Many patients mix up their steroid inhalers and rescue inhalers, and at times will use the steroid inhaler when they are short of breath. I teach my patients to keep their steroid inhaler with their toothbrush. It helps them remember to use it twice a day, every day (not p.r.n), and they can brush their teeth afterward instead of rinsing their mouth. I use it to show how the steroid inhaler helps keep their lungs clean, just as the toothbrush helps keep their teeth clean.—LISA SCHWARTZ, NP, Boston (209-5)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

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