Cynthia, don't know if it works as well w/o albuterol, but I've never used it. It's never been mentioned by either of two pulmo docs I've seen over time. Don

Cynthia, your question pulled my "talkie cord", resulting in the following. This is a letter I just sent to a brother-in-law who also deals with lung problems, I think Bronch.

Like you I'm a customer of a pulmonologist. Also like you I'm noticing gradually increasing shortness of breath. Diagnosed with both bronchiecstasis as well as myco avium complex (MAC). For over two years I've been using a Respirtec Percussion Vest airway clearing device (aka my Thumper). I do it twice daily along with saline inhalation at the same time using a nebulizer. Currently using 4 ml. of a 7% strength saline. For most of the 2 plus years I've been at it, I was using a much weaker 0.09% strength simply because the pulmo doc started me on and, upon his departure, it's what his replacement continued. My naivete remained constant unitl I discovered the Mayo Clinic "Connect" discussion forums, one of which is focused on Bronch and Mac. There I discovered that saline is available in higher strengths to wit: 3% and 7%. I soon wrote a detailed letter to my Pulmo doc and he agreed with my rationale for Rx'ing the 7% concentration. The rationale: in addition to bringing up impressively more mucous, I've learned that the 7% solution is capable of actually killing bacterial lung infections.

I'm hoping my "beefed-up" regimen will result in something tangible like less frequent flare-ups; a flare-up being defined as beginning to run a fever (which makes me feel unmistakably sick) and enduring another round of antibiotic treatment to put things right at the presumed cost of decimating the microbial health of my gut. For the past many years I've not been able to get past the 5 month mark before I get the chills and sweats again, but I'm determined to improve that routine.

This experience over the past several months has impressed me with the virtue of educating myself about the vagaries of my ailments. I've found the Mayo Clinic forum very helpful in achieving a modicum of knowledge.

In Health, brudder

@cynthiajewell7 Hi Cynthia. I nebulize the albuterol first because it will open the airways to allow the saline to reach more places in the lungs.