Need advice re: nebulizing hypertonic saline...

[SarahProcter]

My 3.25yo daughter started hypertonic saline today. It's the first inhaled medication she's ever taken. We do two puffs of albuterol via an inhaler with a spacer and a mask, followed by the nebulizer.

My questions:
1. It doesn't seem to bother her. The CF clinic told me to start out just trying to make it through the first 3 minutes, and then stretch it longer and longer until she adapted well enough to complete the treatment eventually. But, she handles it fine. Her objection seems to be about having something on her face, not the effects of inhaling the hypertonic saline.
<strong>Does this mean we're not doing it right?</strong>
Is she not inhaling enough of it, or not deeply enough? They gave us so much of a build-up about how hard it was to tolerate at first, that I am ironically worried because it isn't hard to tolerate.

2. <strong>Can I sterilize the nebulizer bits and pieces in the same kind of Medela microwave steam bags that I used to sterlize breast pump pieces in?</strong> The nurse practitioner at the CF clinic was unsure, she said she was afraid they might melt in the microwave but didn't know.
Thanks much. We're struggling a little with how much longer this makes her treatments (don't hate us, we had previously been doing just 10 minutes of vesting a day and nothing else; but they said we should step it up now that she's older so we've moved to albuterol/hypertonic saline/vest twice a day, and the impact of changing routines is huge for a 3 year old. Especially I dread getting her to preschool on time in the mornings until we work it out!)

 

[SarahProcter]

My 3.25yo daughter started hypertonic saline today. It's the first inhaled medication she's ever taken. We do two puffs of albuterol via an inhaler with a spacer and a mask, followed by the nebulizer.

My questions:
1. It doesn't seem to bother her. The CF clinic told me to start out just trying to make it through the first 3 minutes, and then stretch it longer and longer until she adapted well enough to complete the treatment eventually. But, she handles it fine. Her objection seems to be about having something on her face, not the effects of inhaling the hypertonic saline.
<strong>Does this mean we're not doing it right?</strong>
Is she not inhaling enough of it, or not deeply enough? They gave us so much of a build-up about how hard it was to tolerate at first, that I am ironically worried because it isn't hard to tolerate.

2. <strong>Can I sterilize the nebulizer bits and pieces in the same kind of Medela microwave steam bags that I used to sterlize breast pump pieces in?</strong> The nurse practitioner at the CF clinic was unsure, she said she was afraid they might melt in the microwave but didn't know.
Thanks much. We're struggling a little with how much longer this makes her treatments (don't hate us, we had previously been doing just 10 minutes of vesting a day and nothing else; but they said we should step it up now that she's older so we've moved to albuterol/hypertonic saline/vest twice a day, and the impact of changing routines is huge for a 3 year old. Especially I dread getting her to preschool on time in the mornings until we work it out!)

 

[Anomie]

See if she'll do it with a mouth piece instead.

 

[Anomie]

See if she'll do it with a mouth piece instead.

 

[edan]

Hi. My experience with my daughter...

She started nebulizing at age 3.5. So afraid of the mask, she popped a blood vessel in her nose at first. anyway, after 2 weeks of a gradual introduction she was fine.

I have recently, at age 5, allowed her to use the mouthpiece. However, it does 't work that well. She tendsto still breath through her nose so the medicine just escapes out through the mouthpiece vent and she does 't get enough in through her nose which I believe helps also with her sinuses for hts.

We do the hts with her even without albuterol. It doesn't affect her at all. The only time she coughs is if she has a cd.
Hope this helps.

 

[edan]

Hi. My experience with my daughter...

She started nebulizing at age 3.5. So afraid of the mask, she popped a blood vessel in her nose at first. anyway, after 2 weeks of a gradual introduction she was fine.

I have recently, at age 5, allowed her to use the mouthpiece. However, it does 't work that well. She tendsto still breath through her nose so the medicine just escapes out through the mouthpiece vent and she does 't get enough in through her nose which I believe helps also with her sinuses for hts.

We do the hts with her even without albuterol. It doesn't affect her at all. The only time she coughs is if she has a cd.
Hope this helps.

 

[edan]

To Clarify due to my poor grammar because of the iPhone...
There are 2 issues with the mouthpiece for her.
1) she basically doesn't breath through her mouth with it so less medicine gets deep into her lungs

2) I like with the face mask that she appears to breath a bit through her mouth and some also goes through her nose, which I believe is helpful for the sinuses when inhaling hts or even Pulm.

3) "cd" is supposed to be "cold".

 

[edan]

To Clarify due to my poor grammar because of the iPhone...
There are 2 issues with the mouthpiece for her.
1) she basically doesn't breath through her mouth with it so less medicine gets deep into her lungs

2) I like with the face mask that she appears to breath a bit through her mouth and some also goes through her nose, which I believe is helpful for the sinuses when inhaling hts or even Pulm.

3) "cd" is supposed to be "cold".

 

[AleksandraKaczynska]

My Asia started using the mouthpiece when she was just over 3 - I think - I use nose clip so she breathes through her mouth - however I must sit with her and remind her too breathe deaply. When she has a running nose - I do the last minute of the inhalation through a mask and also do nose rinses with 0,9% NaCl. Asia always reacted well to hypertonic saline and we never had problems with tolerating it - however We introduced saline inhalation ste by step - first it was from 0,9% - then we worked up to 5,45% - but if your daughter doesn't mine - then great - I guess not all patients have trouble with saline. I sterilize the nebulizer parts in a steam sterilizer - like for baby bottles - but I guess you can sterilize in microwave - but read the instructiion first - I have a pariboy lc spint with a yellow inside - it takes long - but more reaches the lungs - and it's written in the instruction - that you can use microwave and it's written how to do it. So I guess it doesn't always have to be hard to do saline <img src="i/expressions/face-icon-small-happy.gif" border="0"> Asia had saline sine she was 3 months old. started at 0,9% like I wrote.

 

[AleksandraKaczynska]

My Asia started using the mouthpiece when she was just over 3 - I think - I use nose clip so she breathes through her mouth - however I must sit with her and remind her too breathe deaply. When she has a running nose - I do the last minute of the inhalation through a mask and also do nose rinses with 0,9% NaCl. Asia always reacted well to hypertonic saline and we never had problems with tolerating it - however We introduced saline inhalation ste by step - first it was from 0,9% - then we worked up to 5,45% - but if your daughter doesn't mine - then great - I guess not all patients have trouble with saline. I sterilize the nebulizer parts in a steam sterilizer - like for baby bottles - but I guess you can sterilize in microwave - but read the instructiion first - I have a pariboy lc spint with a yellow inside - it takes long - but more reaches the lungs - and it's written in the instruction - that you can use microwave and it's written how to do it. So I guess it doesn't always have to be hard to do saline <img src="i/expressions/face-icon-small-happy.gif" border="0"> Asia had saline sine she was 3 months old. started at 0,9% like I wrote.

 

[CJPsMom]

We started saline when our little one was about 3 months old. He never had a problem with it (7%, full vial daily). In fact, after we had used it for a couple of months, he started coughing when he took it and I worried about that so stopped giving it to him, but apparently, that's what it's supposed to do! He still doesn't cough every time, just in spurts which we think may mean it's helping get stuff out.
As for the facemask, we use the mask or the mouthpiece, just depends on how cooperative he's being.
He'll be 15 months next week.

 

[CJPsMom]

We started saline when our little one was about 3 months old. He never had a problem with it (7%, full vial daily). In fact, after we had used it for a couple of months, he started coughing when he took it and I worried about that so stopped giving it to him, but apparently, that's what it's supposed to do! He still doesn't cough every time, just in spurts which we think may mean it's helping get stuff out.
As for the facemask, we use the mask or the mouthpiece, just depends on how cooperative he's being.
He'll be 15 months next week.

 

[hmw]

I was also very worried initially about how Emily would tolerate the hypersal. Our dr had told us many kids have trouble tolerating it, and to have a strong-tasting drink nearby since she might really hate the taste, etc. Well- after all that build up- she did great with it, right from the start. It's extremely productive for her, and she brings up junk we didn't even know she had down there, and using a mask is helpful as well, since it seems to help clear her sinuses as well. And when it comes to the taste- she will drink it. Yes, right from the vial or neb cup. And then add another one, lol!

If you are using a durable neb like Pari, it should do fine no matter how you sterilize (steaming, boiling, etc.) The mask may or may not- ones like the fish mask can be briefly boiled or go through the electric steamers, but some people report them melting in the microwave. Disposable nebs will generally warp/melt.

 

[hmw]

I was also very worried initially about how Emily would tolerate the hypersal. Our dr had told us many kids have trouble tolerating it, and to have a strong-tasting drink nearby since she might really hate the taste, etc. Well- after all that build up- she did great with it, right from the start. It's extremely productive for her, and she brings up junk we didn't even know she had down there, and using a mask is helpful as well, since it seems to help clear her sinuses as well. And when it comes to the taste- she will drink it. Yes, right from the vial or neb cup. And then add another one, lol!

If you are using a durable neb like Pari, it should do fine no matter how you sterilize (steaming, boiling, etc.) The mask may or may not- ones like the fish mask can be briefly boiled or go through the electric steamers, but some people report them melting in the microwave. Disposable nebs will generally warp/melt.