ACT Timing

Fortunately, my system seems to have gotten used to albuterol and it rarely makes my hands shake or makes me "nervous" anymore after using it.

Good question. We are all different. I do not produce much of anything at the late afternoon/early evening neb session either but I continue to do it because occasionally I get a surprise and get a bit more than usual and also, I think the continued twice daily ACT along with exercise etc is what has brought me to this point of staying well and having less sputum production. Persistent and consistent!

In reading I see that many, maybe all use an inhaler. I have not been prescribed an inhaler to take before nebulizing. All my PFT's are good. Would that be the reason why I have not been prescribed an inhaler, good PFT's?
My NJH diagnosis is Bronchiectasis and Small Hiatal Hernia. All other tests were good, EXCEPT.... I have a small amount of MAI and now understand why I was not started on anti-biotics as yet. (Thanks Sue for that link to NJH about when to Treat.)
When I nebulize, as indicated in my posts, I bring up a mixture of fluids including the white, bubbly, foamy substance along with a clear white gel like substance. The huff coughing afterwards does bring up some colored gel like 'mucus', sometimes more than other times. Overall I feel good just frustrated due to the all day long need to clear my throat of what comes up. As I have indicated I think it may be related to the Hiatal Hernia, don't truly know.
What are your, or others, thoughts or opinion about my not having an inhaler, or inhaler prescribed?
Also, when we use the letters ACT what does that fully mean?
I so appreciate any time you are able to fit in to give an answer with all you do... and as well everyone else does for their health with Bronchiectasis and other issues and tasks. Barbara

I think the LABA can make quite a difference based on experience we had with our dog! She had the worse cough and it went on for many years. We tried everything. We thought we would have to put her down it was so bad. And her lungs sounded terrible and looked terrible on X ray. We had been trying Fluticasone inhaler but it was not helping. Then we tried Fluticasone and Salmeterol combined inhaler. It helped right away and after a couple of weeks her cough completely went away. This is the first time in over a decade she is cough free. She acts and looks great now. The change has been miraculous. I guess prior to the LABA the steroids were not getting into her lungs to help her and now they do?

When the doctor says "twice a day," I always assume they mean roughly 12 hours apart, so I nebulize with levalbuterol and 7% saline upon arising, before coffee and breakfast, about 7-7:30 a.m., and then again before dinner, about 6-6:30 p.m. I really like not having to neb in the evening after dinner!

@sueinmn What time in the p.m.? How much in advance of sleep do you take symbicort?

I don't do evening airway clearance any more (little mucus now, morning ACT and moving all day gets it out.) I use my evening Symbicort between 30 minutes and an hour before sleep - hard to say exactly because my night routine in not fixed)
It doesn't seem to affect my ability to fall or stay asleep (levalbuterol was bad for my sleep)
Sue

Thank you Sue. Even one puff of Leva makes me shaky and jettery throughout the day.

Irene, I've gotta ask: how did you get a dog to use an inhaler? I'm glad it's working for her, but truly, it cracks me up trying to imagine how you do it!

@sweethighland Maybe it's your dose that's making you shaky? After you use it a bit your body might be get used to it.

At first I used Levalbuterol 1.25mg via nebulizer, which made me very nervous and anxious for hours. It seemed impossible to settle. Once I tried Levalbuterol 0.63mg (half of the prior dose) it was much better, very little if any noticeable shaking and the benefit of clear airways.