Lung irritation not only the result of spray inhalation

Dear Dr. Roach: I was prescribed a steroid inhaler to combat a lung and throat irritation. I accidentally inhaled a toxic spray I was using to clean the inhaler. It was not directly sprayed, but rather I inhaled the fumes when they blew back into my face. I do not know what the substance was.

A local pulmonologist prescribed a steroid inhalant, and I overextended the usage period of six and a half weeks. I continued using it because it offered me relief. Consequently, my body became addicted to the steroids. Since August 2020 I have tried unsuccessfully to wean myself off the steroids but have been unable to do so. Currently I am using one puff of 100 mcg of Asmanex HFA per actuation twice a day, a total of 200 mcg. I would like to come off the steroids completely. Any advice or suggestion would be heartily appreciated. — L.V.

Dear L.V.: Since inhaled corticosteroids do not cause physiological dependence, I think your premise is wrong and the real issue is that you have an as-yet-undiagnosed lung condition. You continue to have symptoms when not on the steroids. The most common condition for this is asthma, but there are a many other less-common conditions. Chronic obstructive pulmonary disease would be a consideration if you were ever a smoker or had a history of occupational exposure.

I am not sure whether the spray to your face of the solution has anything to do with your symptoms. I think another visit with your pulmonologist — a lung expert — is appropriate. Get some further testing of why you continue to have symptoms. I suspect a set of X-rays and breathing tests are in your future.