MAC: Just how well do nebs work, anyway?

@sueinmn - Have you ever heard if hypertonic saline helps with pseudomonas?

Hmm, not something I had ever researched, so I took a look on line - look what I found:
Hypertonic saline (6 - 10%) was effective at inhibiting growth of pseudomonas in Cystic Fibrosis patients: https://pubmed.ncbi.nlm.nih.gov/24587256/
And 7% saline, in combination with inhaled gentamicin it was 3X more effective than normal saline (.9%): https://www.nature.com/articles/s41598-020-61413-4

So the short answer is yes, it helps - the final answer is not yet determined, but if I were looking at pseudomonas treatment today, I would probably show these to my doctor and try to find a way to incorporate in treatment. When I had pseudomonas, I had to go through multiple courses of oral levaquin (which scared me) an in haled Tobramycin (which stole my voice.) This looks like it might be an alternative to consider.

Are you fighting pseudomonas right now?

Sue

Yes, I had a bad case right before COVID started and was put on 10 days of cipro which helped and did not appear in cultures again til last week. So ID md has put me back on same for 10 days. 4 days in, feeling better. The 3%saline nebs, done faithfully throughout This past year and a half didn’t touch it. June exacerbation was probably all about the pseudomonas, but too tired to think straight. Learning as I go.

That's the way of it with bronchiectasis - just when you think you have one thing beat, up pops another.
Hope you're beginning to feel better. Cipro neve touched my pseudomonas, levaquin might have done a little. It took 2 rounds of tobramycin to knock it out in 2018.
Sue

Thanks for sharing Sue, I’m catching up on back posts. It helps a lot for my self-education.

Sue, for some time I’ve realized that my bronchiecstasis/MAC is less severe than what you and several others on the Forum contend with . For example, I don’t experience my lungs as “hurting.” I’ve never taken the “big three.” I just cough more than most people, and I bring up a good deal of mucus. Adding 7% saline to the regimen effectively ended periodic feverish flare-ups.

Along with a few others, you form the “backbone of the Forum. I don’t think it’s hyperbolic to say your contributions are a treasure. To wit: your response to Crepass above. Don

Actually Don, my case is called moderate. It just acts up a bit more because it shares my lungs with asthma and allergies. My daughters insist the "hurt" is sore chest muscles from coughing, but in my opinion when it hurts to take a deep breath, I'm allowed to blame my lungs.

I really think 7% saline has been a game changer for several of us.

Have a good weekend.
Sue

The nebs work but the ability of the bronchodilator to penetrate deeply is lessened when the airways are physically blocked with mucous. Bronchodilators relax the muscles on the outside of the airway and the steroids decrease inflammation inside the airways. That is why you started feeling so much better when you took the steroids. Once the swelling inside the airways is less mucous can be expelled easier.

Sue, you have just written my own recent experience. I got lax with the nebbing of 7% saline and took a break from doing it. Bad idea! I developed a cough because I had contracted aspergillus infection, lower O2 levels, they would drop scary low when I walked, and had zero energy. I went back on my tobramycin 3 week ago and nebbing my saline religiously. Cough is gone, oxygen levels back up, energy levels climbing. I have learned my lesson to not let my guard down again.

Toby is what knocked out my pseudomonas also. Good stuff if you can tolerate it.