Airway clearance

Posted by maryjanechilds @maryjanechilds, Aug 17, 2023

I have MAC (found along with pseudomonas in a sputum culture)and Bronchiectasis. I was treated with Cipro for the pseudomonas and have been on the Big 3 for almost two months for the MAC. Every discussion I read talks about nebulizing with saline solution and daily airway clearance. I have no cough and am unable to cough up any mucous. I use my albuterol inhaler and then my accapella but do not produce any mucous. Does anyone else have “dry” MAC? I do have slight drainage down the back of my throat but I wonder if I could figure out how to clear out my lungs if I would get well faster.

Mary Jane

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@maryjanechilds I wonder if you can talk to your doc about nebulizing saline? The albuterol inhaler opens the airways, but does nothing to thin existing mucus (this is where the pseudomonas and MAC bacteria hide and breed. ) The saline would add moisture to your lungs, and possibly loosen the hidden mucus there so you could bring it up using the Acapella.
Maybe it is worth a try?
Sue

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I use albuterol inhalator And 3% saline solution then aerobika and the huff/ cough but I still not produce any mucus. So when you talk to your doctor ask about 3% or 7% saline solution difference. This is what I am going to do during my next visit.

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@lilianna

I use albuterol inhalator And 3% saline solution then aerobika and the huff/ cough but I still not produce any mucus. So when you talk to your doctor ask about 3% or 7% saline solution difference. This is what I am going to do during my next visit.

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Good morning, lilianna, you may have what has recently been recognized as "dry bronchiectasis" which means you produce little mucus. I believe the accepted course of treatment for it is to use saline & airway clearance, but not to be too upset if it is not productive. At least you are keeping the tissues moist and the saline staying there makes your lungs inhospitable to bacteria.
Do ask your doctor about 7% as it is even more lethat to MAC than the 3%.
Sue

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@sueinmn

Good morning, lilianna, you may have what has recently been recognized as "dry bronchiectasis" which means you produce little mucus. I believe the accepted course of treatment for it is to use saline & airway clearance, but not to be too upset if it is not productive. At least you are keeping the tissues moist and the saline staying there makes your lungs inhospitable to bacteria.
Do ask your doctor about 7% as it is even more lethat to MAC than the 3%.
Sue

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Thank you lilianna and and Sue. I will try the 7% saline solution. Definitely want to make the lungs as inhospitable as possible to the MAC and pseudomonas bacteria.

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@sueinmn

Good morning, lilianna, you may have what has recently been recognized as "dry bronchiectasis" which means you produce little mucus. I believe the accepted course of treatment for it is to use saline & airway clearance, but not to be too upset if it is not productive. At least you are keeping the tissues moist and the saline staying there makes your lungs inhospitable to bacteria.
Do ask your doctor about 7% as it is even more lethat to MAC than the 3%.
Sue

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Thank you Sue. Honestly even the 3% solution I use is because I learned from this site. I am going to ask for 7%. How long do you usually do the breathing and huffing/ coughing. After 4-5 times I get dizzy

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@lilianna

Thank you Sue. Honestly even the 3% solution I use is because I learned from this site. I am going to ask for 7%. How long do you usually do the breathing and huffing/ coughing. After 4-5 times I get dizzy

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After 5 minutes if nothing moves, I try a few bending and stretching exercises, then try again. Still nothing, I quit for the day.
Sue

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I am in the same situation. Just finishing antibiotics after two years and six months left on taking Arikayce, which I believe is why I converted to negative for MAC. Even with 7% I can’t get mucous out. My dr just prescribed an Afflo vest. Will try that. I’ll post if it works. Take care.

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I get very dizzy after doing ACTs unless I go super easy on it. 'Lung Matters' on FB suggests a squeezing technique but that makes me very, very lightheaded. I've found that the Active Cycle of Breathing and Autogenic Drainage done a few times brings up a little bit of sputum but at least I'm not reeling around with heart palpations and lightheadedness for hours afterward.

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@sadair20

I get very dizzy after doing ACTs unless I go super easy on it. 'Lung Matters' on FB suggests a squeezing technique but that makes me very, very lightheaded. I've found that the Active Cycle of Breathing and Autogenic Drainage done a few times brings up a little bit of sputum but at least I'm not reeling around with heart palpations and lightheadedness for hours afterward.

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Please take a look at this recent discussion thread:
https://connect.mayoclinic.org/discussion/macntm-is-different-for-everyone-treatment-might-be-different-too/

Everyone of us has a different experience with Bronchiectasis and MAC, so no single protocol is right for all people. That is why we need to be very careful when following recommendations from others, especially if there is any insistence that "everyone needs to do this."

Here is a very sound philosophy for airway clearance - If it makes you feel worse, don't do it! Here is another - from my pulmonologist and respiratory therapist - after you neb, ten minutes of airway clearance and no more, unless you are still bringing up significant mucus - it will only serve to irritate your body. Remember, it is normal to have some mucus in your lungs.

My bronchiectasis varies greatly depending on my general health, the state of my allergies, how my asthma is behaving, and whether I am having an exacerbation. Most of the time, with airway clearance, I bring up a TINY amount of mucus - less than a teaspoon a day. But if I get an exacerbation - whoa! It seems like a quart - but is probably really a half cup. (PS I haven't had a real, serious infection in 2 years with this method)

Finally, dry bronchiectasis is a real thing - only recently recognized. I plan to do a little searching and see if I can find some expert info on how to manage it.

Have you brought up this issue with your doc? what is their recommendation?
Sue

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I think I have the dry MAC you are talking about with the bronchiectasis. I do cough some but don't bring up much mucous so guessing my airways are a bit clogged. Also have some asthma.
My pulmonologist is prescribing inhalers - either Breztri or Stiolto. Just started and don't like some of the side effects - irregular heart beat also little fluttery. I use a device that is a little pipe (stem 2 1/2 inches, bowl 1 3/4 inches) with a ball bearing inside. I breathe in and out into it for about 5 minutes every day and am able to get some mucous up. I like there are no drugs involved and no side effects.

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