3% Saline vs. 7% for Nebulizing

@zscline Please contact your doctor now and let them know you are struggling. When you have a problem, it is not necessary to wait until the time of an appointment.
Also, you can buy "normal" saline vials that are .9% and mix them half and half with the 7% vials, effectively giving you 4% saline for nebbing. Have you tried that? If you neb twice a day, you can carefully save the half vials for use later. I have done that by placing them upright in a clean old prescription bottle and placing them in the refrigerator. My pulmonologist and her respiratory therapist assured me it is safe to do that for use within 24 hours.

Airway clearance can be completely exhausting. Less so I find if it's done 2x day. The morning for me always takes longer than p.m. clearance. Sometimes I use back to back saline vials (so total of 2) which I find gets the gunk out faster and more complete. Remembering to relax and not force the exhalations helps with the exhaustion factor. Gentle but firm exhales.

Do you have asthma? I do and the last 6 months I really pulled back on the steroid inhaler. Somedays I forgot to use it! Unbeknownst to me my asthma got worse and it expressed itself as bronchiectasis exacerbations. Gobs of gunk. Pulmonary suggested a month's trial where I take steroid inhaler 2 puffs/day b.i.d. to see if that helped calm things down. I am a week in of upping the dose and it has helped tremendously. It's made clearance easier. Less gunk. I don't want to stay on this steroid dose long term but until things get under control I'm staying with it. Maybe until the first frost?

Very helpful info. Maybe I will try diluting the 7% with .9% solution. Originally, I was on a plan to have 2 boxes of solution sent to me I think it was once a month. I really got ahead of myself so now have 100 vials to use up! Yes, my doc told me that if I don't use a whole vial up that I can save it until later that day. I've done that and it seems to work fine. Thank you.

Summer has been hard to get a hold of my pulmonologist. We were traveling and I got a bad flair-up. Maybe my first or perhaps second ever. He also was on vacation. I called the office, and his nurse called me back but couldn't suggest much via long distance without the doc being there. I need to discuss a plan that I might be able to have in place when traveling and a flair-up happens. My appointment is in about one more week, so I think I can wait. I'm okay right now.

I don't believe that I actually have asthma, though at times I've had asthma-like symptoms with a cough getting away from me. I've used a steroid inhaler for some time now, though some days I skip it, which probably sort of defeats the plan to use it daily. I have concerns about using it long term and I'm not even sure how helpful it is. Guess I wouldn't know unless I gave it a break for a month or so. Recently, on a trip, I did have a bad flair-up. Hmm...maybe I had been skipping my inhaler. I can't recall. Perhaps that did add to it, though it was during a 100 degree weather stretch and I think that is what really effected it. Who knows? I hope you continue to find relief from the inhaler. So much of dealing with this BE seems to be about experimenting and seeing what works for you personally. There is not one regime for everyone to follow. Of course, that does make sense. We are each unique to some extent. Thanks for your input!

I love it when you say "So much of dealing with this BE seems to be about experimenting and seeing what works for you personally. There is not one regime for everyone to follow."
For years I have been on my soapbox "preaching" that - in fact, there is even a long-running discussion on that exact topic.

As for inhalers, I finally found the one that works - for me - called Breyna (generic for Symbicort). It is a combination very low-dose steroid and and a long-acting beta agonist used twice a day, two puffs. I am exacerbation-free as long as I use it faithfully, but skip a day or two and the old heavy chest/hard to breathe feeling comes back. I know it goes against the common practice of no steroids for bronchiectasis patients, but my doctor says my results are worth the small risk. I have a new pulmonologist in September because mine retired suddenly, it will be interesting to see if she agrees.

Sue, is Breyna (generic for Symbicort) for asthma? Is it the same as albuterol and levalbuterol?

@sueinmn Do I understand correctly that you take 2 puffs twice a day?

Sue, Not sure, but I think that you are asking me this question. Sometimes it's easy to be lost in the threads. Yes, when I'm doing what was prescribed, I do two puffs of Advair twice a day.

Yes two puffs of Breyna twice a day up to 4 additional doses in a day if I'm having breathing issues. Have never had to go beyond 2 additional doses and that has been rare.

Answering one of questions- Symbicort (has steroid) is not the same as albuterol (bronchodilator). Often both are used, though as Sue mentioned, the steroids are used with great caution with Mac or other infections.