to know what we need.

I, for example, need a lot of magnesium. It helps me feel less stressed, so naturally, I like that about it. Also, I don’t have nearly so many asthma attacks or cramps when I take it.

My point is, that taking magnesium can really help offset the effects of the inhalers. I have even noticed that magnesium normally takes the edge off a headache. So, I take magnesium as a preventative for this, too.

There are a lot of studies that find inhalers have benefitted those with lung disease. If they happen to have side effects, I would have some questions. For one thing, I would ask, “How greatly would the side effects affect the patient?” And of course, there is not enough information to find the answer for each individual patient. Therefore, we can only speculate on an individual basis as best we can.

The second question I would ask is: “Is there anything we can do to minimize the side effects?” And again, these hard-to-answer questions would have to take other information into account.

For instance, what symptoms and medical conditions does the patient have? How would they be impacted by the inhalers, either directly or indirectly?

In the long run, I feel that the severe case of COVID-19 I had (although we aren’t sure it was caused by inhalers) doesn’t compare to the outcome of using them. COVID-19 follows no rules, and I would rather have many restful nights than wish for them while I feel a little safer from another bout of illness.