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Have you decreased Airway Clearance from 2 down to 1 a day?

Posted by pjas972j @pjas972j, Apr 9 6:00pm

I have had Bronchiectasis and mucoid pseudomonas for 15 years. After multiple PICC lines, I learned about ACTs 5 years ago from NJH, where I went when MAC was found after a bronchoscopy. I apparently cleared the MAC. NJH put me on inhaled Tobramycin for 18 months then switched me to Colistin because of Toby’s side effects. I have not had any exacerbations for almost three years.
I started Brinsupri in November 2025. At my follow up with Dr. Griffith at NJH, my CT scan was stable, my lungs are less inflamed, and my bloodwork shows less inflammation. All good news.
I have been feeling the burden of all the nebulizing, self- care, restrictions, etc. that is common to us all. I surprised myself when I started crying as I explained how 5 years of twice a day airway clearance has worn me out.
Dr. Griffith said that chronic illness burden is real. He suggested that I go down to once a day doing my airway clearance routine. He said I am stable enough and the Brinsupri should help me stay that way.
I’m excited to think I can nebulize in the morning and not have to schedule my day around a second session. So, why do I feel scared? I’m nervous that once a day won’t keep me healthy and I don’t want to go back to being as sick as I was when all this started. I know I can always add in a nebbing session if I feel something coming on. Have any or you faced this? What tips can you give me for going down to once a day?
Many thanks!!

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scoop | @scoop | Apr 14 11:41am
In reply to @sheila7a "I decided to do airway clearance once a day because of severe jaw pain on left..." + (show)
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I decided to do airway clearance once a day because of severe jaw pain on left side.
Dentist recommended that I see a TMD professional.
I noticed my jaw always hurt after clearance so now I only do in morning.
The pain was terrible.
Now I can eat a sandwich, a slice of pizza.
My Pulmonologist didn't seem concerned about my decision.
He did recommend I take a puff of albuterol before exercise.
The pain was constant.
Ice packs, Tylenol, crying.

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@sheila7a
Insult to injury, right! I developed jaw pain (TJM) after dental work, an inlay. It changed my bite just a smidge, my brain detected it, and I began to clench during sleep. At least, that's the theory. As Sue mentioned hold the nebulizer with your hand not your jaw. Applying Volatren on jaw before sleep helps a lot. Also, I acquired a mouth guard for sleep from dentist at great expense but figured it was worth it in the long run. Apparently, the ones from the drugstore can make it worse. Good luck.

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tte | @tte | Apr 14 11:57am

@pjas972j , I love that quote! "Chronic illness burden is real". Thanks for sharing

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pjas972j | @pjas972j | Apr 14 3:33pm
In reply to @dispatchpat "Very interesting conversation. Thanks for bringing it up! Pun intended… With very slight bronchiectasis disease and..." + (show)
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Very interesting conversation. Thanks for bringing it up! Pun intended… With very slight bronchiectasis disease and slight to nonexistent NTMs , my most burdensome affliction is submucosal gland hyperplasia! Now I'm betwixt and between pulmonary specialists. No problem simply huffing out mucus in my morning pulmonary hygiene. Added Anoro and mucus just glides out. Prayers up and, touch wood, I am experimenting with no nebulization for a few months before my next round of pulmonary function tests, CT scans, another Sputum sample is in the works. Inflammation I think is the driving force behind changing the architecture in my lungs and I am wondering if irritating it for 2 1/2 years with saline and way too forceful huff coughing might have driven some of that inflammation…. Living with hope

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@dispatchpat
What is Anoro?
Thanks!

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2 replies
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sheila7a | @sheila7a | Apr 14 9:04pm

I hold nebulizer with hand.
When I first started I really bit down on mouthpiece.
Now I try to relax and concentrate on breathing.
After reading up on TMD I gave up chewing gum.
Same with aerobika I try not to bite down on it to hard.

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toni4501 | @toni4501 | Apr 15 11:23am
In reply to @pjas972j "@dispatchpat What is Anoro? Thanks!" + (show)
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@dispatchpat
What is Anoro?
Thanks!

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@pjas972j interesting theory! I was on a regime of levofloxacin and tobramycin for 30 days to try to clear pseudomonas. In addition, I was nebulizing with 3% saline and albuterol. During that time I was able to bring up a lot of mucus, all of which was bright lime green, and then turned to tan. But since I finished my antibiotic regime, I continued with nebulizing with the 3% saline and albuterol. Prior to that I was not nebulizing at all. I would just take a few puffs of my albuterol inhaler and then I would go put on my smart vest and do 220 minute Sessions and then do my lawn clearance and for the most part it worked pretty well. Now, doing the albuterol and saline nebulizing. I can’t get anything out whatsoever. I’m wondering if as your suggesting perhaps I have inflammation, which is stifling the removal of the mucus in my lungs. I thought perhaps she maybe everything‘s cleared out and I don’t have anything to bring up but after reading your post I’m thinking perhaps I’m delusional and everything stuck down there because of inflammation. I’ve gotta figure this out. Any suggestions?

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scoop | @scoop | Apr 15 1:06pm
In reply to @toni4501 "@pjas972j interesting theory! I was on a regime of levofloxacin and tobramycin for 30 days to..." + (show)
Profile picture for toni4501 @toni4501

@pjas972j interesting theory! I was on a regime of levofloxacin and tobramycin for 30 days to try to clear pseudomonas. In addition, I was nebulizing with 3% saline and albuterol. During that time I was able to bring up a lot of mucus, all of which was bright lime green, and then turned to tan. But since I finished my antibiotic regime, I continued with nebulizing with the 3% saline and albuterol. Prior to that I was not nebulizing at all. I would just take a few puffs of my albuterol inhaler and then I would go put on my smart vest and do 220 minute Sessions and then do my lawn clearance and for the most part it worked pretty well. Now, doing the albuterol and saline nebulizing. I can’t get anything out whatsoever. I’m wondering if as your suggesting perhaps I have inflammation, which is stifling the removal of the mucus in my lungs. I thought perhaps she maybe everything‘s cleared out and I don’t have anything to bring up but after reading your post I’m thinking perhaps I’m delusional and everything stuck down there because of inflammation. I’ve gotta figure this out. Any suggestions?

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@toni4501 Brinsupri?

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kathyjjb | @kathyjjb | Apr 15 1:51pm
In reply to @pjas972j "@dispatchpat What is Anoro? Thanks!" + (show)
Profile picture for pjas972j @pjas972j

@dispatchpat
What is Anoro?
Thanks!

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@pjas972j Anoro is a non steroidal bronchodilator. Funny you asked that. I get bronchospasms, though greatly reduced since starting brinsupri, I still need my Airsupra-but not daily. I don't like using the Airsupra due to the steroids, so I was thinking Anoro would help.

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crystalena | @crystalena | Apr 17 7:44am
In reply to @sueinmn "@crystalena Airway clearance is the process of using any of a combination of deep breathing, huff..." + (show)
Profile picture for Sue, Volunteer Mentor @sueinmn

@crystalena Airway clearance is the process of using any of a combination of deep breathing, huff coughing, postural drainage, mechanical devices and exercise to assist in expelling mucus from the airways.
Here is a long but excellent video describing how to do it.


After trying several techniques, most of us settle on one or two that work best for us.

If you are on oxygen, please talk to your doctor about whether to add saline nebs. You could also ask for a referral to pulmonary rehab to set up a good program for you.

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@sueinmn Thank you for your time, the information is very much appreciated. I have never used a nebulizer. I will try these methods , and like you suggest, I will see which works best for me . People like you make this site a valuable asset. Blessed Be , Crystalena
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toni4501 | @toni4501 | 4 days ago
In reply to @scoop "@toni4501 Brinsupri?" + (show)
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@toni4501 Brinsupri?

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@scoop I don’t know. I just can’t get anything out

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irenea8 | @irenea8 | 4 days ago
In reply to @toni4501 "@pjas972j interesting theory! I was on a regime of levofloxacin and tobramycin for 30 days to..." + (show)
Profile picture for toni4501 @toni4501

@pjas972j interesting theory! I was on a regime of levofloxacin and tobramycin for 30 days to try to clear pseudomonas. In addition, I was nebulizing with 3% saline and albuterol. During that time I was able to bring up a lot of mucus, all of which was bright lime green, and then turned to tan. But since I finished my antibiotic regime, I continued with nebulizing with the 3% saline and albuterol. Prior to that I was not nebulizing at all. I would just take a few puffs of my albuterol inhaler and then I would go put on my smart vest and do 220 minute Sessions and then do my lawn clearance and for the most part it worked pretty well. Now, doing the albuterol and saline nebulizing. I can’t get anything out whatsoever. I’m wondering if as your suggesting perhaps I have inflammation, which is stifling the removal of the mucus in my lungs. I thought perhaps she maybe everything‘s cleared out and I don’t have anything to bring up but after reading your post I’m thinking perhaps I’m delusional and everything stuck down there because of inflammation. I’ve gotta figure this out. Any suggestions?

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@toni4501
How are you feeling? If you feel ok then you probably just cleared up the infection for now and have no mucus to expel. If you do not feel well then you may have mucus that is not coming up and could try positions while you use the Aerobika.

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