Two bits of good news!! (and nebulizing with saline)

Posted by rits @rits, May 21 12:13pm

Hi Everyone. I had a telemedicine appointment last Friday with the wonderful (I LOVE her) Dr. McShane who is practicing in Tyler, Texas. I have really good news to share. First is mine alone. I am off antibiotics following successful treatment for 14 months with Azithromycin and ethambutol and 4 months on Arikayce. Yay!

The second wonderful news is a shocker and applies to everyone who does airway clearance. Not too long ago, I pontificated here in response to a post by Thumper that nebulizing with .9% saline is a waste of time because it is normal saline and would not do anything. I said that we need to use 7% if we can and 3 % if 7 is too harsh. Well, Dr McShane told me that .9% is just as good and she sent me a copy of a study which proves it. I have attached the study here. It is from Australia and compares airway clearance for patients using 6% to those using .9% for one year. There was no difference!!! Both worked equally well as far as preventing exacerbations, effect on bacteria, etc.

Of course if you are doing well on 7% or 3%, this probably doesn’t matter to you. But for me, it is earth shattering. I started on .9% last night and it is much more comfortablefor me. You can read the study for yourself. Last week, I was despondent believing that, although I would be stopping the antibiotics, I would have to suffer the effects of hyperytonic saline 2x a day for the rest of my life. I had horrible shortness of breath and struggled to function for at least an hour after each clearance treatment. No more! This is such good news!

I hope everyone has a fantastic day!

Rita

Shared files

Hypertonic Saline versus normal saline in Bronchiectasis (Hypertonic-Saline-versus-normal-saline-in-Bronchiectasis.pdf)

@rits That is absolutely the best news! I pray that for all of us who are on that “cocktail.” Congratulations! irene5

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rits — I read with great interest about the.09% saline being as effective as 7 or 9%. My doctor at Mayo's in Rochester has told me the same but I didn't know if that is right. I've always used 3% (and don't have any trouble with that. But he did say the 0.9% was just as effective. Perhaps there are others who do not agree with this?????

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I'd need to see a study disproving it!

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Tagging @thumperguy on this discussion to make sure he sees your original post, @rits
Congrats on the good news.

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@rits That is fantastic news,

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@rits That’s good news. Although I recently started using the 7% and have been tolerating it well, I was worried that my years of using the .9% and then 3% were a waste of time. I’m happy to know it wasn’t. I will still use the 7% but I may alternate using the 3% every couple of days. Thanks for the info.

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@auntnanny

rits — I read with great interest about the.09% saline being as effective as 7 or 9%. My doctor at Mayo's in Rochester has told me the same but I didn't know if that is right. I've always used 3% (and don't have any trouble with that. But he did say the 0.9% was just as effective. Perhaps there are others who do not agree with this?????

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The report says that a higher concentration of saline was more effective in cystic fibrosis patients. That's probably where the recommendation to use 7% came from. This study shows that non cystic fibrosis bronchiectasis saline treatment is different and .9% works just as well for us.

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@ginak

@rits That’s good news. Although I recently started using the 7% and have been tolerating it well, I was worried that my years of using the .9% and then 3% were a waste of time. I’m happy to know it wasn’t. I will still use the 7% but I may alternate using the 3% every couple of days. Thanks for the info.

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I’m new to all this and can you explain the saline treatment? I too have bronchiectasis and have been taking the big 3 daily for 2 months. Is the saline something that is a treatment after the treatment of antibiotics? Thank you for your help.

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@rits Congrats, Rits!

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@marellen

I’m new to all this and can you explain the saline treatment? I too have bronchiectasis and have been taking the big 3 daily for 2 months. Is the saline something that is a treatment after the treatment of antibiotics? Thank you for your help.

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Saline is part of airway clearance that those of us with bronchiectasis should do 2x daily.

Our disease means that we have abnormal, dilated airways and mucus accumulates in them causing plugs, opacities, nodules, etc. Our bodies send antibodies, enzymes, etc to fight the disease and everything gets caught and bacteria finds these areas a good place to grow. Airway clearance is how we shake this sputum loose and expel it.

There are 3 ways to get this gook out: percussion which is when someone thumps on our backs to shake it loose or a vest which does the thumping. A flutter device like the aerobika which causes vibration in the lungs. And finally saline which is nebulized into the lungs. The saline adds liquid to the sputum and irritated our airways into giving it up so we can cough it out. Some of us use all three methods 2x every day.

Saline comes in different concentrations, i.e., 7%, 6%, 3% and normal saline of 0.9%. Normal saline is the amount we have in our body fluids and is what we get through an iv when we are hospitalized in order to maintain our normal fluids.

The study concludes that for those with non cystic fibrosis bronchiectasis, nebulizing .9% works just as well as the higher concentrations which some if us find too hard to use.

I hope this long explanation helps.

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@marellen

I’m new to all this and can you explain the saline treatment? I too have bronchiectasis and have been taking the big 3 daily for 2 months. Is the saline something that is a treatment after the treatment of antibiotics? Thank you for your help.

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I have bronchiectasis and my pulmologist began nebulizer treatments with 3% saline immediately. When I did not have much production he ordered me a percussion vest which has helped tremendously in clearing my lungs. This is very important with bronchiectasis. I would think you would be placed on nebulizing right away. Rits gave an excellent explanation. Do you also have MAC and thus the antibiotics?

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I, too, was diagnosed with MAC/Bronchiectasis in mid-March. I started on the 3 antibiotics immediately. I left a message with my pulmonologist several weeks ago (after reading the posts on this site about thumper vests and saline nebulizers etc) asking if there were any other therapies that he would recommend for clearing my lungs and his nurse called back and said “no, only the antibiotics.” So I guess I am wondering why you guys on this site are receiving this treatment but I am not. Is it recommended only in cases of severe vs mild Bronchiectasis?

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@hayn3705

I, too, was diagnosed with MAC/Bronchiectasis in mid-March. I started on the 3 antibiotics immediately. I left a message with my pulmonologist several weeks ago (after reading the posts on this site about thumper vests and saline nebulizers etc) asking if there were any other therapies that he would recommend for clearing my lungs and his nurse called back and said “no, only the antibiotics.” So I guess I am wondering why you guys on this site are receiving this treatment but I am not. Is it recommended only in cases of severe vs mild Bronchiectasis?

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@hayn3705 I was dx with mild bronchietasis in 2016 and MAC/MAI. I have no symptoms from the NTM infection so my Dr and I agreed NOT to treat with the antibiotics. I was told to use an Aerobika for lung clearance. Since that time I moved and switched pulmonary Drs. He was also in agreement about no antibiotics yet. After reading about nebulizing with saline on this forum and in other studies, I requested the prescription from my Dr so he prescribed .9%. I now use 7% saline, and still have no symptoms from the NTM. I still do my lung clearance 2x per day. I haven't had a sputum test in 2 years, (which I will probably make an appt for this summer), and my CT scans remain the same. Maybe you can request it from your Dr. It can't hurt but definitely may help. And definitely ask about lung clearance. That's very important with bronchiectasis to keep the lungs clear of mucus.

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You should probably have a sputum check to see what is going on. They can send you the materials to collect it and send it to them. I'm sending my samples from Chicago to Texas and it takes 5 days to arrive. I was told that using their packaging, the sample is good for two weeks.

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@ginak

@hayn3705 I was dx with mild bronchietasis in 2016 and MAC/MAI. I have no symptoms from the NTM infection so my Dr and I agreed NOT to treat with the antibiotics. I was told to use an Aerobika for lung clearance. Since that time I moved and switched pulmonary Drs. He was also in agreement about no antibiotics yet. After reading about nebulizing with saline on this forum and in other studies, I requested the prescription from my Dr so he prescribed .9%. I now use 7% saline, and still have no symptoms from the NTM. I still do my lung clearance 2x per day. I haven't had a sputum test in 2 years, (which I will probably make an appt for this summer), and my CT scans remain the same. Maybe you can request it from your Dr. It can't hurt but definitely may help. And definitely ask about lung clearance. That's very important with bronchiectasis to keep the lungs clear of mucus.

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Thanks for the advice!

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