Pari eRapid/eFlow first impressions

Interesting, Sue. I seem to remember that while you don't produce the amount of mucus that I do you seem to have a similar mix of Be and asthma. I am currently on a trip from Perth and spending time in Queensland where I have had very scary sob all the way down
the coast. It seemed to be connected to sugar cane burning, high humidity, low cloud cover. Telephone consult with my GP had her guessing it was an asthma flair, which I don't recall ever having before in WA. She has put me on Symbicort 2puffs, 2xday for 2 weeks. This seems to be addressing the problem. I am hoping that the sob won't return when I stop the Symbicort. From memory you take the Symbicort on an ongoing basis before nebbing, don't you? I used to take the Ventolin puffer before nebbing, but have now swapped for the Symbicort...and may just continue with that while over here to prevent another attack. I know we have discussed LMP and I agree in finding what works for us individually.

I am still bringing up large volumes of mucus, and seem to, in recent months, only have an hour or two where I am not coughing and spitting...it is now seeming to impact much more on my life.

I am interested to hear peoples response to Pari eflow. ..I decided to have the Pari Trek shipped via a friend to Australia rather than the expense of the eflow...for this long overland trip.

I would be interested in your thoughts on the above, Sue.

Interesting - I winter amongst the North American cane fields (US Mexico border) and cane burning is one of my worst times - have had to bow out of outdoor activities on low pressure days when the smoke lingers and retreat to filtered air indoors.

Symbicort (or the generic) is my go-to inhaler twice a day always, and up to 4 times a day in a flare. My pulmo actually discourages use of levalbuterol inhalers - says if my wheezing/coughing/shortness of breath is that bad, to neb levalbuterol and budesonide 2-4 times a day in addition to the Symbicort. At our clinic (my kids and grandkids see the same docs, and we have varying severity of asthma plus my bronchiectasis) here is the asthma protocol -
Mild - requiring meds less than 5X per week or only during illness or heavy exertion - SABA (short-acting beta agonist) like albuterol or levalbuterol inhaler as needed
Moderate - using meds more than 5X per week or with mild exertion -
one of the following combo long-acting beta agonist plus inhaled corticosteroid - LABA/ICS like Symbicort OR long-acting beta agonist plus long-acting muscarinic agent - LABA/LAMA like Anoro Ellipta
Moderately severe - add the other "leg" of the trio above either ICS or LAMA - alone or in a 3-part combination like Trelegy
Severe - the above plus possible oral steroids and biologic medications.

Due to hassles with my health insurance, last winter I ran out of Symbicort for a few weeks. It answered my question as to how effective it is for me - my sob increased while I was off it, and my mucus really increased. I think in my case it truly points to the inflammation being a factor in mucus production.

I hope you are enjoying your travels. Since it seems to be effective for you, if it is offered, you may want to consider continuing Symbicort in the long term.

For the Pari erapid, it says to use .09 isotonic solution for the easy clean device. I guess we can’t use our 3%, so we have to buy another supply of just .09 isotonic?…..

Little update, I found the e rapid to turn off so quickly today that I questioned what was still left in the cup. When I looked there seemed to be a lot, so I tipped the cup forward to allow the saline to flow into the component to touch the head. I was then able turn it back on and nebulize for several more minutes with the mouth piece, pointed slightly downward. I wonder if I had been nebulizing with it perhaps tipped upward a bit, perhaps preventing the fluid from hitting the head (which is what makes it think the session is over). Anyone else have this experience?

@bronchiectasaurus Yes - Salty - Wow! And I just learned to slow the flow by placing my upper lip on the blue flap on the top of the mouthpiece, which keeps from wasting so much saline. And with theopening a little farther back in my mouth, I cough a little less. This is harder to describe, then to do). And I turn the compressor off if I start coughing a lot.

I too am a new user of the Pari eRapid, and I only boil after 2-3 uses. But, this is not my first mesh nebulizer, and trust me when I say the mesh screens are very delicate and can clog easily, so I don't skip the thorough prerinse, detergent soak, or post rinse because the screen (in the head) is pricy to replace.

My routine - use my Symbicort inhaler (used to use Levalbuterol) and wait 15 minutes, neb saline, dismantle nebulizer and rinse, soak (with kitchen timer running), rinse again in filtered water at my tap. On boiling days, I drop the pieces in pot to boil & set the timer for 10 minutes (how long it takes my pot to come to a boil), check the heat and reset timer. When the final timer rings, I turn off the burner and let the water cool.
While I have that going, I do some of my PT or house chores, then start airway clearance when I start the pot. I usually finish about the time the last timer rings. (I reuse my now sterile distilled water several times, leaving it in a covered pot on the stove.

Not nearly as onerous as it sounds, and since the mucus comes up quickly, the whole process is 35 minutes & I have managed some of my PT or tidying up in the meanwhile.

So far 2 weeks in, I am loving it. As it is both smoke and allergy season, it is getting a good workout. As a stable bronchie, with no infection, I usually use saline 2-3 times a week. At this time of year it is daily. I haven't needed to use any of my "other drugs" for an exacerbation yet, so can only say how fast and effective the saline is. But I may ask my pulmo if there is a nebulized version of the Symbicort that may be more effective than the inhaler for this tricky time of year.

@sueinmn, I received the pari E flow when I was approved for Arikayce . I wonder if when i am done with Arikayce if I can use it for my hypertonic saline. But how long can you use the golden colored mesh part that goes in the hand- held part? While doing Arikayce, they have me change it weekly & I get enough (4 in box) for a month, & also a new handset every month with each Arikayce monthly med box...

I just use distilled water.