Medication question - Duo Neb Inhaler?

[beatsme]

I use DuoNeb Inhaler 4 xday in a nebulizer.  Also, Advair 250/50.  When I use the DuoNeb, it actually gives me a feeling of burning (is the only word I can think of).    I have combivent as a rescue inhaler with spacer chamber, lately have had to use it about 2 am. Otherwise I don't use it at all.  These are the same medications, the combivent does not have this effect, but the DuoNeb does.  It also almost makes my lungs feel over expanded.  What is the norm to be expected with this medication?  

I also am on 02,(only 1L) in theory at night and when exercising, but of late it seems I use it more during the daytime as well.  It seems to relieve just an achy feeling I've been getting, primarily in my right lung.  

I'm really trying to do things right, but feel I'm in a loosing battle with pulmonoligist and regular doctor.  I have never been psychotic, but I'm beginning to feel that way, knowing something is wrong.
I have had PFT  and according to it, I'm classed as Moderate Obstruction @36.9% FEV1.

any thoughts are appreciated.

[beatsme]

Saw Pulmo Dr. this week.  All he said about the problem with the Inhaled Duo Neb was I must be reacting to the Saline Solution & not the meds.  Since I also have Combivent, he said just use 3-4 puffs of it, which "should" have the same effect.  I asked about other neb. treatments - he didn't want to discuss them at all.  Then I remembered his nurse mentioning previously he didn't LIKE prescribing nebulizer treatments of any type.  Had to look, my regular GP had prescribed this form of treatment when I was released from the hosp.

So, his response, which seems far fetched to me, I feel he should have requested a test to see if it's the saline solution that I respond badly to.  If so, that might indicate I should avoid anything that has a saline solution in it?  Or just from this one manufacturer, or I don't know!  This is my life on the line here and would he be so cavalier with therapy if it were one of his own family members?  

At the same appt. he wanted a PFT done.  I stated I had a bit of a cold and asked if it would skew the results.  No answer, but the PFT was worse than my first one.  The first one was 10 days after being released from hosp (7 days of neb treatments) and was just finishing some major meds.  He never would say how much it  had changed, so I called after I got home & requested a copy.

It's things such as this that make me feel I'm loosing this battle, in addition to receiving less than reasonable health care.

At the moment, I'm certainly limited by my insurance PPO list,   and who might be taking new patients.  This is too frustrating and adds greatly to the burden mentally.   No wonder people end up in psyco wards, the Dr's make them crazy!

[National Jewish]

Different forms of the same medicine may have different inactive ingredients.  This may explain the feeling of burning that you have with DuoNeb