Thank you. Yes I was referring to cleaning the nebulizer cups. What options do they suggest besides vinegar? It is probably just the nature of the medication vs the saline that makes it shorter time? I remember researching the Ombra and there was something about the instructions that made me hesitant to buy it but cannot remember what that was!

No thoughts as to why it takes 10 minutes to nebulize the 3ml of levabuterol and 20 minutes to nebulize the 4ml of saline. It is a good question. I do not use the Aerobika with it. I find using the Aerobika gives me less of the medicine because it gets stuck in the Aerobika screen.

You said , " What I haven't figured out is why I am able to nebulize 3 ml. Levalbuterol in a much shorter time period than 4 ml. saline." I don't have empirical proof for this, but my guess is that the suspended particles in the levalbuterol solution are much smaller than those in the saline. This would be the same reason saline tends to "clog up" mesh nebulizers unless it is soaked out.

Here is another question to ponder. If the purpose of the saline solution is to thin the mucus and help us cough it out, why have we all concluded that 4 ml is the "magic dose"? I have purchased 7% saline in 3 ml, 4 ml and 10 ml ampules.

When I was struggling with making it through all 4 ml, the RT in my pulmonologist's office said, "Use it until you can huff cough. Huff cough/Aerobika for up to 15 minutes, nebbing in between if you need to. Then stop."

This process has kept me healthy for 3 1/2 years now. I don't fret about the last drops of saline, or force myself to try to clear until my throat and ribs hurt.
sue