Re: saline

[Guest guest]

Do you need a script for the hypertonic saline? I use Pari products. I think they're very good.

Keep well everyone. Theresa

From: Tony Lundy <tonymlundyclara (DOT) co.uk>Subject: Re: Re: salineTo: bronchiectasis@ yahoogroups. comDate: Saturday, October 4, 2008, 8:52 AM

Joy - isotonic means having the same osmotic pressure as blood (body fluids). Same concentration of salts.

Hypotonic means having a lower osmotic pressure than blood.

Tony

Re: saline

Anyone know the diff between isotonic saline and hypotonic saline?joy

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[Guest guest]

Thanks Joy.

The answer to this question is rather more difficult. Of course isotonic saline is usual in iv's but both hyper and hypo is also used for example when there is an electrolyte imbalance e.g. low sodium. With regard to nebs I don't know the answer. It would require an audit of post respiratory function perhaps lung function tests or blood gases. These latter can be a bit uncomfortable since arterial blood is required. I seem to remember that tonicity is potentially important with nebs but perhaps my mind is playing tricks! I am sure that some respondent's pulmonologist would know.

Regards, Tony Lundy

Re: Re: saline

Thanks TonyHmmmm! All I know is that what I’m using is same concentration ie 0.9%! Guess it’s more pertinent when being used for IV, but not relevant for nebs....??Cheers,joy

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[Guest guest]

Wow, I am impressed! I hope I’m not being too trusting in relying on my specialist assuring me that the saline used for wound washing is fine for nebs – it’s the same as what comes in the little plastic vials for nebs.....

But thx Tony, it’s good to understand as much as poss,

joy

[Guest guest]

Hi Tony,

For nebs I wouldn’t imagine such fine distinctions would be needed eg via blood gases (I’ve had done several times for IV, not pleasant!)

Now I’m being a smarty-pants ... I looked up isotonic..

1. relating to the contraction and shortening of a muscle under relatively constant tension, eg in weightlifting

2. see isosmotic – relating to or exerting euqal osmotic pressure

3. Specially formulated to supply the body’s chemical needs in situations in which minerals and fluids are sued up by the body eg during vigorous exercise.

Hypotonic = lower osmotic pressure than another fluid

Hypertonic = having a higher osmotic pressure etc

Just adding a little not so useful information!!

Cheers all,

joy

[Guest guest]

Hi Therese,

I don’t think Aust provides for a scrip for saline nebs. Buying 5 ml vials is expensive, 10ml are actually cheaper – I use about 10ml/day, or if not, would be ok to leave in fridge o/night.

My specialist says fine to purchase Baxter (brand) wound-washing 0.9% saline 500ml / 1L bottles for nebulising.

In hot weather keep in fridge once opened. The hardest part is actually ‘pouring’ 3-5 mls into the neb bowl, but a syringe works ok, keep it in a clean container in fridge too, in summer at least. I keep meaning to buy some Milson or whatever it is used for baby’s bottles etc. Cheaper than Nebuclean? – their products are pricey – neb kits are about $17, I bought a diff brand kit $8 yesterday, the jet is so quiet!!! (some of them shriek - unbearable 15-20 mins x 2/day).

Did just have school hols? Maybe was just Qld....

joy

[Guest guest]

All part of the big jigsaw, Joy

Cheers, Tony

Re: Re: saline

Hi Tony,For nebs I wouldn’t imagine such fine distinctions would be needed eg via blood gases (I’ve had done several times for IV, not pleasant!)Now I’m being a smarty-pants ... I looked up isotonic..1. relating to the contraction and shortening of a muscle under relatively constant tension, eg in weightlifting2. see isosmotic – relating to or exerting euqal osmotic pressure3. Specially formulated to supply the body’s chemical needs in situations in which minerals and fluids are sued up by the body eg during vigorous exercise.Hypotonic = lower osmotic pressure than another fluidHypertonic = having a higher osmotic pressure etcJust adding a little not so useful information!!Cheers all,joy

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[Guest guest]

Joy

The n school holidays finished last week. We have been back a week.

I am having a test on Friday to see if I can tolerate hpertonic saline. If there are no probs my specialist will prescribe it. I would get it from the hospital pharmacy. This is what the adult CF patients have in the hospital where i see my specialist.

Keep well everyone. Theresa

Subject: Re: Re: salineTo: "bronchiectasis " <bronchiectasis >Date: Thursday, October 9, 2008, 10:26 PM

Hi Therese,I don’t think Aust provides for a scrip for saline nebs. Buying 5 ml vials is expensive, 10ml are actually cheaper – I use about 10ml/day, or if not, would be ok to leave in fridge o/night. My specialist says fine to purchase Baxter (brand) wound-washing 0.9% saline 500ml / 1L bottles for nebulising.In hot weather keep in fridge once opened. The hardest part is actually ‘pouring’ 3-5 mls into the neb bowl, but a syringe works ok, keep it in a clean container in fridge too, in summer at least. I keep meaning to buy some Milson or whatever it is used for baby’s bottles etc. Cheaper than Nebuclean? – their products are pricey – neb kits are about $17, I bought a diff brand kit $8 yesterday, the jet is so quiet!!! (some of them shriek - unbearable 15-20 mins x 2/day).Did

just have school hols? Maybe was just Qld....joy

[Guest guest]

Hi Kay,

I’m prescribed 6% - has to be prescribed in Australia, isn’t something I can just decide to do.... Yep, I reckon everyone w/ bronch should be doing saline nebs, espec when have an exacerbation even if don’t need most of the time, I really really really!!!! wish I’d had it years ago...

The saline goes to the lungs as a mist, so apart from an slightly salt taste initially (about same as taste of salt on your skin after swimming in the ocean) it isn’t enough to make any difference digestively speaking. I can’t imagine it could affect gerd (I do have it mildly, I just avoid bending, crouching, lying down etc if have just eaten or even a large drink....).

You don’t need a prescription (in Aust) to use isotonic (0.9% - same as body’s salinity) saline, & here can buy it by 500ml bottle from chemist. I found it didn’t really make any diff for me. My doctor said some people can’t tolerate the higher %, makes them cough too much. Initially I stopped & had a sip of water, or a cough if felt any irritation, now can do full 5mls without needing to stop except if stuff comes up. I was recommended to ease into it gently, I did.... & no problems.

If you’re prescribed it I’m sure you’d have a physio or your doc would guide you along..... It’s certainly worth asking your doctor about, there really are no negative side effects – otherwise swimming in sea-water would be dangerous!

Seems by reputation that the Pari neb pumps are the best, and the handheld nebuliser which has a mouthpiece means that the mist goes directly into the lungs, not half of it over your face as with a mask.

joy

[Guest guest]

Thanks a bunch Joy. I'm printing out your message for reference.

Kay

Re: saline

Hi Kay,I’m prescribed 6% - has to be prescribed in Australia, isn’t something I can just decide to do.... Yep, I reckon everyone w/ bronch should be doing saline nebs, espec when have an exacerbation even if don’t need most of the time, I really really really!!!! wish I’d had it years ago...The saline goes to the lungs as a mist, so apart from an slightly salt taste initially (about same as taste of salt on your skin after swimming in the ocean) it isn’t enough to make any difference digestively speaking. I can’t imagine it could affect gerd (I do have it mildly, I just avoid bending, crouching, lying down etc if have just eaten or even a large drink....).You don’t need a prescription (in Aust) to use isotonic (0.9% - same as body’s salinity) saline, & here can buy it by 500ml bottle from chemist. I found it didn’t really make any diff for me. My doctor said some people can’t tolerate the higher %, makes them cough too much. Initially I stopped & had a sip of water, or a cough if felt any irritation, now can do full 5mls without needing to stop except if stuff comes up. I was recommended to ease into it gently, I did.... & no problems. If you’re prescribed it I’m sure you’d have a physio or your doc would guide you along..... It’s certainly worth asking your doctor about, there really are no negative side effects – otherwise swimming in sea-water would be dangerous!Seems by reputation that the Pari neb pumps are the best, and the handheld nebuliser which has a mouthpiece means that the mist goes directly into the lungs, not half of it over your face as with a mask.joy

[Guest guest]

Hi everyone,

I haven't been on too much lately as my bronch seemed to have improved. However still having fatigue and so forth. After a couple of days of feeling weak, heart racing, etc. I went to the emergency room, was admitted and two days later told I have pulmonary hypertension. Two years ago I was told I didn;t have this, but evidently it isn't that easy to diagnose. Also some sclerosis of the heart valve. I am unable to do much now as I feel faint upon little exertion. There is no cure for this, and it is caused by the COPD, bronch and emphysema, as well as immobile esophagus, which lucky me, I have also.

Just FYI, if you feel weaker, or have fainting spells, heart racing, ask your doctor about pulmonary hypertension,it usually can be diagnosed with an EKG.

Best to all.

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