🔴🔴🔴 Still Can’t Figure Out Why Your Asthma or COPD Is Not Getting Better‼️

本站添加: 2026-05-30

[00:00:00]I'm going to be educating on tips on asthma and COPD today. My name is Dr. McCono and I'm going to go over basically what I expect my patients to understand about asthma and COPD.

[00:00:16]Starting off with how do you afford these medications and I do have a video that I have already posted and I believe it's a short that explains the tips on how to afford your medications. Making sure that you can afford your medications is key. Um because if you do not afford any of your medications, then obviously the asthma care and the COPD care is compromised and it costs you more. It's also going to cost you more when you have the medications and you have no idea how to use them. You have not even figured out that you do not know how to use them, which is why they're not working for you. They're working against you and they're costing you more in the emergency room and they're costing you more by scheduling more unscheduled visits with your doctor. So, I'm a pulmonologist. I'm also an intensivist and I'm going to be going over all the tips I expect my patients to know even before they meet me because I think primary doctors um and clinicians out there are educating their patients about how to optimize their lungs so that their lungs are working um in full force on a daily basis so that they can carry on with their routine activities. um you know being you know most of us are trying to work. We're trying to balance life and um when we get sick it's really an inconvenience because we set ourself basically backwards in our financial goals because we are now stuck on a hospital bed or we in the emergency room over and over again. It's very expensive to take care of um COPD and asthma especially if you do not know how these things work. So again, I'm going to begin um this uh whole um it's about a 20 minute conversation with you about asthma care and in state stating that all your insuranceances have a book that they provide to you that relates to the medications that you should be on and they're usually put into maybe you can print them out in your internet web page where the insurance is exposing what medications are approved for you. And if you don't know that you need to go and get these booklets for your doctor, your doctor will end up picking the wrong inhaler as far as the price but the right inhaler for your disease. And you will have a situation where you have a very expensive inhaler and you're wondering, "Oh my god, how could I have helped my doctor pick a cheaper medication?" And I don't want you to think that you're helping the doctor because the doctor's job is to diagnose you with the disease and then give you a medication. It's not their job to figure out what's cheaper. But that's why I'm beginning here because I want to let you know that if you maybe feel like your doctor should have maybe preferenced one of the inhalers I'm teaching, I don't want you to feel like they made a mistake. Cuz to be honest with you, most of these inhalers are in a class of medications. They are very similar. They change their devices, the colors look a little different and they call it something else. Yeah, but you need to know that within the medications. Um, thank you. Yes, Jesus loves me. I need Jesus today. It's totally what I needed.

[00:03:36]This is a very nice comment. Thank you so much, Carson. Um, and I like positive comments. So, I'm here to give you guys tips about what you guys should do instead of saying, "Oh god, I'm just going to ignore my asthma and COPD."

[00:03:47]Well, it's going to cost you. Asthma and COPD is not going to ignore you. It's going to come back and bite you and it's going to cost you more because you're going to seek care. There's nothing like something hugging you and squeezing your lungs almost to the last breath. You're going to see someone about it whether you like it or not. But by then it's way past the times you should have seen them because you're thinking, "Oh my god, they didn't give me this expensive medication. They gave me something. I didn't think it was helping. I stopped taking it." Guess what? we're probably going to give you pretty much the same thing only more expensive because now it's coming through the ER, it's coming through an an unscheduled visit. So, I'm trying to teach you that. Go to your insurance if you of course if you're in the US. If you're somewhere else, I don't know, maybe ask your pharmacist what else is equivalent, but go to your insurance on the web page and look for the formulary list. It's a formulary list like formula and then you add formulary list. That list is basically what is my insurance willing to pay for my inhalers. It will differentiate them for your doctor so that your doctor is not guessing which inhaler is cheaper and your pharmacist also has no time to look this up. Nor does your doctor. Each plan has its own list of inhalers. So that's where the confusion begins. But it shouldn't end there. I'm just educating you that when you go see your doctor, grab your little booklets. Yes, do it. Do it or have it ready on your phone um where your inhalers are listed or your medications in general. This should apply to all your medic all your medications. If you have heart disease, heart failure, whatever you may have, diabetes, you know, your doctor is going to say, well, the diabetes is treated with these medications, but your insurance is going to say that's true, but we don't cover this medication and that medication. So these booklets, these these reference points, and I have mine, I keep them in the waiting room and I introduce myself. I say, "Hi, my these to me. I send a message out to my my patients because it takes away that valuable time that I have with my patients trying to tell them, you know, let's not fight over medications because I don't select the type of the brand or the I select the combination you have, but I don't pick the brand. I don't pick whether you're going to be in um maybe let's say a mids midsize car that is a Mercedes or a Toyota or I don't pick that. I just pick that you need to be in a midsize car. And if that's what I pick, then your insurance is going to say what kind of midsize car you they're covering. How to figure that out? I'm tell telling you guys in multiple ways.

[00:06:34]These little booklets you can ask your insurance. I need my formula release, which is what my doctor needs because the last time they prescribed something, I could not afford it. And you definitely can't afford to be hospitalized. And while you're hospitalized, by the way, no one is going to come and tell you, you know what, silly you. You didn't take your medications. That's why you're there.

[00:06:54]Sometimes it's because you had a flare.

[00:06:56]Yes, I agree. You got a cold. You should be covering yourself, protecting yourself since you already know when you get a cold, it is a super cold, right?

[00:07:04]It's something you've never seen before and it's just shakes you up and sends you right into the ER. So, cover yourself. Put a mask on you if you feel like you're sensitive to the cold. Yes, please do that because yes, cold will flare up your asthma and your COPD or any of your lung diseases. So, you need to cover yourself. But while you are there, they're going to give you steroids.

[00:07:26]They're going to give you X-rays, images, and all these other things. But the steroids are also inside these inhalers, right? And these inhalers need to be fixed.

[00:07:39]Maintenance inhalers. So, you're going to say, "Well, what's the maintenance inhaler?" Maintenance inhaler is the one that you are prescribed to take every single day. It said that on the box. And you may have already discarded that and then you now have forgotten. And you're using these things. some of these things and I've taught all how to use these medic these medications. You need the right technique so that the lung actually receives the medications and it gets deposited there. So yes, you have to know how to use that. And I'm here every day to just show you how to use them. But I'm also here to emphasize that the schedule itself matters.

[00:08:19]Realizing that they are inhalers that are rescue only, meaning they are only used for rescue purposes. They are addon to such medications that are meant for maintenance inhaler. Maintenance inhaler means you need to use it every single day. Rain or shine. And sometimes you're scheduled at twice a day and some are scheduled as once a day medications.

[00:08:42]You've got to differentiate those. If you don't, it will cost you. And I hate to keep saying this over and over again because I'm not here to hide anything.

[00:08:50]I'm only here to tell you what it is, right, that you need to know. And whether you agree or disagree, it is what you need to know. I'm just going to be very honest with you. Now, you either receive it here or you receive it peacemeal over a period of time. Like with everything, we all learn over time.

[00:09:07]Ask me 10 years ago how to handle some of my own issues. I'll say, "Oh my god, I didn't know." But over now I can summarize what I would have done if I knew this 20 10 years ear I mean 10 years before it happened. Right. Right.

[00:09:21]So the reason I'm here is really to make sure that you understand that some of it is you need to know that your inhalers are scheduled and some are as needed.

[00:09:32]And if you're using your as needed as you're scheduled is a problem. And if you're using your as needed as at night all the time constantly on the rescue inhaler there's a problem with your one that is supposed to be scheduled either your technique is off or your schedule of that particular inhaler is also off.

[00:09:51]Realize some are set up for once a day and those build compound once a day every single day assuming you use it for 10 days every single day without skipping. At 10 days, you're going to be at max therapy and it will hold it there by continuing to use it every every day.

[00:10:09]Hi. And for those people who are like, "Okay, what about the twice a day? Can I make the twice a day, once a day?"

[00:10:15]Because it's cheaper for me. I can just do one can over two months. Well, you're wrong. You know why? Because the twice a day is used one puff in the morning, one puff at night, one puff in the morning, one puff at night, and each one is building in that step twice a day. So first dose 10%, second dose 10%, you you add 10, 20, 30, 40, 50. So by the time on the twice a day you get to 10 days or maybe 5 days, you already maxed out on how much you could have compounded in your benefit. So it becomes starts off with the first dose at 10%. But by the time you get to the fifth dose, you've already are building on that 10% each time. So 10, 20, 30, 40, and you eventually get to this max therapy. And that max therapy then tells you, okay, now I'm maxed out on how much I'm benefiting from this inhaler. And you will continue to take it every single day. So it's not something that I'm expecting you to understand. But if you really have these inhalers, you really want to cross-ch checkck the technique and do not dismiss it because if the inhaler is not getting into your lungs at the same time, even if your schedule is off, it's just going to add to the problem. But you need to start with making sure the medication is deposited in your lungs and that you are holding that schedule that it's prescribed. If you're not, this is why I'm here. So I I've given you two points just to summarize it. When you have asthma and COPD, go to your insurance and ask them, "What are the approved inhalers for me? I need to know because I cannot afford to pay extra by my doctor picking the wrong medication." Then you grab these books and you go and take them to your provider and you say, "Well, it doesn't have to be books. Some people have printed out sheets for me. This this is a sample of what a patient has provided me and they just printed out what was related to the lung inhalers. And within these booklets there is a list of all the medications and they are they actually tiered tier one, tier two, tier three in the generic level. So that way it's very clear when I'm selecting the medication that they're supposed to be on that I'm going to try to pick the cheapest level in the tier and then try to pick the combination that matches my patient's need and then that way the patient then has a higher chance of filling that medication which would be you right and then keeping on to this task that I have in teaching you that once you've figured out then your doctor has prescribed you an inhaler you now need to Check whether your inhaler is getting inside your lungs. And I teach this every day because I see it every day in my pulmonary office that a patient sits down and they literally don't even know that they got to prime the inhaler. They you have to shake it up and then you you spray it because you see when I sprayed nothing came out. You see now it came out, right? And then you want to empty your lungs because some of you actually trap air and your lung is full of air that doesn't have medication and then you're trying to squirt in in a full lung. So exhale first. Exhale, empty your lung and give yourself a full breath of medication by extracting it from your device. So look at this.

[00:13:51]So now that breath that air with medication is sitting in the lungs it's getting deposited where it should work which is in the lungs and it takes time to settle but sometimes some of these medications some people feel like oh my heart is racing especially the albuterol you need to talk to your doctor about that quitting your medications or dismissing them is not an answer.

[00:14:15]Rather go with these side effects or concerns to your doctor. Let them know, hey, when I take this, I feel this way or I feel that way. Because sometimes it's a matter of removing that particular ingredient or making sure that your inhaler doesn't have that ingredient. And if you need it, sometimes separating it and giving it when you need it, which is like a rescue as you need it. But in your device, they can just put what you need. if it's an inhaled serum by itself or if it's something like an epotropium by itself.

[00:14:43]So I need you to understand that it's everything even when some people report I have urinary retention meaning you cannot urinate after you take your inhalers. There are some inhalers that do that. It's not all of them. So it's on you to tell your doctor about that.

[00:14:59]It's not a good decision to just stop taking your inhaler because your lungs unfortunately rule when they go totally wild.

[00:15:07]you know what happens, right? Which is the reason why they gave you the inhalers in the first place. So, it's very important that we are not ignoring these um concerns and dismissing them and saying, "Well, I I I had a problem with that." And if you don't know how to use it, then you come here, we teach you or you go to your doctor or you search your inhaler and see whether there is an inhaler technique that you could improve you from losing all your medications or wasting it. So, I'm here again today briefly because um I do have to run in a little bit. I will be looking at your messages and your questions, the appropriate questions I will answer. I want to also let you know that when inhalers don't work, um and I have plenty of videos showing you guys how to use your specific inhaler. If you don't see your brand, just look at the shape.

[00:15:54]If it looks like this, it's going to be taught exactly like this. But the schedule is different.

[00:15:59]This one is usually twice a day while this one is as needed. And you can't confuse these things. You you really really can't just assume because they look alike, they may even have similar colors that they have the same ingredients. They don't. They don't.

[00:16:14]This one has albuterol only. This is meant for rescue. And if you use too much of your rescue, you have a problem.

[00:16:20]whether your doctor needs to do an X-ray and figure out if it's deeper than just asthma and COPD or you need to check out if you have other issues like reflux, post-nasal drip. You could have other things that are combining and causing you hell. But that's not how you decide by just puffing, puffing, puffing. And if it's not working, maybe this puff is not getting in or this puff is not scheduled right or is misused or you misunderstand you misunderstood your doctor or you confuse these. Right? This one on the other hand, I'm just giving you an example. It has two medications inside. It's got an albuterol component and it has a steroid component. And we need to rinse your mouth after this one.

[00:17:00]You don't necessarily have to rinse your mouth after this. You don't need to memorize all that. You can go to your doctor. You can look up yours and say, "Hey, am I supposed to rinse my mouth?

[00:17:09]And why am I rinsing my mouth?" You're rinsing your mouth, especially if some of you have soreness, horarsseness, change of voice because of some of these inhalers. The answer isn't to quit. The answer is to talk to your doctor and see whether you just missed gargling with water after your use of inhalers. I remind you guys when I show you inhalers, I tell you which ones you should maybe consider rinsing your mouth. I tell you which ones you should consider putting next to your toothbrush. Which ones are those?

[00:17:36]They're maintenance inhaler. Put them next to your toothbrush because you really should be going next to your toothbrush twice a day. Most of them are twice a day and some of them are once a day. And you're not supposed to skip them. They're not optional. When you get up in the morning, when you feel good or don't feel good, they are going to be applied. They are maintenance. They are meant for that. If you're expecting your asthma to make a change, you to be in control of your asthma, not your asthma is in control of you, you need to know your schedule. And you unfortunately need to know your technique before you even your schedule. And the schedule compounds when you are using it correctly and consistently. So, if you're missing any of these, that's all chances of you to improve. chances of you to reduce your chances to see someone like me, a pulmonologist, or someone like me in the hospital or someone like me in the ER and then you lose out thinking, well, they gave me steroids and antibiotic. They gave you steroids. Steroids are in here. This is a safer way to give it to you. And if they give you steroids is because they're trying to save you from having a respiratory compromise. They have no choice at that point. But when you get out, when you recover from that or when you meet me and I'm telling you this is a missing link, go back to your doctor and say, "Oh my god, was I supposed to use this twice a day? And was it one puff or two puff?" Because this could be prescribed two puffs twice a day for those people with severe lung disease that we find that we need to give you two puffs twice a day. It is not two puff when you want for this one or two puff when you're sick. Once you're sick, you're already up here. You're so high up there that these inhalers are maintenance. they're down here when you're controlled that we are mismatching. We got to give you steroids and pills IV to bring you back to Earth, right? And discharge you on inhalers. We hope you go and follow up with your doctor to see whether you're going to have a soft landing or have a regression of disease. So, it's very important that you understand that these inhalers do work. They really work for majority of your patients. And for those people who are patients already, they work. Just don't miss the technique, which I'm emphasizing. My whole presence is just realizing that this little tiny little thing that I'm teaching you, which is technique comes first, could save your life and save your bank at the same time and save you from this revolving spinning sensation that you have that you feel like you're tied to a doctor every two weeks in the ER and somewhere.

[00:19:58]You don't have to be. You can live pretty normal life. You can for majority of you and even for the people who are severe we can get you down to moderate or get you down to mild if you use your medications the way you're supposed to and if it fails then it's a good idea to consider of course there are upgrades but I think I personally think because that's what happens in my clinic 90% of you can get better without having to involve yourself with injections yes I know I'm aware that there is injections I'm aware I don't emphasize them because my goal here is really literally to be very basic. And if you're beyond the basic and you've actually taken a check mark and said yes, technique is perfect.

[00:20:39]I hold my breath for 10 minutes and I allow my medication to settle in my lungs just like Dr. McConnell said. Then perfect. And then you follow it up with I was told this medication is twice a day and I do not miss every single day.

[00:20:52]um twice a day because I know when I use it twice a day, it goes from 10% to 20, the next day 30, 40, 50, 60, 70, 80, 90, 100. And I hold it at 100% use and compliance and benefit by continuing that schedule at twice a day. And if you didn't know that, well, you know what?

[00:21:12]That's why I'm here. It's like these tiny little things that make a huge difference. And the problem is when you go see your doctor, why are they not spending the time with her? Because we wrote it down. We told you that this inhaler is supposed to be twice a day.

[00:21:24]Therefore, it's really silly to ask your doctor, why did you not ask me that I'm using it twice a day and vice versa. If the doctor ask you, you feel offended like, do you think I'm an idiot? I already know. You told me it's twice a day. So, people get offended either way.

[00:21:39]I feel like this is the best place for you to learn that if you're skipping around and you haven't quite seen a year without a flare, then maybe that's your problem. And then you need to protect yourself. You need to follow up with your doctor. They need to test you, do the breathing test if you haven't had one to see whether this schedule that I'm given for this inhaler that I'm using properly is working because then they will do the breathing test, they will see your lungs showing calmness that they controlled. And that is what is key in control that when we do your breathing test, we shouldn't see asthma again. We should see it when we diagnose you, but we should not keep seeing it repeatedly. We're going to assume well you know what I keep seeing asthma and I've given her the best treatment that she should be on maybe I need to upgrade her that's how we move to these things and we go higher and higher in the scale of medications because you have failed the lower level the more safer options of treating your asthma and COPD. Now how do the allergy and reflux and postnasal drip play a role? They all do.

[00:22:43]the allergies, dust, keeping your environment clean, making sure that the AC um vents are clean or the filters are changed and you're using filters that are appropriate for asthma. These are all important because the environment irritates your asthma and that asthma flares. It's pretty much sensitive lungs, right? Even for the COPD, sensitive because you're doing things that you shouldn't be doing, which you should stop, by the way. No smoking, no vaping. None of that is good for your lungs and it will cost you more. If you don't get it, you will get it with a bill, right? Over time. And I'm just saying to you that yes, we can treat you through smoking and asthma and COPD and all that. We can treat you through that, but it is just a very aggressive measure of care. And if you didn't know and all you needed to do is be compliant with your medications and follow up with your p your doctors. Well, why are you following up with your doctors? Is because some of these inhalers are dosed at low and we give it to you and you're good. you use it twice a day but it's low and when you see your doctor you say you know I got relief but I'm not all the way there they can go to it maybe from 100 mcg to 200 mcg they have dozing on these they have a dose and that dose tells us if we have controlled you this is working for you if it has not controlled you then maybe we need to upgrade you right and we can upgrade you by adding combinations with inhalers or we may have to say look add an allergy medication Because asthma is an allergy disease, not so for COPD, but for asthma. If maybe we add an allergy pill, it may make a huge difference and we can keep the lower inhaler. Or maybe we add it and it's not better. We higher the inhaler dose or we add a combination within one inhaler like this one has three inhalers inside one. This is why it's silly to compare with somebody else who's taking a two and one is taking a three and you assume, oh my god, my doctor messed up. One is you could be using this one wrong and not even get the benefit of this because you're using this one wrong. They're used about the same. Technique matters, combination matters, dos matter, compliance matter.

[00:24:50]There are so many factors in this and how um um you will be able to get yourself controlled and reduce the risk of showing up in the ER repeatedly going over steroids, pills, IV over and over again. Steroids and IV steroids, they help you get the flare down, but they're not meant for you to use every single day for the long term. So, I'm only here to emphasize those very important minor but very important points. My name is Dr. Morno. I would love for you to take a look at some of the inhaler techniques because I really believe before you go see your doctor, you should know how to use it. They may not have the time to check on this. Yes, it's not a minor problem that they they don't check, but if the person checking doesn't even know and they're checking you, that's even worse because some of the medical assistants don't know and they tell you what, they wing it. They really should direct that to the right place so you can get the right directions, right? And you should take it as your responsibility to know how to use your inhalers and be consistent and tell your doctor the truth. Yes, I've been seeing you, but guess what? It was all social cuz I never um hopefully you can still hear me. I don't know if you can. I'm getting a call at the same time. So, if you can't hear me, please just let me know um at any time. Well, if you can't hear me, I won't know, right? you can just definitely freely let me know that you can't hear me. But it is very important that you understand your role in your care because if you do not know in your care, you don't get the full benefit. So hello to everybody. I see eight people visiting right now. If you guys have questions, you can definitely ask me, but I would really recommend that you take a look at a long list of all the inhalers, prior um techniques that I've showed. The tips are key. If I wrote something, maybe you should read it because maybe it applies to you. It is like these subtle little things that you're making a mistake on, but they are so easy to fix and they can change you from a person who has multiple flares a year to less than whatever you had last year. Another So, I don't know if you can hear me, but I just want to let you guys know and I'm going to end with showing you guys how to use um a few inhalers. Um I don't know if you can hear me. Can you hear me? Because if you can't hear me, please just make sure that you let me know. So, I'm going to go over um like a quick little tip before I leave. You see this little sticker right here? I put this sticker there for my patients to remember when they should use the inhaler. And I would say I would recommend even if you do not know that you can do little things, you can definitely if you're getting confused, this is a twice a day medication. And if you don't know what yours is, go find out. And do not confuse this inhaler or anything that's a twice a day to as needed. They're very different. That's the key that you should take home and go to your pharmacist and find out is mine a twice a day because I need to do it twice a day. And did your doctor prescribe one puff or two puffs? Because if they say two puff, they know the difference between writing one puff versus two puffs. And separate those puffs. Do not stack them. Do not do this.

[00:28:14]Don't do that. Separate them. Allow the lung to actually digest the first dose.

[00:28:19]Wait 30 seconds and do another one. So, I'm going to go through um inhaler technique quickly and then I'm going to be out of here. Okay. So, shake it up.

[00:28:29]Prime. This one may be out, but you see that's why we prime. We check it. And then that's how we use this type of inhaler.

[00:28:50]But this one is dera. This is a twice a day medication. Therefore, and it's a 200 dose, but they're lower doses. It's two puffs twice a day or one puff twice a day. But it's a twice a day medication and you shouldn't be using it as needed, right?

[00:29:06]H I keep getting calls, so hopefully you can hear me. Um, this here, I'm going to show you this one over here. This is a twice a day medication also. You know, you open it, you check your supply right there, and you tell you you have enough. You open it up like this. You click it down. But look at this. You still exhale everything out.

[00:29:33]And then count slower. Allow that medication to digest. Now, if you're joining in in the middle of this, I tell you guys in the beginning, I did talk about if your inhalers are expensive or you think your doctor should switch around your inhalers, go to them with their uh booklet of what is supposed to be um your insurance. You know, when you sign up for your insurance, you're marking off yes, I like United, yes, I like Etna, yes, I like Humana, yes, I like Sunshine. Whatever you're choosing, you're also tagging it. And they should tag it. They should put a card with a pamphlet with all your medications and what you can afford. Don't get mad at your doctor. They don't get to have any contribution to which one is covered on which plan. We just know what is appropriate for what lung, right? And you need to know how to use it so that that lung medication is actually settling in your lungs. You're not blowing it off like this.

[00:30:38]You're not doing that because it's not going to work if you do it that way. It doesn't matter if you have the best of the best and it's covered. Your technique is off. The lungs will never receive the medication and you need to actually get that medication down in your lungs. I'm going to go over this.

[00:30:52]This is the most difficult one and then I'm probably going to run out of time.

[00:31:10]I don't know if I understand that. So, albuterol, well, albuterol can be used for a rescue. I'm not sure if that's what you're trying to tell me, but if you're using it, um, tobaccof free Florida. Yeah, good. That's good that we should stop smoking because if we don't stop smoking, we'll run up our bills with care of lungs that are completely debilitated from smoking and how they would work against you. So yes, our bureau which I showed here but just realize our bureau can come in different formats. This is also a bureau but this is very easy to use. You just open it and you very easy right on this one here and I've showed all these before. You would twist one and then twist again two. Then you exhale.

[00:32:13]Mine whistles. Yours doesn't. But when you're doing your second dose, you would twist it again and take the second dose.

[00:32:20]And then in the evening, this is a twice a day medication. You would do the same thing. One puff, wait 30 seconds, do the next puff. And I've showed you guys pretty much everything. And I want to just end by showing you how to use a spacer because some of you can just get this technique right and the medication escapes. Anyways, so I know I hope we don't have those people here, but I don't know their solution to that.

[00:32:54]Maybe it's kind of like any other addiction. I guess maybe try to talk to the doctor. I don't know. I've never really had anybody who does that.

[00:33:02]Anyways, thank you for your questions. We appreciate any question as long as it's polite and nice.

[00:33:09]I can answer or maybe entertain any of the comments at this point in my life.

[00:33:13]Anyways, this is a spacer. It prevents you from allowing your medication from escaping.

[00:33:24]It traps it in here. Gives you time to coordinate your breath. You can put it in here. Remember to prime your inhaler.

[00:33:32]You spray and then you put your mouth here and you take shallow breath. You count two, two or three.

[00:33:47]Okay. So, I just want you guys to know that some of these will require rescue.

[00:33:55]Inhalers don't require rinsing, but maybe there's one out there that I can recall right now called a Supra that you may need to rinse your mouth. But what I'm saying to you is that if it's one of these and you put in an inhaler that needs to rinse off like this one, goggle with water and rinse off. Um, so I just want us to make sure that we know the reason that we take inhalers and realizing that I may not have all the time to go over all types of inhalers today, but I would rather we have gone through the very beginning of this video, which is when I tell you why it's important to take to your doctor the formulary list so that they can afford they can prescribe an affordable medication for you and that you feel like they did not give you the most expensive. Um, I wish you all the best in your future and your care. And if you have any questions, please post the questions. I am usually watching and looking and trying to respond and teach you at the same time as much as I can.

[00:34:57]Um, I'm definitely not your doctor. I'm only here to teach you the tips and they're very basic. They usually do make a big change and if things don't work out, make sure you follow up with your doctors anyways. Confirm. Take your medications with you to your doctor and make sure that they're doing the best they can to take care of you. I wish you all the best. Again, this is Dr. McConnell. I wish you all the best. Take care.

[00:35:26]True. Before I go, yes, don't smoke otherwise it causes a lot of problems and when you do, it is very devastating to your future including adding oxygen, cancers, and much more. Just a miserable life to be honest and some of that could be avoided. And even if you have been smoking, we can definitely care for you.

[00:35:43]It's just better when you don't smoke.

[00:35:45]All right. No vaping either. Take care.

[00:35:48]Wish you all the best.