7% Saline in Nebulizer for Mac

Posted by healthybon @healthybon, Mar 7, 2023

Could you all give me your opinion?
I have Mac..don’t know species yet.

I’m new at this but have seen many posts on here about how important it is to clear the mucus. Saline in nebulizer, flutter valve!

I requested that my pulmonary call in a script for the 7% saline to be used in a nebulizer! His response was “just use the flutter valve, the saline could make things worse.”
I have read in this support group that everyone uses the saline and also videos on UTUBE…..etc. I’m confused.
What is your opinion on this?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@healthybon

Thanks so much for the wealth of information. I have been learning so much from this blog. I am making it my business to search out doctors who are familiar with MAC. After I meet with upcoming infectious disease Dr, I am considering an appointment with expert at Univ. NC chapel Hill.

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I hope you have found an expert in MAC. I will recommend a Duke MD who is an expert if you haven't found one at UNC, Chapel Hill.

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@kagilb

Hi group. I was dx. with bronchiectasis 5 yr. ago and mac positive about 2 years. Thankfully the disease progression has been fairly slow. I'm on 3% saline/ Duoneb, do airway clearance and use Aerobika. I have a good pulmo doc (NJH affiliated) who changed me over to 7% saline. I quickly noticed alot of bronchial irritation/soreness, excess coughing and sputum - been doing extra airway clearance to control it. I'm now alternating 7% and 3% daily to see if this helps. Anyone else experience this?
Thanks, Karen

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I'm using 7% Saline for about two months now with the Aerobika. I've interrupted the use of it for two to three days due to irritation in my throat but it does help me to bring up the sputum more easily than the budesonide/albuterol nebulizer. I like the idea of alternating between 7% and 3% and will speak to my pulmonologist about this if the irritation continues.

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@judytpt

I'm using 7% Saline for about two months now with the Aerobika. I've interrupted the use of it for two to three days due to irritation in my throat but it does help me to bring up the sputum more easily than the budesonide/albuterol nebulizer. I like the idea of alternating between 7% and 3% and will speak to my pulmonologist about this if the irritation continues.

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Hello Judy -
After my MAC cleared up and my asthma was well-controlled (a long journey) I had no new exacerbations for a year. With my pulmonologist's blessing, to cut back on my 7% saline nebs. First I decreased to one a day, then 5 times a week, now only twice a week. I still do airway clearance each day.
Here is the interesting part - the cut back on days came accidentally - went out of town for an overnight without my equipment. But the next day, I could still "taste" the salt in the sputum I brought up - and even a little the third day as well. That's when it occurred to me that if some of it persists in the lungs, and my body is able to clear mucus with my inhaler and no neb, maybe cutting back would be okay (for me.)
This has been my regimen for over 16 months now and I have had one (minor) exacerbation with a bad cold - managed with a single course of steroids and no antibiotics. During the exacerbation, I nebbed saline daily and continued for 4-5 days after I was symptom free, then went back to my 2 per week.
Also, if I have an asthma attack, or a tighter-than-usual feeling in my chest, I neb daily until it passes - but sometimes just enough to bring up the extra junk in my lungs.

Everyone is different, so feel free to talk to your doc about managing your care in a way that works for you.
Sue

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@healthybon

Thanks so much for the wealth of information. I have been learning so much from this blog. I am making it my business to search out doctors who are familiar with MAC. After I meet with upcoming infectious disease Dr, I am considering an appointment with expert at Univ. NC chapel Hill.

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Hi Bon, you are not going to Emory anymore? Let me know about Chapel Hill.

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@sueinmn

Hello Judy -
After my MAC cleared up and my asthma was well-controlled (a long journey) I had no new exacerbations for a year. With my pulmonologist's blessing, to cut back on my 7% saline nebs. First I decreased to one a day, then 5 times a week, now only twice a week. I still do airway clearance each day.
Here is the interesting part - the cut back on days came accidentally - went out of town for an overnight without my equipment. But the next day, I could still "taste" the salt in the sputum I brought up - and even a little the third day as well. That's when it occurred to me that if some of it persists in the lungs, and my body is able to clear mucus with my inhaler and no neb, maybe cutting back would be okay (for me.)
This has been my regimen for over 16 months now and I have had one (minor) exacerbation with a bad cold - managed with a single course of steroids and no antibiotics. During the exacerbation, I nebbed saline daily and continued for 4-5 days after I was symptom free, then went back to my 2 per week.
Also, if I have an asthma attack, or a tighter-than-usual feeling in my chest, I neb daily until it passes - but sometimes just enough to bring up the extra junk in my lungs.

Everyone is different, so feel free to talk to your doc about managing your care in a way that works for you.
Sue

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Thank you for sharing your experience with me. This is a new diagnosis and totally caught me off guard. After seeing a local pulmonologist, I met with a doctor in New York who spent 90 minutes with me, explaining and encouraging me not to go to the worst case scenario. He also put me on the saline nebulizer. I still have questions and worries as I navigate through this but I have an appointment at the end of May so I should get more information as well. This site has already been helpful with good practical advice and now support and understanding. Thank you again!

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@lp8

I had to send reports that were posted here, to my pulmonologist in order to get him to prescribe 7% saline. I do it twice a day with the percussion vest. I have MAC and Bronchiectasis. It has made my condition stay the same for a year. Not better but, thankfully not worse. I can't do without it. I feel it's very important to keep airways clear.

Lorraine

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Should you use saline if you can’t get any sputum out?

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@reneemc

Should you use saline if you can’t get any sputum out?

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I would say this question gets the hated answer, "It depends.. "
If you or have had MAC, 7..% saline is demonstrated to suppress the growth of the bacteria in your lungs. Even if your airway clearance doesn't produce sputum, the saline will be in there keeping the sneaky pockets of mucus from being a breeding ground .
On the other hand, I'm not sure what if any research has been done on whether it is helpful if you have never had MAC.

There is a frequently asked companion question, "Should I continue airway clearance if I don't produce mucus?"
The answer is Yes!
This will prevent mucus pockets and plugs from forming, which are an ideal breeding ground for MAC and other infections.
Are there any circumstances under which you produce mucus?

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Thanks Sue. Yes, I have MAC.
I use Anoro , Arikayce, plus, Azithromycin Rifampin and Ethambutol.
Haven’t coughed any sputum since January. Bought an Inversion table, it’s useless. But I cough blood several times a week. Don’t want another bronchoscopy because my lung collapsed last time.
I have a flutter valve but it’s not helpful. What is the Aerobika I hear so much about?

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I use 7% for almost a year now but I also drink 2 cups of Mullein Tea daily. I buy it from Amazon. Research it as it was used in the thirties for TB.

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@reneemc

Thanks Sue. Yes, I have MAC.
I use Anoro , Arikayce, plus, Azithromycin Rifampin and Ethambutol.
Haven’t coughed any sputum since January. Bought an Inversion table, it’s useless. But I cough blood several times a week. Don’t want another bronchoscopy because my lung collapsed last time.
I have a flutter valve but it’s not helpful. What is the Aerobika I hear so much about?

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The Aerobika is another type of flutter valve - I prefer it to the Acapella I was originally given by the pulmonologist.

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