I love my nebulizer!
Although recent research shows that in most situations, an inhaler is as effective as a nebulizer, when I am having an exacerbation, I really like using the nebulizer.
A nebulizer vaporizes the medication, which is premixed with a saline solution. You can inhale it through a mouthpiece or through a mask. I personally prefer a mask.
It can be easier to use when you are having attack, because you don't have to control your breathing the same way you do to use an inhaler. Of course, if you use a spacer--a plastic charaber to hold the medicine from your inhaler until you finish inhaling it--you don't need as much breathing control. My sister uses a spacer. I'd rather pull out the nebulizer when I'm having trouble.
I have a friend who uses a nebulizer with plain saline and find some relief from the hydration alone. (Word of caution: don't do this without talking to a doctor; you can't use just any saline solution, you need the right amount of salinity for inhalation, which is not the same as for other uses)
I personally think every asthmatic would be wise to have a neb handy and know how and when to safely use it. One problem though, is that it can lead to overconfidence. It is tempting to think "if I go to the hospital, they'll just give me a neb treatment, why not just do it here?" That is faulty reasoning though. You aren't primarily going to the hospital to get the neb treatment. You are going to the hospital so that medical personnel can treat the situation as required. That usually begins with a neb treatment and monitoring. Sometimes your condition can worsen quickly, so the monitoring component is important. The first time I was treated for an asthma attack in a trauma room, with IV steroiRAB and someone hurriedly preparing an intubation tray, I resolved to take asthma treatment seriously (I didn't need the intubation, by the way, the steroiRAB and nebulizer helped quickly). But, the nebulizer still has tempted me to stay home when I shouldn't. So, I agree, it is important to see the pulmo and have a plan for when to use the neb and when to go to the doctor or ER.
I find the neb most useful when I start experiencing symptoms, to head off an attack, or if things get serious and I do need to go to the dr or ER, I will use the neb for several days as I'm recovering. Again, it feels good, it soothes irritated tissues and it's as effective as the inhaler while being somewhat easier to use, and relaxing as well. It can be a good time to focus on breathing properly, if you can. Deeply, completely, with complete exhalations. I'm always on the run, and the nebulizer forces me to slow down and pay attention to my breathing, while working on improving my symptoms.
That said, I recommend shopping around. My unit is bulky and loud. One of these days, I'll see if I can get a smaller, portable unit, or at least one that is quieter. You may have insurance limitations, but it's something you probably want to look into. You do need a prescription to buy one.
