I use 7%, he said 7% is more effective. I had a hard time to adjust to it. I think doing once a day helps. It takes me about 10 minutes. I use an Ombra compressor. Thanks, I am doing well.
@bayarea58 I think most of the research on hypertonic saline was done in cystic fibrosis patients. It seems for them the recommendation is 2x daily if they can tolerate it and one time/day if they can’t.
I’m new to hypertonic saline since last month. I only have bronchiectasis without recent positive culture. My pulmonologist from Penn’s Bronchiectasis Ctr (I trust a lot) suggested I start hypertonic saline a few times per week to see if it helps me have a better winter. I have young grandkids and caught every bug they had last year.
My impression from this and other forums is that if people have a lot of mucus, they do airway clearance 2x/day. Mayo suggested airway clearance with albuterol, aerobika and postural drainage 2x/day and walking 30” to me when I was initially diagnosed (March 2023) with bronchiectasis and thought to have MAC. Note-hypertonic saline wasn’t mentioned. When those cultures were negative and I wasn’t producing sputum, the Mayo doc approved cutting the regime to daily.
When I finally got in to current pulmonologist in August, 2023, he agreed daily was OK and as I said, just last month suggested adding the hypertonic saline. I had stopped postural drainage due to reflux. If I start producing mucus. I’d increase to 2x/day because the studies I’ve found so far (brief searches) were on 2x/day , but done on CF patients.
Thank you for your feedback. I do not have any sensation of mucus, though my CT shows mucus impaction, so one’s sense of mucus and the need for airway clearance doesn't seem to directly correlate. I was recently diagnosed with an MAI infection (at same time as BE) and doing some more workup testing before I make a decision on the antibiotics. In the meantime, I want to get my ducks in a row on AC and environmental “hygiene”. I was curious if having an active infection was what supported 2x a day, as opposed to just daily hygiene with BE, regardless of mucus production. I am largely asymptomatic and produce very little sputum when I do airway clearance (with albuterol, vest, breathing techniques, Aerobika). But was thinking 2x daily might improve the anti microbial impact of the 7% saline. Just not sure if there is any science to support my thinking or if more than once a day is unnecessary. It is a lot of time to do 2x a day but hopefully I will get more efficient with AC all over time.
Thank you for your feedback. I do not have any sensation of mucus, though my CT shows mucus impaction, so one’s sense of mucus and the need for airway clearance doesn't seem to directly correlate. I was recently diagnosed with an MAI infection (at same time as BE) and doing some more workup testing before I make a decision on the antibiotics. In the meantime, I want to get my ducks in a row on AC and environmental “hygiene”. I was curious if having an active infection was what supported 2x a day, as opposed to just daily hygiene with BE, regardless of mucus production. I am largely asymptomatic and produce very little sputum when I do airway clearance (with albuterol, vest, breathing techniques, Aerobika). But was thinking 2x daily might improve the anti microbial impact of the 7% saline. Just not sure if there is any science to support my thinking or if more than once a day is unnecessary. It is a lot of time to do 2x a day but hopefully I will get more efficient with AC all over time.
You are doing a lot and that will benefit you. Since my tests were negative and I rarely get anything up, I haven’t discussed this with my Penn doc (who I’d trust for advice).
I tried searching (not extensive) for how long hypertonic saline stays in lungs after doc suggested a few days a week, but it looks like it rapidly decreases over 6 hours. Sue has mention coughing salty sputum 24 hours later.
One thought would be an abbreviated session of saline and Autogenic drainage app/huff cough, but I don’t have evidence for that.
Hoping some with more experience chime in.
Met with pulmonary recently who reiterated the importance of twice a day airway clearance in mild+ bronchiectasis. The goal is to make it a habit so it's not optional. They also stressed that exercise does not replace actual airway clearance. Next time I'm in I will ask for reasoning behind 2x day. I suspect it has to do with functioning of the diseased lung; pockets fill up approx. every 12 hours and lungs benefit from clearing out those pockets and behave more like normal in between clearances.
I use 7%, he said 7% is more effective. I had a hard time to adjust to it. I think doing once a day helps. It takes me about 10 minutes. I use an Ombra compressor. Thanks, I am doing well.
Met with pulmonary recently who reiterated the importance of twice a day airway clearance in mild+ bronchiectasis. The goal is to make it a habit so it's not optional. They also stressed that exercise does not replace actual airway clearance. Next time I'm in I will ask for reasoning behind 2x day. I suspect it has to do with functioning of the diseased lung; pockets fill up approx. every 12 hours and lungs benefit from clearing out those pockets and behave more like normal in between clearances.
I gave e this answer on another discussion yesterday- different doctors, different protocols. Both my pulmonologist and Dr Pamela McShane, UT at Tyler accept exercise as an alternative to other airway clearance methods AS LONG AS EFFECTIVELY MINIMIZING OR ELIMINATING EXACERBATION and the CT is stable or improving. In other words, I only do other methods if I can't exercise or am ill. This kept me exacerbation-free for 22 months, even when I got Covid in September and cared for sick grandsons in October.
Met with pulmonary recently who reiterated the importance of twice a day airway clearance in mild+ bronchiectasis. The goal is to make it a habit so it's not optional. They also stressed that exercise does not replace actual airway clearance. Next time I'm in I will ask for reasoning behind 2x day. I suspect it has to do with functioning of the diseased lung; pockets fill up approx. every 12 hours and lungs benefit from clearing out those pockets and behave more like normal in between clearances.
I appreciated both of your comments on this topic because most days I'll do airway clearance 2x a day but some days I only do it once (using 7% HS). The CT scans are a bit difficult to understand because I've shown improvement in one area but slightly more BE in another with mucus impaction. I think more than anything 2x a day AC provides me with peace of mind that I'm doing my best.
Even with mild BE, I'm paranoid about its inevitable progression and hope to do everything possible to limit that. The one big area that I'm lacking on is consistent aerobic exercise. It's super hard for me to fit everything into my day as a working mom but I need to try to do it even if it's just 15 minutes.
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My ID doctor Kevin Winthrop at OHSU also recommends once a day.
Ling
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2 ReactionsLing, for how many minutes and what percent? Hope you are feeling better.
Hi sweethighland,
I use 7%, he said 7% is more effective. I had a hard time to adjust to it. I think doing once a day helps. It takes me about 10 minutes. I use an Ombra compressor. Thanks, I am doing well.
Ling
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2 ReactionsThank you for your feedback. I do not have any sensation of mucus, though my CT shows mucus impaction, so one’s sense of mucus and the need for airway clearance doesn't seem to directly correlate. I was recently diagnosed with an MAI infection (at same time as BE) and doing some more workup testing before I make a decision on the antibiotics. In the meantime, I want to get my ducks in a row on AC and environmental “hygiene”. I was curious if having an active infection was what supported 2x a day, as opposed to just daily hygiene with BE, regardless of mucus production. I am largely asymptomatic and produce very little sputum when I do airway clearance (with albuterol, vest, breathing techniques, Aerobika). But was thinking 2x daily might improve the anti microbial impact of the 7% saline. Just not sure if there is any science to support my thinking or if more than once a day is unnecessary. It is a lot of time to do 2x a day but hopefully I will get more efficient with AC all over time.
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1 ReactionYou are doing a lot and that will benefit you. Since my tests were negative and I rarely get anything up, I haven’t discussed this with my Penn doc (who I’d trust for advice).
I tried searching (not extensive) for how long hypertonic saline stays in lungs after doc suggested a few days a week, but it looks like it rapidly decreases over 6 hours. Sue has mention coughing salty sputum 24 hours later.
One thought would be an abbreviated session of saline and Autogenic drainage app/huff cough, but I don’t have evidence for that.
Hoping some with more experience chime in.
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3 ReactionsMy trainer told me to nebulize with saline and albuterol first to “open everything up”. Follow with Arikayce.
Met with pulmonary recently who reiterated the importance of twice a day airway clearance in mild+ bronchiectasis. The goal is to make it a habit so it's not optional. They also stressed that exercise does not replace actual airway clearance. Next time I'm in I will ask for reasoning behind 2x day. I suspect it has to do with functioning of the diseased lung; pockets fill up approx. every 12 hours and lungs benefit from clearing out those pockets and behave more like normal in between clearances.
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3 ReactionsThank you Ling.
I gave e this answer on another discussion yesterday- different doctors, different protocols. Both my pulmonologist and Dr Pamela McShane, UT at Tyler accept exercise as an alternative to other airway clearance methods AS LONG AS EFFECTIVELY MINIMIZING OR ELIMINATING EXACERBATION and the CT is stable or improving. In other words, I only do other methods if I can't exercise or am ill. This kept me exacerbation-free for 22 months, even when I got Covid in September and cared for sick grandsons in October.
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6 Reactions@scoop @sueinmn
I appreciated both of your comments on this topic because most days I'll do airway clearance 2x a day but some days I only do it once (using 7% HS). The CT scans are a bit difficult to understand because I've shown improvement in one area but slightly more BE in another with mucus impaction. I think more than anything 2x a day AC provides me with peace of mind that I'm doing my best.
Even with mild BE, I'm paranoid about its inevitable progression and hope to do everything possible to limit that. The one big area that I'm lacking on is consistent aerobic exercise. It's super hard for me to fit everything into my day as a working mom but I need to try to do it even if it's just 15 minutes.
Appreciate you both.
Kate
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3 Reactions