### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am an Asthma patient from my childhood. I am 68 now. I am regulaly practicing Yoga, Pranayam, Surya Namaskaram and Meditation for the past 3-4 years and am able to be active throughout the day. I havent got an attack recently. I have also reduced my dosage of Ketasma(Ketotifen 1mg.) 1tab and Unicontin-400- 1tab taken in the night daily to 1/2 tabs. each now for the past app.six months. I use Asthaline inhaler for the suport. I have a feeling that the Inhaler is not working effectively.(using it for more than 2 decades) My consumption is three inhalers of 200 metered doses. Can you suggest an alternative and effective inhaler. Ultimately I want to be out of tablets first and inhalers following it.

### output:

Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. First, I personally congratulate you for adopting lifestyle changes including Yoga, Panama, Surya Namaskaram, Meditation, which help to reduce medicine requirements in chronic disorders such as asthma. Please continue efforts towards improving your body & mind.2. As an Allergist-Immunologist, I would suggest you allergy testing for airborne allergens such as house dust mites, molds, pollen, insect proteins, etc. It will help you to identify the substances causing allergies to you and also to know the measures to avoid them.3. Based on allergy testing, an Allergist-Immunologist may suggest you allergen specific immunotherapy which works gradually on immune system to improve allergy symptoms over a long time duration.4. If your requirement of Stalin inhaler is 3 inhalers (600 metered doses), I would rate it as high. As you have mentioned that it is not working for you recently, I would suggest you a test named Spirometry with post bronchodilator reversibility testing. This test is usually best performed by pulmonologists, and it measures your lung capacity and amount of airway obstruction, also the reversibility of the airway obstruction.5. Such testing will help your doctor to decide whether you need rescue inhalers such as Stalin (albuterol) or "preventer" inhalers (such as inhaled corticosteroids) to dilate your constricted airways.6. There are many alternatives to Stalin inhaler such as levosalbutamol or other brands of albuterol, but at present, from your history, I doubt whether they will be really helpful to you. So I would not suggest them prior to spirometry testing.7. Please try to avoid exposure to dusts, smokes and air pollution as much as possible.8. A healthy diet rich in vitamins, minerals and antioxidants as well as adequate fluids during day to maintain HY Chat Doctor. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.