Advice about airway clearance devices

Posted by dulwich @dulwich, Apr 8, 2019

I'm newly diagnosed with bronchiectasis and MAC, based on CT findings and bronchoscopy. No symptoms yet and not bringing up much mucus after 6 weeks of airway clearance with nebulizer and acapella, although adding some chest percussion recently might be helping. CT scan to review whether this is working planned after 6 months. The philosophy seems to start with the simplest treatment, even if it is possibly not that effective, but I'd like to get the gunk out of there the most effective way possible. I'm willing to invest more in time or resources if that would be useful. Does anyone have opinions or experience about the Aerobika versus Acapella and has anyone used the Vibralung, which uses soundwaves to break up mucus? Are any of you non CF patients using mucolytics and if so, which?
Thanks for any advice

@soflo, I could be wrong, but I don't think levalbuterol has a steroid in it. I am back to using albuterol because my insurance wouldn't cover the levabuterol. It is wickedly expensive.

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@windwalker I don't know :(….I heard it is expensive and if that is the case I will ask for albuterol. But do you take it with or without the steroid?

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@windwalker, I don't even know much about the albuterol. I thought I heard it comes with or without the steroid and I'm not sure which is the better way to go.

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@windwalker, I believe Levalbuterol is the generic of Xeponex. I understand it is less expansive. You can get it without steroid and was told it is not addicting. I believe that is what one of the lovely ladies shared with me. Hopefully she will respond but I will check my notes. I forgot her name 🙁

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@soflo Albuterol & Levabuterol do not contain a steroid. They are bronchodialators. The hand-held 'puffers' that are used 2 puffs in the morning and 2 at night are typically the ones that contain steroids.

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@windwalker

@soflo Albuterol & Levabuterol do not contain a steroid. They are bronchodialators. The hand-held 'puffers' that are used 2 puffs in the morning and 2 at night are typically the ones that contain steroids.

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Hello All asking about Xopenex/levalbuterol – Yes, the generic is much more reasonable than the name brand. The nebuliser solution comes from a company called Rite Dose. According to my insurance documents, the cost is $14.00 for 25 vials before adjustment for your coverage. I am on Medicare, it is covered under Part B (medical) as are all the inhaled meds, not Part D (Rx plan.) The inhaler is from Actavis (sp?) and costs $165 for 3 inhalers before insurance. My copays are less – I think my inhalers are $30 for 3 (same as generic albuterol) and my solution is $8 (albuterol is free). Because these are generic, they are on the formulary for my insurance plan, while the name brand is specifically on the list of excluded drugs. For those of you suffering tremors and shakes from abuterol, it is worth checking with your insurance company to see if you are covered.

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@soflo

@windwalker @sueinmn @merpreb and others. As I have mentioned, I recently started anoro daily(powder inhalor). I asked my doctor to also prescribe for me levalbuterol inhalor(Xopenex) as I read in some of your posts that it helps clear the airways. Do you all take the levalbuterol with or without steroid in it and how often do you use it. Thanks for your input. Well wishes to all xx

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@soflo– Morning. You bring up a great topic- what are the different kinds of inhalers. It really can be very confusing because there are so many. I believe that what is prescribed by your Pulmonologist depends on the breathing test results and your ability to tolerate the medicines. When I first started it was the middle of the summer, very humid and very very hot. I complained to my surgeon that I was having difficulty breathing. He sent a message to my Pulmonologist that it was ok to prescribe an inhaler. One type of inhaler has a steroid in it and this was what was prescribed for me. Mine is called QVAR. It helps reduce swelling. It made a huge difference. My second inhaler was Spiriva, a bronchodilator. I use this because it can prevent bronchospasms caused by COPD and helps asthma patients as well. I do not have asthma. It relaxes the muscles around the airways so that they open up and you can breathe more easily. It's an anticholinergicst. According to Wikipedia :" An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. These agents inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells."
The final type of inhaler is called a rescue inhaler that you use in an emergency. These are also bronchodilators but have albuterol as the main ingredient. It's quick acting and opens airways. Let's say you unfortunately inhale an allergen and your airways start to close. Albuterol will open them back up- temporarily, and help relax the controlling muscles giving your pipes a chance to relax.
I also use my pro-air- or Ventolin HFA first thing in the AM to open my tubes so that my airways can more easily absorb my other inhalers. Pulmonologists have their own ways of prescribing how to take these so don't go by me. Albuterol makes me shake and my heart race. There are very normal reactions and aren't usually dangerous – and I resisted it for a long time. It does help. I also have a nebulizer at home in case I get bronchitis.
Your medicine treats bronchospasms (narrowing of the airways). It's used for COPD and asthma. It does take time for it to build up in your system so that it works at its maximum. It's very important to inhale the medicine properly- from deep down in your belly, not the top of your lungs. When you inhale your tummy should expand and shoulders should not move. It takes time to learn but there is a big difference in the amount of medicine that is absorbed. I use a spacer too, which allows me to inhale slowly. By doing this I get less shaky.
Are you seeing a difference now that you are taking it? Are you having any side effects?

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@merpreb

@soflo– Morning. You bring up a great topic- what are the different kinds of inhalers. It really can be very confusing because there are so many. I believe that what is prescribed by your Pulmonologist depends on the breathing test results and your ability to tolerate the medicines. When I first started it was the middle of the summer, very humid and very very hot. I complained to my surgeon that I was having difficulty breathing. He sent a message to my Pulmonologist that it was ok to prescribe an inhaler. One type of inhaler has a steroid in it and this was what was prescribed for me. Mine is called QVAR. It helps reduce swelling. It made a huge difference. My second inhaler was Spiriva, a bronchodilator. I use this because it can prevent bronchospasms caused by COPD and helps asthma patients as well. I do not have asthma. It relaxes the muscles around the airways so that they open up and you can breathe more easily. It's an anticholinergicst. According to Wikipedia :" An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. These agents inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells."
The final type of inhaler is called a rescue inhaler that you use in an emergency. These are also bronchodilators but have albuterol as the main ingredient. It's quick acting and opens airways. Let's say you unfortunately inhale an allergen and your airways start to close. Albuterol will open them back up- temporarily, and help relax the controlling muscles giving your pipes a chance to relax.
I also use my pro-air- or Ventolin HFA first thing in the AM to open my tubes so that my airways can more easily absorb my other inhalers. Pulmonologists have their own ways of prescribing how to take these so don't go by me. Albuterol makes me shake and my heart race. There are very normal reactions and aren't usually dangerous – and I resisted it for a long time. It does help. I also have a nebulizer at home in case I get bronchitis.
Your medicine treats bronchospasms (narrowing of the airways). It's used for COPD and asthma. It does take time for it to build up in your system so that it works at its maximum. It's very important to inhale the medicine properly- from deep down in your belly, not the top of your lungs. When you inhale your tummy should expand and shoulders should not move. It takes time to learn but there is a big difference in the amount of medicine that is absorbed. I use a spacer too, which allows me to inhale slowly. By doing this I get less shaky.
Are you seeing a difference now that you are taking it? Are you having any side effects?

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@merpreb — Merry – Excellent information! Stay well!
–Dee

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@danielad– Thank yo Dee. How are you feeling?

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@merpreb — Hi Merry! Thanks for asking; I am feeling better — I have been more diligent in the use of the meds, as you recommended!!! 🙂
–Dee

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@daniallad that is great to hear that you are feeling better!

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@heathert

@daniallad that is great to hear that you are feeling better!

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Hi @heathert — Thank you! How are you doing?
— Dee

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