3% sodium chloride solution and Albuterol vs 7% saline

Hi. Sue.
Thank you. How many puffs would be equivalent with albutirol (or in my case, levalbutirol) to a nebulizer? My pulmonologist (works mostly with CF patients, not as much non-CF bronchiectasis) put me on:
Symbacort 2 puffs twice a day;
Levalbutirol in neb once a day; lung clearing exercises twice a day.
She did not mention saline, which might be a red flag.
She also has a standing order for azithromycin for flare ups, which I am now learning is really frowned upon as those treating MAC/NTM (which I may or may not have now/mucus testing soon, but of course easily could have in the future) since it's only of the only effective tools they have for treating mac.
Thanks!

If you are using the Symbicort twice a day, I wonder if you need the albuterol at all? I use it too, and only add levalbuterol if I am wheezing or have an exacerbation.

Hmmm, are you near Mayo or NJH where you could find a bronchiectasis-wise doc?
Sue

Hi. I actually am holding off on the symbacort (taking Flovent, that the former pulmonologist- who said, "you have Bronchiectasis. Come back in 9 months for a follow up" (with no mention of lung clearing, or flare ups, or genetic testing, so he was quickly dismissed once I had done a teeny bit of research!). I have started the levalbutirol once a day by nebulizer and lung clearing with an Aerobika twice a day. Mostly just getting slightly thick spit up bit always still feel I stuff in my throat.
Reason I am holding off is that I do have an appt in boston this week. Not with one of the top BE people as they are booked months out (I am Maine). But with someone affiliated with a teaching hospital who works with adult CF patients but also with BE patients. I am waiting to see what he says, assuming it might be different to the guidance I have so far.
I do want to start on saline but with the asthma I want a little guidance as my airways are super-reactive and I also have vocal cord dysfunction.
I am am actually curious about the bronchiectasis treatment centers. I keep hearing there are "about 10 in the country and that they are almost all tied to universities and/or research centers." Which would these be, besides Mayo and NJH?

Thank you!

I saw on one comment about using a spacer - what is a spacer?

I agree with what’s been said. The 7% saline helps me clear more easily than the 3% and the albuterol I rarely use anymore as it wasn’t really helping. I’ve had Bronchiectasis with no MAC for 30 years.

Hi, Sue.
I am curious about this as have asthma as well as a new Bronchiectasis diagnosis. My pulmonologist said, as I introduce saline (I am building up a tolerance, day by day, with 3% as I tolerate it more and more and will aim to increase to 7%). My pulmonologist (more of a CF and asthma specialist but does treat a lot of Bronchiectasis patients, too) said to take the levalbutirol nebulizer first, then the saline, followed by the Symbacort (which I haven't started yet as am so jittery and have hypertension. Despite being 49- and a non-smoking, non-drinking, thin vegetarian. Sigh. Just venting.
He said the symbacort should be taken after the saline so it doesn't "wash away." What are your thoughts?
Thanks!

Hmmm, well, with the agreement of my pulmonologist, I skip the albuterol neb (that's what makes me shaky) unless I am having an asthma attack or an exacerbation (infection, cold, etc.)

According to my pulmo, the Symbicort inhaler can effectively be used in place of albuterol for asthma control for many people. I have been using it twice a day for one year, and it has been a "game changer." The combination of budosenide (a corticosteroid) and formoterol (long-acting beta agonist) is meant to provide both long-term control & can be used one extra time for short-term relief on difficult days. Albuterol ( a short-acting beta agonist), is meant to immediately relieve wheezing & open airways, but is only effective for a few hours. I have not used the full contents of one levalbuterol inhaler, nor more than a dozen saline ampules, since I began Symbicort last June.

So I use my Symbicort first thing in the morning, then go about my routine. I neb saline anytime at least 20 minutes later. According to my doc, by then the mist has been as fully absorbed by my lung tissue as it is going to be, there is no danger of washing away.

Sue

Hi Sue,
Just chiming in here! I decided against Brio inhaler because of my osteoporosis. I’ve come a long way with my bones so I don’t want to jeopardize that success. Injecting Forteo daily for 20 months helped the most.
I will take Brio if needed, but right now I have no symptoms of adult onset asthma. It showed up on former PFTs. Recent PFTs have shown an improvement.
I will certainly take Brio, if needed. In the meantime, I’m listening to my body and following my gut.

Do you use albuterol also then the 7%. Or just the 7% alone?

I use only the 7% Saline. The albuterol wasn’t making a difference in the amount of sputum I cleared and it makes me very jittery.