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Airway Clearance daily therapy vs a few times a week
The recent Lecture Series by National Jewish Health stressed that the most important element of treating your MAC or Bronchiectasis is Airway Clearance! Airway Clearance! Airway Clearance!
Has anyone had good results of reducing the number of days that they use nebulized saline along with vest therapy?
A recent episode of Hemoptysis followed by a week of severe back spasms has forced me to not use saline nor vest therapy until I can tolerate coughing, although I continue 2x daily Levalbuterol inhaler, followed by 5 minutes of steaming (to prevent blocking up with stuck mucus), followed by Symbicort inhaler.
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@happy2023 Let me preface this by saying I was treated for MAC in 2018 & 2019, but have been off antibiotics and my bronchiectasis stable for over 4 years. At first I did rigorous airway clearance with 7% saline twice a day, and was still having a lot of trouble controlling my asthma.
Over 2 years ago, my pulmonologist determined through testing, imaging and symptoms that my main issue is asthma and reactive airways, bronchiectasis is second, and other than some leftover artifacts, there appears to be no MAC. I was still having 2-3 exacerbations per year, and needing steroids and sometimes a short course of antibiotics.
She switched my asthma medication from levalbuterol (inhaled & nebulized) plus nebulized budosenide for attacks to a Symbicort inhaler (low dose budosenide plus formoterol) twice daily. I continued 7% saline and airway clearance once a day. After a year with NO exacerbations I was allowed to decrease the 7% saline nebs gradually - to about 2-3 times a week now, unless I have a respiratory bug - then it is upped to daily or twice daily. Through all, I have continued daily airway clearance with either vigorous exercise or my Aerobika.
I have now passed 16 months with no exacerbations, in spite of having 2 respiratory viruses in that time.
My story is not your story, but under certain conditions, it is possible to reduce saline use and be healthy. I am lucky that Mucinex and NAC allow me to keep my mucus thin enough to clear easily. But I will practice airway clearance for the rest of my life - I believe getting the mucus out reduces the places for the germs to breed.
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2 ReactionsCould you please explain what “steaming” means that you do?
I heat water to boiling in my electric kettle, although you could use a pan of boiling water that is taken off the stove and set aside. Then I raise the lid of the electric kettle. After the boiling stops, I let the water rest a minute or so. I take a dish towel and cup this around my mouth and the opening of the kettle, then leaning over the hot water, I breathe in the steam for 5 minutes. The internet will mention steaming for 3 to 5 minutes. This steaming will loosen mucus; of course not as much as nebulized saline. But since I have had back spasms for about a week and it hurts too much to cough, I was forced to continue any type of airway clearance I could, and this is still with firstly levabuteol inhaler (2 puffs), then steaming, then budesonide-formoterol inhaler (2 puffs).
I have always rinsed 2 times after using the steroid inhaler, and have luckily never had thrush.
Thanks for sharing your protocol. What is the "low" dose budesonide included in the inhaler you use? Is that the lowest dose? My husband uses nebulized budesonide and formoterol and 3% saline. Each in separate ampules, used one after the other. He also takes NAC 2x daily. The powder form of steroid inhalation causes him sore throat and hoarse voice after 3 days of use despite vigorous mouth rinsing afterwards. His doctor then prescribed the nebulized forms of the meds. Now he nebulizes only when he hears wheezing. The mucus buildup persists. He knows the research on long term use of steroids and proceeds with caution.