Living Dangerously - Nebulizer Cleaning

Posted by thumperguy @thumperguy, Mar 12, 2021

I marvel at the time consuming, meticulous way many, perhaps the majority, of contributors to this forum clean and sanitize nebulizers. Following the treatment session I soap and hot water “bathe” the mouthpiece then let it air dry until its next use. The tube gets no special attention except being fully disconnected from the compressor. I’ve read of some regimens aimed at sanitizing shower heads; another activity I ignore entirely. I’m closing in on 16 months free of a “flare-up” involving fever, and an antibiotic to defeat.
The lengthening periods of freedom from acute symptoms is something I attribute solely to learning about 7% saline nebulizer solution which I read about on this forum.
My comparatively minimal attention to “sanitation” may catch up with me but so far so good.

I should add that I realize many forum participants are contending with considerably more virulent pathology than I am. Don

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

Interesting- I ve had one for at least 18 months and another newer but no problems with reliability

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@dulwich

Interesting- I ve had one for at least 18 months and another newer but no problems with reliability

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I think we all have differing experiences with our nebulizers. Over many years, I have tried several; my daughters even more. Some, like my old Pari Vios seem to refuse to die, others have a much shorter life, or are more prone to clogging, slowing compressors, or sudden death. I think it's just like anything else…
Sue

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@kathyhg

Would the use of a (baby bottle) sterilizer after every use be a good substitute for boiling or vinegar? I read about that on a CF site. I wonder if it would work as well. Any comments?

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I dug deep on the Internet the other day and found a number of studies showing that the best method is baby bottle sterilizers. With some of them (e.g. Phillips Avent), you can just leave the lid on with the sterilized stuff in it for up to 24 hours until you use it again. (Cheaper, though, is getting a microwave bottle sterilizer some of those can also be left with the lid on until next use, like this one).

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@tatilove

I dug deep on the Internet the other day and found a number of studies showing that the best method is baby bottle sterilizers. With some of them (e.g. Phillips Avent), you can just leave the lid on with the sterilized stuff in it for up to 24 hours until you use it again. (Cheaper, though, is getting a microwave bottle sterilizer some of those can also be left with the lid on until next use, like this one).

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I either use a WABI Baby or boil daily. A friend pointed out that the WABI is a sanitizer, not a sterilizer. I still think it’s an easy and excellent alternative to boiling. The directions for my nebulizer say to boil after daily use and customer service wouldn’t comment on other ways.

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@cavlover

I either use a WABI Baby or boil daily. A friend pointed out that the WABI is a sanitizer, not a sterilizer. I still think it’s an easy and excellent alternative to boiling. The directions for my nebulizer say to boil after daily use and customer service wouldn’t comment on other ways.

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Actually, Wabi baby is definitely a STERILIZER! That is, in fact, what they call it 🙂

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I am new to this forum and very appreciative of the discussion. I am currently with what I suspect is my 3rd ntm infection over the past 15 years. While my doctors have made the diagnosis the management seems to be something they are not familiar with. And thus recurrent issues. I now realize this is a radical life shift for me and how I can contribute to the management. I started the 7%saline nebs a week ago and am amazed at how helpful they are. Thanks again. Any other tips appreciated.

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@amandajro

Hello @thumperguy. I am so glad to hear that you continue to maintain good health and are flare free for 16 months! That is wonderful news.

You will notice that I added to your title so that others can recognize an opportunity to contribute to this discussion about nebulizer cleaning regimen. How long have you been using this process, if you don't mind me asking?

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Hi Amanda..I boiled my equipment in a silicone basket for 10 minutes, every second day..in the am I soak in hot boiled soapy water, then put in a baby bottle sterilizer to dry..tubing is changed monthly.this info is coming from Dr Falkingham, the MAC guru.

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@tatilove

Actually, Wabi baby is definitely a STERILIZER! That is, in fact, what they call it 🙂

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This is from the WABI manual

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@tampamac

I am new to this forum and very appreciative of the discussion. I am currently with what I suspect is my 3rd ntm infection over the past 15 years. While my doctors have made the diagnosis the management seems to be something they are not familiar with. And thus recurrent issues. I now realize this is a radical life shift for me and how I can contribute to the management. I started the 7%saline nebs a week ago and am amazed at how helpful they are. Thanks again. Any other tips appreciated.

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Hello, and Welcome to the MAC and Bronchiectasis group. If read some of the posts/discussions, you will see many of us experience reinfection or other exacerbations from time to time – that is "the nature of the beast" and most of us will try whatever strategies we can to avoid having to take the Big 3 antibiotics again (azithromycin, ethambutol and rifampin or a similar combo.)

If you want to read more of the discussions, some have hundreds of posts and go back many years – to read the most recent, you can click the arrow right below the first post and select "Newest to Oldest."

As you have learned, in spite of all the activity on Mayo Connect, Bronchiectasis and NTM are fairly rare, and not a lot of doctor's, even many pulmonologists, are familiar with how to treat it. Since you are a repeat customer, it may be beneficial to you to either have a consult at a large multidisciplinary practice like Mayo, where there are specialists in the disease, or seek out a pulmonologist in your area whose practice includes NTM/MAC and Bronchiectasis. (You may be able to find this in the doctor's bio, or call the office and ask specifically.)

Also, there are new guidelines about when to treat MAC with antibiotics and how to stay healthy here: https://www.lung.org/lung-health-diseases/lung-disease-lookup/nontuberculous-mycobacteria/learn-about-nontuberculosis-mycobacteria and here: https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis/questions-to-ask-your-doctor

You are correct about the 7% saline – I truly believe that it, in combination with Duoneb, got me back on my feet after a recent serious bout of bronchitis, without needing antibiotics.

What did your doctor recommend? Was a sputum specimen taken for doing a culture to determine exactly which bacteria you have?

Sue

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@sueinmn

Hello, and Welcome to the MAC and Bronchiectasis group. If read some of the posts/discussions, you will see many of us experience reinfection or other exacerbations from time to time – that is "the nature of the beast" and most of us will try whatever strategies we can to avoid having to take the Big 3 antibiotics again (azithromycin, ethambutol and rifampin or a similar combo.)

If you want to read more of the discussions, some have hundreds of posts and go back many years – to read the most recent, you can click the arrow right below the first post and select "Newest to Oldest."

As you have learned, in spite of all the activity on Mayo Connect, Bronchiectasis and NTM are fairly rare, and not a lot of doctor's, even many pulmonologists, are familiar with how to treat it. Since you are a repeat customer, it may be beneficial to you to either have a consult at a large multidisciplinary practice like Mayo, where there are specialists in the disease, or seek out a pulmonologist in your area whose practice includes NTM/MAC and Bronchiectasis. (You may be able to find this in the doctor's bio, or call the office and ask specifically.)

Also, there are new guidelines about when to treat MAC with antibiotics and how to stay healthy here: https://www.lung.org/lung-health-diseases/lung-disease-lookup/nontuberculous-mycobacteria/learn-about-nontuberculosis-mycobacteria and here: https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchiectasis/questions-to-ask-your-doctor

You are correct about the 7% saline – I truly believe that it, in combination with Duoneb, got me back on my feet after a recent serious bout of bronchitis, without needing antibiotics.

What did your doctor recommend? Was a sputum specimen taken for doing a culture to determine exactly which bacteria you have?

Sue

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I have an NJH phone interview this week so any suggestions on how to prepare for this or if I can request a provider. I have heard Dr. Gwen Huitt's name . Also trying to get an appt with our local Mac specialist but slow going. Wondering if any other suggestions for getting connected with a Mac specialist. I live in Tampa, FL. ? Mayo Jacksonville.

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@tampamac

I have an NJH phone interview this week so any suggestions on how to prepare for this or if I can request a provider. I have heard Dr. Gwen Huitt's name . Also trying to get an appt with our local Mac specialist but slow going. Wondering if any other suggestions for getting connected with a Mac specialist. I live in Tampa, FL. ? Mayo Jacksonville.

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@tampamac I have been going to Mayo in Jacksonville (I live in Spring Hill, FL) for about a year now and very pleased with the Pulmonary clinic there. My lead doctor is Margaret Johnson MD, but I only got to see her on my first visit, I primarily see her "Fellow" Dr Kukhon MD. I also had 1 visit with Dr Julio Mendez an Infectious Disease doctor. They are all excellent doctors very knowledgeable about Bronchiectasis and MAC. Dr Johnson stated that she had taken more people off antibiotics than she has put on them, and she was very supportive of me nebulizing 7% saline, which is all that I do now. Bill

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Great info Bill. Will look into an appt. at Mayo Jax. currently on the big 3. Tried Arikayce but couldn’t handle the side effects. Working thru some fatigue issues but cough getting better.

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