Nebulizing 7% saline issues

Posted by mimifeels @mimifeels, Mar 22, 2023

Can everyone on this forum tolerate nebulizing with the 7% saline? I tried it and I think my lungs loved it, but my throat absolutely did not. I got a terrible sore throat afterwards that lasted 24 hours and then had a heavily runny nose for a couple of days. How do you all tolerate it when you nebulize every day? Twice a day? Also, are there ways to help the body (well, my throat) tolerate it better?

BTW, I have just learned my insurance doesn't cover the 7% saline. Wonder why? Isn't it a medication?

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@healthybon

I am so grateful for all that you have shared with me… I so appreciate it and I will look into this doctor in Texas. How are you faring with your Mac and everything…? Thank you so much for all you’ve said it means the world to me because right now I have no direction or decent doctor

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Well, I was started out on a clinical trial with Clofazimine only. It was 4 months on 200 mg once daily for 4 months and then 2 months on 200 mg daily. After 4 months, my MAC numbers were cut in half, and my sputum smear was negative. After being on only the 100 mg for a few weeks, I started losing weight again and produced more sputum. I had not had any hemoptysis in the 6 months on the trial, and it returned afterwards. My doctor did not have access to the closed trial results, but she followed me herself with monthly sputum samples and labs every 3 months.

Since it takes about a month for the cultures to come back, I won’t know how strongly the MAC returned or progressed until then. I did not e left a cure from the Clofazimine, but I also did not expect progression. The CT scan showed a little more nodularity and bronchiectasis, but I had a short-lived other infection for a few weeks that was treated with Augmentin successfully.

I am now on MWF Azithromycin and Ethambutol. Dr. McShane has me taking all of it at one time just before bed and then just going to sleep. She said her patients seem to tolerate that.

The nurse has me taking daily over the counter saccharomysis boulardi and also the rhamnosis probiotic, along with daily yogurt. They are available on Amazon and apparently withstand the effects of antibiotics. The good quality yogurt provides strands that the 2 individual ones don’t.

If, after 6 months, I don’t become culture negative, the doctor will start me on Arikayce (so) in addition. She said they used to worry about not doing the 3 meds that included Rifampin, but they found patients did well on the 2, and for any who did not convert, the Aricayce took care of.

The scary part for me is that if I use the nebulized Albuterol or the puffed version, I have to do it very minimally only before the 7% saline. Otherwise, I get hemoptysis from out of the blue. I was in the ER the other day because it was pretty copious.

My appetite is good, I sleep well, and I try to walk briskly for 2 miles a day. My husband had a stem cell transplant 7 yrs ago for primary amyloidosis and is still in remission, but the procedure so damaged his kidneys, that he is now close to dialysis, so we deal with that and all his dietary restrictions. So, it is a lot because I have been the caregiver and always so healthy. Never got sick, so this thing is tough because the treatment is lengthy. The bronchiectasis is the underlying issue, and it does not go away.

I still mask when I go out and have been able to avoid most other infections. I eat a crushed clove of raw garlic every day. This also helps to prevent fungal infections, along with low sugar.

It is important to eat very well and healthy and to get good rest. Get lots of antioxidants, good fats, and good protein. It will make you feel better and be more resilient.

This group is wonderful, and I, too, appreciate all the support and information.

Yes, I hope that you can get to TX to be seen!

REPLY

Thanks for all the valuable info!

REPLY
@formergardener

Well, I was started out on a clinical trial with Clofazimine only. It was 4 months on 200 mg once daily for 4 months and then 2 months on 200 mg daily. After 4 months, my MAC numbers were cut in half, and my sputum smear was negative. After being on only the 100 mg for a few weeks, I started losing weight again and produced more sputum. I had not had any hemoptysis in the 6 months on the trial, and it returned afterwards. My doctor did not have access to the closed trial results, but she followed me herself with monthly sputum samples and labs every 3 months.

Since it takes about a month for the cultures to come back, I won’t know how strongly the MAC returned or progressed until then. I did not e left a cure from the Clofazimine, but I also did not expect progression. The CT scan showed a little more nodularity and bronchiectasis, but I had a short-lived other infection for a few weeks that was treated with Augmentin successfully.

I am now on MWF Azithromycin and Ethambutol. Dr. McShane has me taking all of it at one time just before bed and then just going to sleep. She said her patients seem to tolerate that.

The nurse has me taking daily over the counter saccharomysis boulardi and also the rhamnosis probiotic, along with daily yogurt. They are available on Amazon and apparently withstand the effects of antibiotics. The good quality yogurt provides strands that the 2 individual ones don’t.

If, after 6 months, I don’t become culture negative, the doctor will start me on Arikayce (so) in addition. She said they used to worry about not doing the 3 meds that included Rifampin, but they found patients did well on the 2, and for any who did not convert, the Aricayce took care of.

The scary part for me is that if I use the nebulized Albuterol or the puffed version, I have to do it very minimally only before the 7% saline. Otherwise, I get hemoptysis from out of the blue. I was in the ER the other day because it was pretty copious.

My appetite is good, I sleep well, and I try to walk briskly for 2 miles a day. My husband had a stem cell transplant 7 yrs ago for primary amyloidosis and is still in remission, but the procedure so damaged his kidneys, that he is now close to dialysis, so we deal with that and all his dietary restrictions. So, it is a lot because I have been the caregiver and always so healthy. Never got sick, so this thing is tough because the treatment is lengthy. The bronchiectasis is the underlying issue, and it does not go away.

I still mask when I go out and have been able to avoid most other infections. I eat a crushed clove of raw garlic every day. This also helps to prevent fungal infections, along with low sugar.

It is important to eat very well and healthy and to get good rest. Get lots of antioxidants, good fats, and good protein. It will make you feel better and be more resilient.

This group is wonderful, and I, too, appreciate all the support and information.

Yes, I hope that you can get to TX to be seen!

Jump to this post

Error in typing. I was on Clofazimine 200 mg for 4 months and then reduced it down to 100 mg for 2 months (not 200mg). It was. 6 month trial and rather small. It is nearing completion, so in the not so distant future, they will have the data on results to publish. I wonder how other participants did, relative to how I did. I am sure that my participation was helpful. It is good to potentially be able to make a difference by helping others. This illness can leave you feeling a little helpless sometimes. Hope is encouraging.

REPLY

The PARI LC Plus nebulizing cup is much easier to tolerate for me than the Sprint. When I use the Sprint, I feel overwhelming saltiness in my mouth, but I do not get that with the PARI Plus. The Sprint did cause a raw throat after a few days, and when I switched back to the PARI Plus, that stopped. I asked the respiratory therapist and was told that the two are the same, except for the handle. However, she did say that the PARI Plus is recommended when nebulizing antibiotics because it delivers a finer mist ( I think I remember that correctly). Anyway, I have gone back and forth between the two, and the PARI Plus is definitely easier on the throat. You might try that, if you haven’t already.

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To Mimifeels- In response to your question about 7% saline being covered by insurance, the answer is yes, it is supposed to be covered, but many of us have not been able to get pharmacies to agree with that. I don't know if you are on Medicare or not, but if you are, saline should be billed to your Part B plan under durable medical equipment, not your Part D plan. If you are not yet old enough for Medicare, I have no idea if saline is covered. Donna T

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@donnaturn

To Mimifeels- In response to your question about 7% saline being covered by insurance, the answer is yes, it is supposed to be covered, but many of us have not been able to get pharmacies to agree with that. I don't know if you are on Medicare or not, but if you are, saline should be billed to your Part B plan under durable medical equipment, not your Part D plan. If you are not yet old enough for Medicare, I have no idea if saline is covered. Donna T

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Hi Donna T, thank you for your response. I am still too young for Medicare. I have Managed Madicaid which is a great insurance to have when you are relatively healthy. When you deal with more complex issues you find it does restrict access to some drugs and some specialists. For this reason I cannot see any pulmo as many don't accept my insurance. Have a great day!

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