Timing of nebulizing - before or after meals

Posted by Melissa Nelson @melissa08, Nov 28, 2022

Hi all,
My husband, who has Bronchiectasis, is currently testing negative for MAC following 11 months of killer antibiotics, which have been suspended after they came way too close to ending him over this past summer.
He nebulizes with albuterol followed by 7% saline twice a day. Some of the comments within discussions that I have seen in this group suggest that there be a 2-3 hour time lag before or after a meal, before nebulizing. The same was suggested on timing of sputum collection for culture purposes.
His ID/Pulmonology team at Johns Hopkins have never provided any advice on the subject. Since we have gotten most of our knowledge and survival tips from this group, what are the best practice options you have found to be most workable? Any thoughts or input are welcome.
You have been an invaluable source of information, guidance and support which has been very much appreciated.
Thank you.
Melissa

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

@equanimous

Your yoga and postural drainage mention inspired me to look up the link between them. I found this article. Granted, most of the poses are challenging and geared for younger folks but they may be modified and can be helpful for the opening the lungs. https://www.wellcurve.in/blog/yoga-asanas-for-lungs/

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Hi,
Just a word of caution about the yoga poses. I have osteoporosis in addition to bronchiectasis & MAC. I’m afraid most of those poses would not be recommended for me. Best to discuss with your Dr. and/or an experienced physical therapist.
Take care,
Linda

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@sueinmn

Please talk to your doc about seeing a respiratory therapist - with your vest - to get a better airway clearance routine established. Besides being so disruptive to your life, spending that much time at it has to be irritating to your lungs and ribs, which could be making things worse.
Sue

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Thank you. I have an appointment at UNC Chapel Hill on June 7th. I will see if I can get a respiratory therapist appointment also.

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@equanimous

Your yoga and postural drainage mention inspired me to look up the link between them. I found this article. Granted, most of the poses are challenging and geared for younger folks but they may be modified and can be helpful for the opening the lungs. https://www.wellcurve.in/blog/yoga-asanas-for-lungs/

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Thanks Arlo, I do triangle pose, cobra , and spinal twists along with some other “senior poses”. I am very protective of my back. Glad to hear these are good for lungs ! The deep breathing while holding positions for a minute is also helpful.

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@scoop

@sueinmn you wrote, "And I do active breathing with huff coughing during and after exercise (@scoop) – "

Combining clearing with exercise is something I plan to try. Thanks for the suggestion. Before exercise do you neb or use Symbicort only? In my mind I spend too much time clearing. Sometimes clearing feels like a workout in itself! I'm trying to figure out if I can can get the most gunk out in the first 2 tries and then move on with my day. Do you stop during walking to huff cough? It would be great to decrease nebs to 4-5/week but that's not likely even bronch is mild. Too much gunk in the a.m. Do you mind sharing where your bronch is in your lungs? Mine appears to be diffuse.

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I'm pretty flexible about my routine...usually inhaler, stretch & a cup of tea, neb and a few buffs, then walk or work in the garden - both help bring stuff up. I stop what I'm doing for a short time to huff and cough, when the urge hits again, repeat - usually 2-4 times over a half hour. The bending/standing sequence of pulling weeds or tending plants really seems to bring up the gunk.
You need to learn what works for you.
Sue

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@sallyb827

I have found that, if I don’t hydrate before Acts that my throat and sometimes my chest get irritated and feel like they are burning. I also do not produce any sputum.

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Same situation for me

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If I can help it, I try and do mine before eating, as I suffer from GERD and have tendency to aspirate.

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