Albuterol to open airways

You really need to try a few different things to see what works for you.

How about telling your doctor that since bronchiectasis is a heterogeneous disease it's necessary to figure out what works for you. Send doctor a link to Dr. McShane's talk. Tell him that the experts in the filled recommend it. Put in a request for a script for hypertonic saline into the portal. Keep asking. Good luck.

I was treated at NJH and Mayo. Both places stressed how important it is to nebulize everyday with hypertonic saline solution.

If your doctor doesn’t recommend saline, he or she is not a bronchiectasis expert. To advocate for yourself, you might want to request a three month trial with .9 isotonic saline. Isotonic saline is the same salt level as our bodily fluids -tears, blood -so it would be a conservative approach and I find it difficult to believe that a pulmonologist would push back on it.

I’ve heard that there is an overuse of albuterol in our community. Just because one person is using it doesn’t mean everyone else should. A very experienced respiratory therapist told me that people usually know when they need it. They have tightness in their chest. However, the gold standard is when you have your Pulmonary Function Tests, first have them without albuterol and then with albuterol. If there is a substantial improvement with the albuterol then perhaps it’s worth using.

There are side effects with albuterol and levalbuterol, including jitteriness and the possibility of reflux from relaxing the LES, the lower esophageal sphincter.

In the meantime, depending on what’s available in your community, you might want to try to find someone who understands BE well and regularly attends PE and NTM conferences.

The good news is that over the next three years the COPD foundation along with NTM Info & Research will be certifying centers throughout the US. In this first round of certifications, 33 centers were approved. The goal is to reach 150. So, if there isn’t an expert available in your community now, there might be in the near future. However, in the meantime, you might think about going to one of the centers.

Remember… Never change your current care without first discussing it with your medical team.

I hope this is helpful,
Linda Esposito

I am one of the patients that developed breathing symptoms when I was doing Sprint Triathlons (swim portion). I went to PCP. PCP ordered CT and saw some areas of concern and referred me to Pulmonology.

Pulmonology had me do a very extensive pulmonology exam. Nothing came back. Saw first pulmonologist and quite frankly not much advise. So went back to PCP and said try Atrovent. Atrovent actually made is worse. So my other doctors said try albuterol. This seem to help some but did not stop it.

Then PCP said try Advair. This seemed to really help but was an ongoing every day treatment that I was concerned with as contains a steroid powder.

So back to another appt. with pulmonolgist (different one). This pumonolgist said my lungs and physical condition were good. However was quite frankly the test they do cannot specifically always determine if you have asthma or other disease as you cannot duplicate the same triggers. I was given 3 different mists to breathe in that represent the normal triggers but does not duplicate what your actually triggers are.

This pulmonolgist said use albuterol prior to race and not the daily advair. So you can see I have been all over the treatment scene. I have not had a sprint triathlon yet to see if the albuterol will work. Personally, and it just my opinion not a medical diagnosis, is that I have a psychological response to the swimming portion as you are over your head in water and I freeze up. The reason I say this is that I can swim a mile in a lap pool without incident.

In the past I had no issues at sprint triathons during the swim. I got injured sliding off a dock into water tearing up the back of my legs and was the first time I had the breathing problem and could not finish swim. So I think that epiosode started the trigger and the swim triggered that reaction again

Thus you can see why the pulmonary test I was given could not duplicate the trigger. I think important for all with breathing problems to try and see what triggers them and the try to address them with the medical help of your medical providers.

We’re all different. Some have asthma, some don’t. Some have MAC or other infections, some don’t. Some produce a lot of mucus, others rarely do. The severity of bronchiectasis varies, some with mild and some severe. I believe that’s why we often get different advice.
I have mild bronchiectasis with very small amounts of mucus, but have trees-in-bud nodules, mucoid impactions, etc and was thought to have MaAC . I went to Mayo in March of 2023 and was started on albuterol nebs, postural drainage, Aerobika 2x/day and left on Stiolta (not typical and she said would prob change) for asthma until cultures were back. Had to be bronched to get specimen.

When the cultures were negative 6 weeks later, Mayo doc changed airway clearance to daily and stopped the postural drainage (I’d developed reflux.) I wasn’t bringing up anything and had no saline ordered. . She also changed inhaler to Advair.

I was finally able to get into Penn’s bronchiectasis clinic and doc left my clearance at 1x/day. (I try to do 2x/dayif sick.) He said I probable don’t get much out because I might not have a lot in there. Last month, he added hypertonic saline a few times/week this winter because I caught several viral illnesses from grandchildren last winter. We’re hoping the saline will decrease the frequency.

My point is that one routine doesn’t fit everyone’s needs and change as our needs change. It’s important to have a doc well versed in bronchiectasis who knows the treatments and can guide us in making our plan.

Would it be possible to list the 33 centers so far approved? Thank you.

The list will be available in December!

Njh respiratory therapist albuteral 10 minutes to open up airway then saline 10 minutes I am here now

Good luck at NJH! Here's hoping you get everything you need from your visit.

Linda, do you have a link that lists the 33 Centers currently certified?