nebulizing albuterol and saline
I have had shakiness after nebulizing albuterol 2.5mg/3ml. The last time I saw my pulmo. He suggested using only half the vial, which has helped some. He also said that we could change to a lower dose when I need a refill. Have any of you experienced the same thing and what dose is most commonly prescribed? Also, I think I have read on this site that nebulizing saline causes coughing. I have problems with that often and have to stop and cough and drink before resuming. It is frustrating because it just makes the session longer. I am using 7% saline. Has anyone had less coughing with 3%? Also, I assume 3% is less effective and perhaps I should put up with the coughing if the 7% does a better job. I appreciate any advice. Thank you. Donna Turnbaugh
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Thank you so much, @sallyb827. Just learned this from you. I need to check it out.
My pulmonologist switched me to LEVALBUTEROL. I've had a much better experience. I may feel a little hyper, but it is not that crazy 1-2 hour heart racing, hands shaking experience.
Sodium Chloride designated DURABLE GOOD by MEDICARE?
Has anyone been able to figure out why Medicare doesn't pay for sodium chloride vials; they consider them a "durable good" such as a nebulizer. Or is there someone out there who has been able to get Medicare/Supplemental pay for sodium chloride (saline solution)? If so, please tell me your supplemental name and/or how you got this to be paid for. Thank you so very much!
Saline vials are covered under Medicare Part B – if you are using a prescribed nebulizer. Have the pharmacy resubmit.
I have also been unable to get sodium chloride vials covered by Medicare. The problem was really the pharmacies that told me it was not covered under Part B. I finally gave up and used a GoodRx coupon. I got 180 vials for about $18. Donna Turnbaugh
Thank you so much. Your replies are always so helpful and informative. I appreciate your advice. Donna Turnbaugh
My pleasure, Donna.
I am new to all of this (MAC, Bronchiectasis, COPD and will begin treatment in a few weeks) and was wondering if the Levalbuterol is used in inhaler form after nebulizing sodium chloride 7%? I have been on Spiriva 2.5 and was told by others going through treatment I should get off Spiriva because of Bromides and switch to Levabuterol. It was also suggested I use Aerobika instead of my AirPhysio. Any feedback would help.
Hello, and welcome to Mayo Connect, where we are happy to walk this path with you.
First, I would like to point out that Connect is a community of people with similar conditions sharing their experiences and trying to help one another live well in spite of our health conditions. But each of us is unique, with different health and lung status and other conditions, so very much NOT "one size fits all."
Second, we are not medical professionals, and do NOT suggest you should substitute any of our suggestions for the directions given by your health care team.
Third, COPD is a fairly common disease, but bronchiectasis is uncommon (maybe 1-3 million people) , and MAC infection is rare (under 1/2 million people per year.) Many doctors have limited experience treating us, and may not be totally aware of the latest and best recommendations from the "gold standard" facilities like National Jewish Health, Mayo, Cleveland Clinic, and a few others. So you may read new things here that you would like to bring to your doctor's attention.
To answer your questions – Spiriva and its sister Symbicort are used by people here, depending on their other conditions.
Levalbuterol or Spiriva or Symbicort should be used before you neb with saline. It opens the airways and allows better penetration. I use Symbicort because I also have chronic asthma. My friend used Symbicort because he had COPD.
Most PEP devices, AirPhysio, Aerobika, Acapella – will help. The choice is individual – discuss with your doctor or ask for a visit with a respiratory therapist to see which is most helpful to you. I prefre the Aerobika, but keep a Acapella in my car in case I need help bringing up mucus when out and about.
Other here can chime in with their preferences.
Are you comfortable calling your doc with questions?
I have actually been calling the nurse for a week just to get the name of an infectious disease doctor and she keeps saying when she finds out who the doctor recommends she will let me know. I’m calling back again tomorrow because it shouldn’t take that long to get an answer. It is so disappointing.