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Confused about saline

Posted by AZ @equanimous, Apr 11, 2023

I was diagnosed with bronchiectasis and MAC and am relatively new to this whole battle. I have a constant cough which is much worse at night but no shortness of breath. The mucus I cough up is pretty thin. I have ordered a wedge to elevate my upper body at night and am praying it will help. I was also told I am allergic to dust mites. My nasal drip is pretty bad at times. I am taking an antihistamine.

I repeatedly see mention of 7% saline nebulizer treatment. Does this help with controlling the MAC bacteria and curbing cough? I have asked my pulmonologist about saline with this response: "I don't generally use 7% saline. I use mucomsyt mixed with albuterol to thin the mucus, along with the vest. If this does not work, then I use dornase. "
I am not asking for medical advise but am curious to get your take on this.

At the present time I am using the compression vest 2x per day.
I have a Rx for Albuterol Sulfate, 0.083% for nebulizer. A respiratory therapist (who taught me how to use the compression vest) who said it would not help with cough and she did not think it was necessary.

I am confused and trying to keep the faith that I will find what works. I appreciate your feedback.

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sweethighland | @sweethighland | Sep 12 2:50pm
In reply to @jlarray "Yes, I use the rubbery cups for tapping. I learned a routine with a respiratory therapist...." + (show)
@jlarray

Yes, I use the rubbery cups for tapping. I learned a routine with a respiratory therapist. I lie in different positions and tap different parts of my lungs and also use the aerobika while I'm in these positions. I go back and forth between the aerobika and the tapping and different breathing patterns. And then I huff cough

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Thank you for sharing your routine and techniques.

REPLY
sweethighland | @sweethighland | Sep 12 2:55pm
In reply to @jlarray "Initially (I've had NTM for about 15 years), I would try to do clearance first thing..." + (show)
@jlarray

Initially (I've had NTM for about 15 years), I would try to do clearance first thing when I got up and I would clear nothing. Eventually, I figured out that I could clear mucus if I did it later in the day (11 AM or later) after exercising. Also, I need to do the airway clearance routine for a long time (45+ minutes) in order for it to work and even then, sometimes there is nothing. My symptoms improved a lot from this routine (cough went away, more energy).

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Thank you. You have cleared NTM but doing these methods? I'm very much like you, nothing come up in the morning, only jelly like clear mucus but little. I produce around noon after nebulizing. Do you nebulize with saline and bronchodilators too?

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1 reply
irenea8 | @irenea8 | Sep 13 7:39am
In reply to @jlarray "Initially (I've had NTM for about 15 years), I would try to do clearance first thing..." + (show)
@jlarray

Initially (I've had NTM for about 15 years), I would try to do clearance first thing when I got up and I would clear nothing. Eventually, I figured out that I could clear mucus if I did it later in the day (11 AM or later) after exercising. Also, I need to do the airway clearance routine for a long time (45+ minutes) in order for it to work and even then, sometimes there is nothing. My symptoms improved a lot from this routine (cough went away, more energy).

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I also have to wait till around 10 am to start my nebulizing routine. The mucus is just not ready to clear otherwise. And I have to use two saline packets or 1.5. Then like you I use the aerobika in different positions starting with just sitting. The majority of my mucus comes up after lying head lower than body while using the aerobika.

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lilianna | @lilianna | Sep 13 9:13am

I wonder how you do the cupping- yourself or someone does it for you. I can’t think how to cup my back or even sides by myself. My husband does it with the resuscitation cup ( got the idea from a pulmonary therapist) I do not see difference in my ability to remove any mucus and my husband is impatient. It seems our life is about me all the time and sometimes both of us are tired of this lifestyle. So I regularly use levalbuterol, then nebulize with sodium chloride, then come a vest with aerobika and finally ACB. And I only hope it protects me because I cannot produce sputum and my huff cough is dry. Today I tried exercising and walking before airway clearance but it looks I am even more dry. It’s so different for everybody.

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 13 9:54am
In reply to @lilianna "I wonder how you do the cupping- yourself or someone does it for you. I can’t..." + (show)
@lilianna

I wonder how you do the cupping- yourself or someone does it for you. I can’t think how to cup my back or even sides by myself. My husband does it with the resuscitation cup ( got the idea from a pulmonary therapist) I do not see difference in my ability to remove any mucus and my husband is impatient. It seems our life is about me all the time and sometimes both of us are tired of this lifestyle. So I regularly use levalbuterol, then nebulize with sodium chloride, then come a vest with aerobika and finally ACB. And I only hope it protects me because I cannot produce sputum and my huff cough is dry. Today I tried exercising and walking before airway clearance but it looks I am even more dry. It’s so different for everybody.

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"You cannot force what isn't there" - words from my crusty old pulmonologist over 6 years ago. Some people have "dry bronchiectasis" and produce very little mucus.

Early on in my MAC days, I tried to clear every last bit out of my lungs - ended up with sore ribs and throat. When I saw the RT, she explained that keeping everything moving is the point, not getting every drop out. She told me trying too hard can irritate the lungs and actually produce even more mucus. She recommended stopping "as soon as the flow slows down" but not doing the airway clearance any longer than 30 minutes.

These days I neb or exercise, use the Aerobika, then try huff coughing and deep breathing for 6-8 minutes. If nothing comes out by that point, it isn't going to. Sometimes, later in the day, I can feel stuff moving and do the breathing and coughing again to get a little out. This method has kept me healthy for almost 5 years.

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1 reply
lilianna | @lilianna | Sep 13 10:27am
In reply to @sueinmn ""You cannot force what isn't there" - words from my crusty old pulmonologist over 6 years..." + (show)
@sueinmn

"You cannot force what isn't there" - words from my crusty old pulmonologist over 6 years ago. Some people have "dry bronchiectasis" and produce very little mucus.

Early on in my MAC days, I tried to clear every last bit out of my lungs - ended up with sore ribs and throat. When I saw the RT, she explained that keeping everything moving is the point, not getting every drop out. She told me trying too hard can irritate the lungs and actually produce even more mucus. She recommended stopping "as soon as the flow slows down" but not doing the airway clearance any longer than 30 minutes.

These days I neb or exercise, use the Aerobika, then try huff coughing and deep breathing for 6-8 minutes. If nothing comes out by that point, it isn't going to. Sometimes, later in the day, I can feel stuff moving and do the breathing and coughing again to get a little out. This method has kept me healthy for almost 5 years.

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Thank you Sue for your voice of reason.

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jlarray | @jlarray | Sep 13 10:36am

First I nebulize 7% saline while sitting.
Then I lie on my back on a flat surface. I alternate 30 seconds of tapping the front of my chest with 30 seconds of breathing out of the aerobika (for me this is 3 outbreaths). I repeat this three times and then I breathe in (no aerobika) where I sip in more breath three times as if with a straw and hold it for a few seconds and blow it all out very slowly through pursed lips. Then I breathe in again where I sip in like before and hold briefly. And then I immediately huff cough. I think that is what they call it, it's kind of like lion's breath in yoga, if you are familiar with that. Then I relax and breathe quietly for 1 minute. Then I cough, a regular cough. Then I repeat again in this position
Then I do the same thing lying on my left at an incline, about 30 degrees with my head lower than my body. I tap the front right side of my chest and alternate it with aerobika, etc, as explained above. Then, still on my left side, I tip slightly forward, my left elbow propped on a pillow so that I can reach and tap my back right side. This is a bit hard to reach. I do the exact same alternating patterns as described above, then repeat on the right side what I did on the left.
If I feel like something is stuck I might just stay lying in one of the inclined positions and do nothing but wait until I have something to cough up.

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jlarray | @jlarray | Sep 13 10:41am
In reply to @sweethighland "Thank you. You have cleared NTM but doing these methods? I'm very much like you, nothing..." + (show)
@sweethighland

Thank you. You have cleared NTM but doing these methods? I'm very much like you, nothing come up in the morning, only jelly like clear mucus but little. I produce around noon after nebulizing. Do you nebulize with saline and bronchodilators too?

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I have not cleared my NTM, it is very much there. Drugs haven't worked for me. I don't use bronchodilators, just saline.

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1 reply
sweethighland | @sweethighland | Sep 13 3:06pm
In reply to @jlarray "I have not cleared my NTM, it is very much there. Drugs haven't worked for me...." + (show)
@jlarray

I have not cleared my NTM, it is very much there. Drugs haven't worked for me. I don't use bronchodilators, just saline.

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Thank you for your response. Glad that airway clearance is working out for you.

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kgggg | @kgggg | Sep 14 9:40am

The fewer drugs, the better. Saline 7% one time a day. On this for less than a year and having good results. Anyone have any negative long-term effects from saline?

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