Yes, in a recent webinar, she said to use the Albuterol (or Levalbuterol) to open the airways first, then do the nebulizing of saline. She also said it's more effective to do nebulizing first and then vest and Aerobika afterward, much to the dismay of a lot of people in my support group because of time constraints. It makes sense with a traditional vest particularly because it is squeezing the airways and working against getting the saline into them to wet them down to allow you to clear the mucus.

But something she said in that same webinar is one of the reasons I've continued with Albuterol, even though my PEF didn't change with it when tested at NJH. She said that NTMs like to hang out in the very small airways at the ends. Yikes. I was first prescribed Albuterol when I got my Monarch vest about three years ago and have used it since. Of course when I was on Arikayce, it was recommended to continue it to avoid bronchospasms. My pulmonologist and I discussed my continuing or stopping it when I saw him last week, and since I tolerate the Albuterol well, I will continue to use it for now. Been off all meds since June and so far so good!