1. < MAC & Bronchiectasis

3% Saline vs. 7% for Nebulizing

Posted by zscline @zscline, Aug 13 11:07am

I started out using 3% saline but the company seemed to discontinue that option. I am finding the 7% saline solution so harsh for nebulizing. True. I do cough out a lot of mucus but feel almost exhausted when I finish 20 min. of this. I am wondering if the process is only helping to clear my lungs or if it's irritating my throat and lungs and generating more mucus than need be. Any comments or suggestions? I plan to talk to my pulmonologist about this but don't have an appointment until the end of the month. Thanks!

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narelled23 | @narelled23 | Aug 15 9:16am
In reply to @pacathy "Answering one of questions- Symbicort (has steroid) is not the same as albuterol (bronchodilator). Often both..." + (show)
@pacathy

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.

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Could you please explain to me exactly why Symbicort or other steroids are used with great caution with MAC?

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1 reply
scoop | @scoop | Aug 15 10:37am
In reply to @narelled23 "Could you please explain to me exactly why Symbicort or other steroids are used with great..." + (show)
@narelled23

Could you please explain to me exactly why Symbicort or other steroids are used with great caution with MAC?

Jump to this post

Steroids reduce the activity of immune cells in the airways making lungs more susceptible to disease. They also affect the production and function of mucus in airways. I think because of these things it makes it more difficult to fight off infections such as MAC/NTM etc. Some of us have asthma and have little choice when it comes to inhaling corticosteroids for inflammation.

This is what the internet says about low, medium and high levels of steroid inhalers:
1. Low Dose:
* Beclometasone: Up to 200-400 micrograms per day.
* Budesonide: Up to 400-800 micrograms per day.
* Fluticasone: Up to 200-500 micrograms per day.
* Mometasone: Up to 200-400 micrograms per day.
2. Medium Dose:
* Beclometasone: 400-800 micrograms per day.
* Budesonide: 800-1600 micrograms per day.
* Fluticasone: 500-1000 micrograms per day.
* Mometasone: 400-800 micrograms per day.
3. High Dose:
* Beclometasone: More than 800 micrograms per day.
* Budesonide: More than 1600 micrograms per day.
* Fluticasone: More than 1000 micrograms per day.
* Mometasone: More than 800 micrograms per day.

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1 reply
zscline | @zscline | Aug 15 11:18am

This is quite informative, but do you know why a steroid inhaler would be prescribed for BE or other similar health issues? I wonder what the benefits are. I will check with my Pulmonologist but thought I'd ask here, since you seem to know quite a bit about this. Thank you.

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1 reply
scoop | @scoop | Aug 15 12:23pm
In reply to @zscline "This is quite informative, but do you know why a steroid inhaler would be prescribed for..." + (show)
@zscline

This is quite informative, but do you know why a steroid inhaler would be prescribed for BE or other similar health issues? I wonder what the benefits are. I will check with my Pulmonologist but thought I'd ask here, since you seem to know quite a bit about this. Thank you.

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Steroid inhalers are usually prescribed for asthma or COPD, not generally for bronchiectasis only. The benefits are that steroid inhalers reduce inflammation caused by asthma/COPD.
https://static.vecteezy.com/system/resources/previews/003/244/384/original/asthma-diagram-with-normal-lung-and-asthmatic-lung-free-vector.jpg

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1 reply
zscline | @zscline | Aug 15 1:16pm
In reply to @scoop "Steroid inhalers are usually prescribed for asthma or COPD, not generally for bronchiectasis only. The benefits..." + (show)
@scoop

Steroid inhalers are usually prescribed for asthma or COPD, not generally for bronchiectasis only. The benefits are that steroid inhalers reduce inflammation caused by asthma/COPD.
https://static.vecteezy.com/system/resources/previews/003/244/384/original/asthma-diagram-with-normal-lung-and-asthmatic-lung-free-vector.jpg

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Interesting. Thank you. I feel like sometimes the doctors are sort of throwing darts at the problem trying to see what works and what doesn't.

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suzyqueue | @suzyqueue | Aug 16 7:29am
In reply to @pacathy "Answering one of questions- Symbicort (has steroid) is not the same as albuterol (bronchodilator). Often both..." + (show)
@pacathy

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.

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My team of doctors state that oral steroids are what is used cautiously. The inhaled one's are safe.

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1 reply
manorhill22 | @manorhill22 | Aug 18 1:17pm
In reply to @sueinmn "@zscline Please contact your doctor now and let them know you are struggling. When you have..." + (show)
@sueinmn

@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.

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Sue
You are a wealth of information. I am relatively new to this disease and treatment.

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narelled23 | @narelled23 | Aug 18 8:01pm
In reply to @scoop "Steroids reduce the activity of immune cells in the airways making lungs more susceptible to disease...." + (show)
@scoop

Steroids reduce the activity of immune cells in the airways making lungs more susceptible to disease. They also affect the production and function of mucus in airways. I think because of these things it makes it more difficult to fight off infections such as MAC/NTM etc. Some of us have asthma and have little choice when it comes to inhaling corticosteroids for inflammation.

This is what the internet says about low, medium and high levels of steroid inhalers:
1. Low Dose:
* Beclometasone: Up to 200-400 micrograms per day.
* Budesonide: Up to 400-800 micrograms per day.
* Fluticasone: Up to 200-500 micrograms per day.
* Mometasone: Up to 200-400 micrograms per day.
2. Medium Dose:
* Beclometasone: 400-800 micrograms per day.
* Budesonide: 800-1600 micrograms per day.
* Fluticasone: 500-1000 micrograms per day.
* Mometasone: 400-800 micrograms per day.
3. High Dose:
* Beclometasone: More than 800 micrograms per day.
* Budesonide: More than 1600 micrograms per day.
* Fluticasone: More than 1000 micrograms per day.
* Mometasone: More than 800 micrograms per day.

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Thank you very much, Scoop. Great information there.

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zscline | @zscline | Aug 19 11:33am
In reply to @suzyqueue "My team of doctors state that oral steroids are what is used cautiously. The inhaled one's..." + (show)
@suzyqueue

My team of doctors state that oral steroids are what is used cautiously. The inhaled one's are safe.

Jump to this post

I will ask my doc when I go in to see him tomorrow. I thought that my inhaler says that it's a steroid but maybe not or maybe it's a low dose. I just don't know, and it does concern me when taking it over a long period of time.

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suzyqueue | @suzyqueue | Aug 19 11:40am

Your inhaler probably is a steroid which is fine. Its the oral pills or IV of steroids that aren't good for constant use

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