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@poodledoc

@lorifilipek You make a good point and it did make me wonder a bit if the results could have been skewed to show PulmoSal killed the bacteria better to better sell their product. For me it's all about the acidity. In the early stages of my coughing history I was diagnosed with LPR (laryngopharyngeal reflux) or Upper Airway Reflux as the reflux can actually get down into your bronchi. Long story there but I got that under control with lifestyle changes. But I believe the damage to my airways from that reflux caused my bronchiectasis, I believe then I got NTM/MAC which made the BE even worse.
Reflux consists mainly of HCl (acid) and pepsin. It has been shown that pepsin is the really bad player in LPR as it is the enzyme that breaks down protein in your stomach. Pepsin has the ability to attach itself to tissue such as the delicate lining of your airways for a long time until it is activated by anything acidic in nature, at which point it starts to eat away at the lining of your airways causing damage. So I want to always make sure I am not inhaling anything acidic into my lungs. I used a pH strip to compare the acidity of PulmoSal (the pH was about 7) vs HyperSal (the pH was about 6). On the pH scale a 6 is 10X more acidic than 7.

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Replies to "@lorifilipek You make a good point and it did make me wonder a bit if the..."

Thank you so much. What are you using now? You once told me I can get it from Sam's club, right? After reading your post, I think I might have damaged lining of my airways. I also lay flat on my back and do deep breathing, so that the mucus moves up and cough up. I think the lining of my airways got damage while mucus are moving up due to its acidity. My airways are very dry now and it is worst in the mornings. Please advise me again on the saline you use from Sams club.

@poodledoc I agree that acid reflux is a problem. I’m not as convinced that the measured acidic pH of many 7% saline solutions is. I’m a retired aqueous environmental geochemist. (I dealt with water quality issues, especially acid and metal laden waters produced by mining companies.) The question is the buffering capacity of the saline solution. Sodium and chloride have no buffering effect because salts of a strong acid (e.g. HCl) and a strong base (e.g. NaOH) have a neutral pH (pH 7). Distilled/deionized water in equilibrium with atmospheric carbon dioxide (a weak acid—H2CO3) has a pH of about 5.5, which is most likely why some hypersaline solutions have that pH. I’d need to know how well buffered the various saline solutions are, as well as how buffered our lungs are. If water is purged with an inert gas, such as nitrogen, the pH would rise to pH 7. However, it would have no buffering capacity when exposed to air.
Some articles suggest that PulmoSal is buffered with bicarbonate. However, I cannot find that info on the PharmaCaribe website itself. Depending on how PulmoSal is buffered, it’s possible that the nebulization process, pumping compressed air at atmospheric CO2 concentration to make fine particles, might lower its pH before it gets to the lungs. Perhaps you could do an experiment by using your pH paper with nebulized PulmoSal, say, at the end of your nebulization(?). (I don't have PulmoSal, so I can't try it myself.)