1. < MAC & Bronchiectasis

Confused about saline

Posted by AZ @equanimous, Apr 11, 2023

I was diagnosed with bronchiectasis and MAC and am relatively new to this whole battle. I have a constant cough which is much worse at night but no shortness of breath. The mucus I cough up is pretty thin. I have ordered a wedge to elevate my upper body at night and am praying it will help. I was also told I am allergic to dust mites. My nasal drip is pretty bad at times. I am taking an antihistamine.

I repeatedly see mention of 7% saline nebulizer treatment. Does this help with controlling the MAC bacteria and curbing cough? I have asked my pulmonologist about saline with this response: "I don't generally use 7% saline. I use mucomsyt mixed with albuterol to thin the mucus, along with the vest. If this does not work, then I use dornase. "
I am not asking for medical advise but am curious to get your take on this.

At the present time I am using the compression vest 2x per day.
I have a Rx for Albuterol Sulfate, 0.083% for nebulizer. A respiratory therapist (who taught me how to use the compression vest) who said it would not help with cough and she did not think it was necessary.

I am confused and trying to keep the faith that I will find what works. I appreciate your feedback.

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bee1950 | @bee1950 | Apr 19, 2023
In reply to @sueinmn "@sallyb827 Sally, You asked "How long does it take for you to nebulize 7 ml of..." + (show)
@sueinmn

@sallyb827 Sally,
You asked "How long does it take for you to nebulize 7 ml of 3% sodium chloride with the Pari ProNeb and the cups that you use and shared with me. I find it is taking me about 19 to 20 minutes. How much chloride solution do you neb at one time, 15 ml or 7 ml?"

I decided to answer in this discussion because the topic is of interest to many members.

I neb 3-4 ml of saline - usually 7%, but sometimes 3% if my lungs are sensitive. 7-15 ml is a lot to neb in one session. I was using the Innospire Go and it took 5 minutes, but that died. When using my DeVilbiss Traveler, it takes roughly 8 minutes, a little longer if I stop to cough.

PS When I could only get 7, 10 or 15 ml vials, I would open it carefully, pour out enough for one session, press the little cap back on & store it upright in the refrigerator to use for the next session. The RT told me as long as I was careful to keep it clean & use up within 24 hours, this is safe.

Can anyone tell Sally hw long this takes with their nebulizer?

Sue

Jump to this post

Hi Sally,
I regularly use the Pari Vios (Go Green) compressor with Pari neb cups. It is loud but reliable & takes about 10 minutes using 4 ml vials. I also have an Innospire Go for travel & like Sue that takes about 5-6 minutes. I recently bought the Pari Trek S as a backup for travel & my one & only use took about 10 minutes. I use 7% sodium chloride but originally used 3% that came in 15 ml vials. At the time I didn’t know there were smaller vials so I just did my best to fill the cup with 4ml. I hope the above is helpful. Take care.
Linda

REPLY
scoop | @scoop | Apr 20, 2023
In reply to @sueinmn "@sallyb827 Sally, You asked "How long does it take for you to nebulize 7 ml of..." + (show)
@sueinmn

@sallyb827 Sally,
You asked "How long does it take for you to nebulize 7 ml of 3% sodium chloride with the Pari ProNeb and the cups that you use and shared with me. I find it is taking me about 19 to 20 minutes. How much chloride solution do you neb at one time, 15 ml or 7 ml?"

I decided to answer in this discussion because the topic is of interest to many members.

I neb 3-4 ml of saline - usually 7%, but sometimes 3% if my lungs are sensitive. 7-15 ml is a lot to neb in one session. I was using the Innospire Go and it took 5 minutes, but that died. When using my DeVilbiss Traveler, it takes roughly 8 minutes, a little longer if I stop to cough.

PS When I could only get 7, 10 or 15 ml vials, I would open it carefully, pour out enough for one session, press the little cap back on & store it upright in the refrigerator to use for the next session. The RT told me as long as I was careful to keep it clean & use up within 24 hours, this is safe.

Can anyone tell Sally hw long this takes with their nebulizer?

Sue

Jump to this post

Sue, You mentioned "I was using the Innospire Go and it took 5 minutes, but that died. " Question: have you cleaned the gold/brass colored contacts on the hand held piece with an alcohol pad? And boiled the mouthpiece for 10 minutes? The saline/salt builds up on the contacts and prevents the hand held piece from making a connection with the mouthpiece. Philips discontinued this neb workhorse because these devices stopped working. People returned them under warranty when simple maintenance (alcohol swab and boiling) but the company never asked users to try this. I realize the mouthpiece is supposed to be replaced every year according to Philips but if it's properly maintained I believe it should last longer.

The only decent alternative I have found is the PARI eRapid https://nebology.com/products/pari-erapid-nebulizer-system-with-eflow-technology . Pricey but fast and reliable. It's been out since 2013 so tried and true. There's a new model in Europe with a built in mesh cleaner but not yet available in US. The US one has a separate mesh head cleaner. From what I understand one can neb saline, albuterol, abx.

This post is redundant possibly but since clearance is cornerstone of BE, the nebulizer/compressor is a vital tool in daily maintenance. It's frustrating to me that with the amount of lung disease out there, along with covid, that there aren't more efficient devices and cleaning methods. Personally, I'd like to see an autoclave/sterilizer for nebulizers only and not have to resort to makeshift methods (for baby bottles, boiling on stove etc).

REPLY
1 reply
mwturner | @mwturner | Apr 20, 2023
In reply to @sueinmn "@sallyb827 Sally, You asked "How long does it take for you to nebulize 7 ml of..." + (show)
@sueinmn

@sallyb827 Sally,
You asked "How long does it take for you to nebulize 7 ml of 3% sodium chloride with the Pari ProNeb and the cups that you use and shared with me. I find it is taking me about 19 to 20 minutes. How much chloride solution do you neb at one time, 15 ml or 7 ml?"

I decided to answer in this discussion because the topic is of interest to many members.

I neb 3-4 ml of saline - usually 7%, but sometimes 3% if my lungs are sensitive. 7-15 ml is a lot to neb in one session. I was using the Innospire Go and it took 5 minutes, but that died. When using my DeVilbiss Traveler, it takes roughly 8 minutes, a little longer if I stop to cough.

PS When I could only get 7, 10 or 15 ml vials, I would open it carefully, pour out enough for one session, press the little cap back on & store it upright in the refrigerator to use for the next session. The RT told me as long as I was careful to keep it clean & use up within 24 hours, this is safe.

Can anyone tell Sally hw long this takes with their nebulizer?

Sue

Jump to this post

I use AeroEclipse and Aerobika with 4ml 7% saline and it takes about 1/2 hour.

REPLY
Mentor
Sue, Volunteer Mentor | @sueinmn | Apr 20, 2023
In reply to @scoop "Sue, You mentioned "I was using the Innospire Go and it took 5 minutes, but that..." + (show)
@scoop

Sue, You mentioned "I was using the Innospire Go and it took 5 minutes, but that died. " Question: have you cleaned the gold/brass colored contacts on the hand held piece with an alcohol pad? And boiled the mouthpiece for 10 minutes? The saline/salt builds up on the contacts and prevents the hand held piece from making a connection with the mouthpiece. Philips discontinued this neb workhorse because these devices stopped working. People returned them under warranty when simple maintenance (alcohol swab and boiling) but the company never asked users to try this. I realize the mouthpiece is supposed to be replaced every year according to Philips but if it's properly maintained I believe it should last longer.

The only decent alternative I have found is the PARI eRapid https://nebology.com/products/pari-erapid-nebulizer-system-with-eflow-technology . Pricey but fast and reliable. It's been out since 2013 so tried and true. There's a new model in Europe with a built in mesh cleaner but not yet available in US. The US one has a separate mesh head cleaner. From what I understand one can neb saline, albuterol, abx.

This post is redundant possibly but since clearance is cornerstone of BE, the nebulizer/compressor is a vital tool in daily maintenance. It's frustrating to me that with the amount of lung disease out there, along with covid, that there aren't more efficient devices and cleaning methods. Personally, I'd like to see an autoclave/sterilizer for nebulizers only and not have to resort to makeshift methods (for baby bottles, boiling on stove etc).

Jump to this post

I tried boiling, but not cleaning the contacts - I'll gladly give it another try! And I'll report back on whether it works.
Thanks, Sue

REPLY
yogima | @yogima | May 15, 2023
In reply to @miloandlisa "I use 7% saline solution. It helps to keep the bacteria count down. I use it..." + (show)
@miloandlisa

I use 7% saline solution. It helps to keep the bacteria count down. I use it twice a day.

Jump to this post

How many ml of saline do you use. I’ve been doing 4 ml but Amazon only sell 5 ml dosages.

REPLY
1 reply
candifitz | @candifitz | May 16, 2023
In reply to @yogima "How many ml of saline do you use. I’ve been doing 4 ml but Amazon only..." + (show)
@yogima

How many ml of saline do you use. I’ve been doing 4 ml but Amazon only sell 5 ml dosages.

Jump to this post

For most of the past year I would nebulize 4ml ($70 for 60 vials) and then I found the 5 ml vials ($35 for 50) and I have discovered that I have way more mucus clearance with 5 ml than I did with 4.

REPLY
suethenanny | @suethenanny | May 17, 2023

The amount of saline is neither here nor there, if you accidentally put 10mls in, you would just nebulise for 20 minutes or whatever your normal routine would be, so it's not necessarily the amount but the time nebulising. The saline is used to loosen mucus to make it easier to bring up, however, it also is regarded as lung hygiene, so just like cleaning your teeth every day, airway clearance every day will keep your lungs the best they can be and using saline is like keeping them clean. But that's my humble opinion and I'm on the "Big 3" for MAC, I don't produce much and my bronchiectasis is stable, so we all differ. If you've got an NTM specialist doctor, they will know the best for you. I wish you well.

REPLY
healthybon | @healthybon | Jul 10, 2023

I just got back from National Jewish Health. I got a wrap, which is similar to the vest. I started using it today while I nebulize. 2 times per day. NJH told me it will shake up the plugs and debris and stuff in the lungs, so it will come out over time.

REPLY
kathleenlp | @kathleenlp | Jul 17, 2023

Hi Arlo
This is a late response but I wanted to chime in...this forum has been SO helpful to me with the wonderful, knowledgeable folks like Sue and others. I have MAC(untreated), Aspergillus and bronchiectasis.
I discovered the saline here and it has been a huge game changer for me. Since using it at least a year I have had a CT and that showed actual improvement and "resolved" areas. Unexpected by all the docs. I also think it helps keep you healthy and less likely to catch infections. Add the lavage to that!! same, same.......sometimes I even do extra sessions if around a crowd or someone who seemed like they were sick. 😎 My pharmacy always has some "coupon" and it is very inexpensive. I do the 7% 2X daily, cough, clear mucus but not much random coughing during the day, none at night. Good luck and blessings!

REPLY
1 reply
AZ | @equanimous | Jul 17, 2023
In reply to @kathleenlp "Hi Arlo This is a late response but I wanted to chime in...this forum has been..." + (show)
@kathleenlp

Hi Arlo
This is a late response but I wanted to chime in...this forum has been SO helpful to me with the wonderful, knowledgeable folks like Sue and others. I have MAC(untreated), Aspergillus and bronchiectasis.
I discovered the saline here and it has been a huge game changer for me. Since using it at least a year I have had a CT and that showed actual improvement and "resolved" areas. Unexpected by all the docs. I also think it helps keep you healthy and less likely to catch infections. Add the lavage to that!! same, same.......sometimes I even do extra sessions if around a crowd or someone who seemed like they were sick. 😎 My pharmacy always has some "coupon" and it is very inexpensive. I do the 7% 2X daily, cough, clear mucus but not much random coughing during the day, none at night. Good luck and blessings!

Jump to this post

Hi Kathleen, Thank you for your post. I have been using 7% saline which I took upon myself to purchase from Amazon, thanks to a kind soul sharing this info with our group. I really feel it is helping me a lot. I nebulize with the Aerobika 2x per day and then do 20 minutes with my Hillrom compression vest. Every time I neb, I cough up a good amount of mucus. I am now able to sleep through the night with very little coughing. I can see a marked difference since using the 7%. Good luck to you as well!

REPLY
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