The hypertonic saline (super sonic- that's about right - I love this stuff <img src="i/expressions/face-icon-small-wink.gif" border="0"> ) is usually inhaled in a 3% or 7% solution, 4 ml at a time (I use the 7% in the am, and the 3% in the pm). If the 7% is too strong to start out, ask for the 3% <img src="i/expressions/face-icon-small-wink.gif" border="0"> . It is supposed to help draw water up to the surface of your lungs, and thereby helping the cilia to move the mucus out. I believe the effect is also supposed to last for several hours, though I (and a lot of people from what I've read) usually cough up a lot while doing the neb. After my HS, I usually can breathe soooo much better- I hate, hate to miss it, and I think I've only missed it twice since I started it <img src="i/expressions/face-icon-small-tongue.gif" border="0"> .
I always take my Xopenex (albuterol equiv.- usually my neb, but sometimes my puffer) before my saline, to open my airways up better, and to head off any broncospasms that *might* occur (I haven't had that problem yet).
I also take Pulmozyme and Advair. You might want to ask about the Advair HFA inhaler too- it's like an albuterol inhaler, instead of a disk with powder, and you do 2 puffs for your total dose instead of one, but it is a lot less irritating for my lungs than the powder (I started having shortness of breath problems with the disk <img src="i/expressions/face-icon-small-wink.gif" border="0"> ).
The Pharmacy in Mount Olive (on Mt. Olive Rd, before you get to Mt. Olive/Brookside Rd, going away from I-65) has been the only place in town I have been able to get my Dey HS to mix for the 7% (and my 3%) and also the cheapest (about half the cost of Pari Hypersal, though I do get the Hypersal for traveling <img src="i/expressions/face-icon-small-wink.gif" border="0"> ).
The first week or 2 can be kinda rough, but once you get through it, I think Richard will be happy with the results <img src="i/expressions/face-icon-small-smile.gif" border="0"> . Are they going to start him back on the Pulmozyme after a while? I usually just stop mine for 24 to 48 hours, depending on how bad the bleed was (I do realize that his circumstances are different right now however).