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terryb1
@128128terry11t

Posts: 178
Joined: Jan 07, 2017

Practical questions about nebulizer, shower head filters & gargling

Posted by @128128terry11t, Dec 20, 2017

This forum is so helpful and I thank all for their contributions. I have three questions:
1. Do we have to rinse the aerobika or nebulizer in distilled water after we soak in plain sudsy water or can we just rinse in regular water for our daily cleaning? I ask because lugging distilled water can be cumbersome and I would love to skip the use of distilled water if it is unnecessary.
2. For those who have put a filter(s) on their shower head so that showering can be the equivalent of bathing, please let us know specifically what filter or filters you installed and any other information that would be helpful for us to know.
3. Was anyone advised to gargle after using inhaled amikacin? If so, was any particular mouthwash recommended?
As always, thank you and wishing all a Merry Christmas and a Happy and Healthier New Year. Terry

Liked by loveblue

REPLY

@128128terry11t , you can rinse your equipment in tap water that has been boiled,. Boiling it kills the organisms that are most likely in your pipes and made you sick in the first place. I periodically soak my neb cups and mouthpieces in vinegar after I have washed them with warm soap & water. As for the shower heads, I think I saw that they needed to 2 micron filter to be effective. I have that info saved somewhere, I will try to find it again. You can also tie a baggie with vinegar in it onto your showerhead and soak it to kill bacteriums in there. Baths are advisable over showers. Gargling after inhaled meds is always a good idea, especially meds that contain steroids; as it can cause thrush, a yeast that can grow in your mouth and other areas. I do not know about amikacin, I am sure you can ask a pharmacist or google it. Or maybe someone on this forum can answer this question.

Liked by tdrell, luvocean, brigby

@windwalker

@128128terry11t , you can rinse your equipment in tap water that has been boiled,. Boiling it kills the organisms that are most likely in your pipes and made you sick in the first place. I periodically soak my neb cups and mouthpieces in vinegar after I have washed them with warm soap & water. As for the shower heads, I think I saw that they needed to 2 micron filter to be effective. I have that info saved somewhere, I will try to find it again. You can also tie a baggie with vinegar in it onto your showerhead and soak it to kill bacteriums in there. Baths are advisable over showers. Gargling after inhaled meds is always a good idea, especially meds that contain steroids; as it can cause thrush, a yeast that can grow in your mouth and other areas. I do not know about amikacin, I am sure you can ask a pharmacist or google it. Or maybe someone on this forum can answer this question.

Jump to this post

Hi, My Dr. advised gargling after inhaling amikacin. It’s really tough on the throat. I gargle w/ warm water and honey. It seems to help. I used to lose my voice when I first started inhaling it. Now, I’m fine. However, I’ve cut back to 3x a week. I can’t tolerate it more.

Many thanks for the tip. Much appreciated.

Hi folks, I edited the title of this discussion thread to “Practical questions about nebulizer, shower head filters & gargling” to be descriptive of the questions asked and to help people find this again when they are search for the same answers.

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Hi @128128terry11t, I merged the answers that you found out from Dr. Falkinham to the discussion that you started with the questions. I think this will help others members to have the questions and answers in one discussion thread. Thank you for getting the answers from Dr. Falkinham! Nice info for everyone.

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

@ronaf, Rona, I soak mine in a bowl of vinegar for a half hour, that kills the bugs, then rinse with boiled, then cooled water. Don’t put your cups into the pan of boiling water or you can melt your equipment. (that happened to me).

Liked by heathert

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

I am confused and need some clarification. Terri, you mentioned that you soak “mine” in a bowl of vinegar for half an hour and then rinse in water that has been boiled and allowed to cool. Are you referring to nebulizer used for inhaled amikacin and if so, do you soak it in plain distilled white vinegar (not diluted with water) for 1/2 hr. followed by the rinse each time that you use it? Do you do that for all your equipment such as aerobika and regular nebulizers daily? I have just been soaking in sudsy water followed by rinse in plain water. I just started to use water that I boil the night before and it sits on my stove until the next day when I use it for cleaning and rinsing. I do it the day before because I am unsure just how long it would take to cool a large amount of boiled water. This is the first time that I am hearing a recommendation to soak in vinegar. Thank you very much. Terry

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

Hi Terri,
I can’t remember if I replied. Thanks for the suggestion of what you do w/ your nebulizer cup. I’ve been putting mine in boiling water every third time I use it and nothing happened; i.e. it didn’t melt. However, now I’ll be more careful. The instructions say it’s OK to boil and to change the cup every 6 months. I’ll have to re-read the instructions. But this is what I recall.

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

I sterilize mine once a week in a baby bottle sterilizer gizmo. When do you soak it in vinegar? Daily, instead of sudsy water? I am finding it difficult to get some suds going now that I use the sterile water!!! Happy holidays. Terry

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

@123123terry11t, Hi Terry. The equipment I clean is my nebulizer cups, mouthpiece, and spacer. I use straight vinegar because it kills all bacteria, including mac. Use boiled water for the rinse; as straight tap water may have the mac in it.

@123123terry11t, Terry, you had asked about why vinegar was suggested as a cleaning solution…..it was recommended by the doctors at the conference last spring. They said the acid in vinegar kills bacteria and the bugs have not become resistant to it yet. They suggested wiping countertops and kitchen handles with it as well. Some species of the MAC have become resistant to chlorine now, so they recommend vinegar. Restaurants have been using vinegar to wipe the tables and counters for years for it’s antibacterial properties. Some say to use industrial strength, I just use regular vinegar. I keep a gallon of it in the house. It lasts a long time as I am not super diligent about using it like I should be.

@128128terry11t

Thank you to those who have responded to my questions. I look forward to other responses. I emailed Dr. Falkinham (well known and respected microbiologist who lectures on NTMs) and asked him the questions about using distilled water to rinse the equipment, cleaning aerobika/nebulizer just once a day, and recommendations for shower head. The following is his response:
Dear Terry:

Here are a few answers.

Question 1. Yes, it is important to ensure that the water added to a nebulizer after disinfection is as sterile as possible. Rather than buying sterile water, simply boil the necessary volume of water on the stove, let it cool before adding it to the instrument. Use that water for rinsing and final filling. Rinsing with regular tap water will likely “inoculate” the nebulizer with NTM. Remember, regular drinking water has NTM. Also, distilled water is not sterile.

Question 2. If the instrument has been filled initially with sterile water it is probably all right to not clean/disinfect before the next use. However, remember, that it is possible to “inoculate” the nebulizer with your own sputum.

Question 3. Shower heads can be unscrewed and cleaned by scrubbing the inside as best you can and then submerging the shower head in Chlorox for 30 min. Alternatively, you can filter the water before it enters the shower head. Pall Medical makes 0.2 micrometer pore size filters and those prevent passage of NTM (we’ve confirmed). However, the 0.2 micrometer pore size filters clog easily, so we recommend adding a 5 micrometer pore size filter before the water passes to the 0.2 micro meter filter. The Pall filters are expensive and good for 30 or 60 days, so if possible, I would simply scrub out a standard shower head and disinfect in Chlorix for 30 minutes monthly.

Further, some shower heads have a fine spray and generate a great deal of mist that stays in the air of the bathroom. That is not so good as the NTM are in the aerosol. Look around for a shower head with large holes that generates streams (usually 1-2 mm diameter holes). That will not generate the mist that can enter the farthest reaches of your lungs. Big drops are better.

Let me know if you have further questions.

Merry Christmas and Happy New Year,

Joe

Jump to this post

Hi @128128terry11t and welcome the vinegar should be 10% strength to kill the MAC,.

@windwaker, Thanks for the tip. Do you use distilled white vinegar? I am a little (well, maybe a lot) confused about how a gallon lasts a long time. Don’t you have to put quite a bit of the vinegar in a bowl in order to adequately soak? If someone does this daily, I would imagine that a gallon would go fairly quickly unless it is diluted with some boiled water?? …. and if you use an aerobika with nebulizer, even faster. When you stated that you were not super diligent, did you mean that sometimes you clean/rinse in boiled water? By the way, what is a “spacer”? Your knowledge and advice is much appreciated.

@128128terry11t

@windwaker, Thanks for the tip. Do you use distilled white vinegar? I am a little (well, maybe a lot) confused about how a gallon lasts a long time. Don’t you have to put quite a bit of the vinegar in a bowl in order to adequately soak? If someone does this daily, I would imagine that a gallon would go fairly quickly unless it is diluted with some boiled water?? …. and if you use an aerobika with nebulizer, even faster. When you stated that you were not super diligent, did you mean that sometimes you clean/rinse in boiled water? By the way, what is a “spacer”? Your knowledge and advice is much appreciated.

Jump to this post

@128128terry11t, I just use whatever vinegar is in the house. I could be wrong, but I believe the acid is probably strong enough in any of the vinegars to kill bacteria. Some people like to buy the industrial strength just to make sure. I think you can buy it at places like Lowe’s. I suggest you start with one gallon first to gage how much you use in a week’s time. It will depend on how diligent you are with cleaning your equipment. Mine lasts a long time because I am not so diligent as I should be. I soak my nebulizer cups and mouthpieces about once a week . Some reports say that every three days is fine.

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