Confused about saline

Posted by AZ @equanimous, Apr 11, 2023

I was diagnosed with bronchiectasis and MAC and am relatively new to this whole battle. I have a constant cough which is much worse at night but no shortness of breath. The mucus I cough up is pretty thin. I have ordered a wedge to elevate my upper body at night and am praying it will help. I was also told I am allergic to dust mites. My nasal drip is pretty bad at times. I am taking an antihistamine.

I repeatedly see mention of 7% saline nebulizer treatment. Does this help with controlling the MAC bacteria and curbing cough? I have asked my pulmonologist about saline with this response: "I don't generally use 7% saline. I use mucomsyt mixed with albuterol to thin the mucus, along with the vest. If this does not work, then I use dornase. "
I am not asking for medical advise but am curious to get your take on this.

At the present time I am using the compression vest 2x per day.
I have a Rx for Albuterol Sulfate, 0.083% for nebulizer. A respiratory therapist (who taught me how to use the compression vest) who said it would not help with cough and she did not think it was necessary.

I am confused and trying to keep the faith that I will find what works. I appreciate your feedback.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

miloandlisa | @miloandlisa | Apr 11, 2023

I use 7% saline solution. It helps to keep the bacteria count down. I use it twice a day.

AZ | @equanimous | Apr 11, 2023

In reply to @miloandlisa "I use 7% saline solution. It helps to keep the bacteria count down. I use it..." + (show)

Thanks for your comment. Have you experienced any side effects i.e. increased cough, throat irritation?

kwi | @kwi | Apr 12, 2023

In reply to @equanimous "Thanks for your comment. Have you experienced any side effects i.e. increased cough, throat irritation?" + (show)

I also use 7% saline and a vest twice a day. The saline has kept my MAC knocked down. When I used it the first couple of times it was a bit irritating and caused me to cough right away. Now it doesn’t. I don’t have a constant cough either, so I don’t know how it may affect you. Others have said they mix 3% and 7% until they are able to tolerate the 7%. The knowledge I have gained from others on this site indicates that the saline does more than just thin the mucus. It helps keep the MAC knocked down too. I don’t think most pulmonologists know that. I had to stop using albuterol because it made my heart race and made me very jittery.

AZ | @equanimous | Apr 12, 2023

In reply to @kwi "I also use 7% saline and a vest twice a day. The saline has kept my..." + (show)

Thank you so very much, kwi. I agree, most pulmonologists don't know a lot about MAC, and that is what I fear. I am going to address this again with my dr.

tconz | @tconz | Apr 13, 2023

I also have MAC and Bronchiactisis. I use to cough a lot until my Pulmonologist put me on Levabuteral and 7% Saline twice and a day (always use Levabuteral first because it opens up the lungs). Then I use my Aerobika and do Autogenic Drainage and I feel so much better and healthier too.

pacathy | @pacathy | Apr 13, 2023

I have bronchiectasis, mild I think, and CT's suggestive of NTM (awaiting culture.) FWIW, Mayo prescribed Albuterol, but not saline for me.
I have a suggestion for your PND and cough. I also had terrible PND and a wretched cough until pulmonary referral for my abnormal CT. He thought the PND was a major contributor to the CT findings and started Azelastine nasal spray and continued my nasal steroids. (The steroid never impressed me.) The Azelastine has truly been a miracle drug for my PND and cough and I can travel and eat out occasionally now. You could ask you doc about Azelastine.
Note: he also put me on Stiolto and Guaifenesin.
Have you had a sinus CT? My frontal sinus shows opacification and Ent has me using Tobradex eye drops into nostril while I have head upside down to try to clear it.
I went to Mayo in March and the chest CT hadn't improved despite the PND improvement. They started Albuterol nebs, Aerobika and postural drainage. They also prescribed their own nasal spray mix, but I haven't switched yet. (Going on trip and didn't want to mess with success.) It sounds like they'll also change the Stiolta to a steroid in future.

Good luck! That coughing wears a body down.
Note this was hard to edit. I just wanted to move a paragraph and kept getting extra ones. 😀

AZ | @equanimous | Apr 13, 2023

In reply to @tconz "I also have MAC and Bronchiactisis. I use to cough a lot until my Pulmonologist put..." + (show)

Thank you so very much, tconz. I appreciate your feedback and I plan on addressing this with my pulmonologist as I keep hearing mention of the benefit of 7% saline over and over.

AZ | @equanimous | Apr 13, 2023

In reply to @pacathy "I have bronchiectasis, mild I think, and CT's suggestive of NTM (awaiting culture.) FWIW, Mayo prescribed..." + (show)

Thank you so very much, pacathy. Have a wonderful and safe trip!

fdixon63 | @fdixon63 | Apr 18, 2023

In reply to @equanimous "Thank you so very much, tconz. I appreciate your feedback and I plan on addressing this..." + (show)

@tconz. Just putting my 2 cents in... I used 7% Sod Chl with a past pulm doc. He would not say it was better than 3% but he was OK for me to use it--I tolerated it well. Two years later was referred to another pulm doc closer to home. He would just shake his head and smirk when I brought up the subject. "just don't think it makes a difference." I brought it up again with him today. He said the same thing again but is OK to write a Rx for 7%. We all learn from our doc's but also from each other. Blessings all.

Sue, Volunteer Mentor | @sueinmn | Apr 19, 2023

@sallyb827 Sally,
You asked "How long does it take for you to nebulize 7 ml of 3% sodium chloride with the Pari ProNeb and the cups that you use and shared with me. I find it is taking me about 19 to 20 minutes. How much chloride solution do you neb at one time, 15 ml or 7 ml?"

I decided to answer in this discussion because the topic is of interest to many members.

I neb 3-4 ml of saline - usually 7%, but sometimes 3% if my lungs are sensitive. 7-15 ml is a lot to neb in one session. I was using the Innospire Go and it took 5 minutes, but that died. When using my DeVilbiss Traveler, it takes roughly 8 minutes, a little longer if I stop to cough.

PS When I could only get 7, 10 or 15 ml vials, I would open it carefully, pour out enough for one session, press the little cap back on & store it upright in the refrigerator to use for the next session. The RT told me as long as I was careful to keep it clean & use up within 24 hours, this is safe.

Can anyone tell Sally hw long this takes with their nebulizer?

Sue