My first pulmonologist did prescribe albuterol for me to nebulize before the saline but it made me very jittery. When I complained about it, and told her I wasn’t using it in the evening because I had trouble getting to sleep later, she prescribed levalbuteral which was a little better but I still quit using it in the evening. She was insistent that I use it twice a day. When I went to NJH, one of their lung functioning tests included testing the effect of albuterol. It made about 12% difference in opening up my airways, which is not much. The doctor left it up to me about whether to continue or not to use albuterol, but it seemed he didn’t think it made enough difference. He did say that I might want to use it before I went out to exercise or hike, etc, but it was only a suggestion not a recommendation. He told me that I have no problem getting air into my lungs but my problem is a lot of trapped air that doesn’t get exhaled.

I don't use albuterol or levalbuterol nebs before saline nebs. But I do have a daily long-acting inhaler which I use faithfully morning and evening. My pulmonologist also recommends using it 15 minutes before nebulizing saline/airway clearance if my chest fells tight. I have asthma as well as mild-moderate bronchiectasis.

@kwi raises a good point - for many of us, the problem isn't getting sir in, it is that our damaged airways don't effectively push air out. I have learned over time that I need to consciously exhale fully because my lungs no longer do it naturally - pursed lip breathing helps me do that.

What is your current airway clearance routine?
Sue