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