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 Spiriva and mucus drying - moving Mucus
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Dave-OH
Administrator

USA
3367 Posts

Posted - Apr 15 2010 :  12:10:53 PM  Show Profile  Reply with Quote
Three months ago, my doctor had me see the Bronchectasis specialist in the group. I had a growing problem with impacted secretions in the lower left lung. The doctor had me stop taking Spiriva and Benadryl. She stated the all Atrovent like drugs cause drying and that she felt that trying to stop these two drugs might help the situation.

I had no air movement in that portion of the lungs 3 months ago, and my lung function values had decreased over the last 3 years. It was hard at first (and with bad allergies) to drop these drugs.

Now three months later, my FVC is up almost 15%, my DLCO is up 10% and my total lung volume is up. And she can now here air movement in the lower left lung. I see here again in July and after that we will redo the CT scan.

Moving mucus, lung clearance, is much easier. I had used a lot of tools to get it out. I had 2 weeks of mucamyst. The mucus is looser and easier to cough up.

If you are having problems with you lung clearance, and you use Spiriva or Atrovent, talk to your doctor to discuss if a different therapy might be better.

Dave, Forum Administrator
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Casey-CA
Senior Member

USA
782 Posts

Posted - Apr 15 2010 :  5:07:04 PM  Show Profile  Reply with Quote
That is just plain incredible Dave. I was wondering how you were doing without those drugs.
Way to go!

Casey formerly majseventh
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Dave-OH
Administrator

USA
3367 Posts

Posted - Apr 18 2010 :  12:16:56 PM  Show Profile  Reply with Quote
I posted several days ago about the issue with Mucus drying and Atrovent class of drugs. That includes Spiriva, Combivent and Ipatropium (Generic Name). Many people on this list have problems with mucus clearance from the lungs. I do. I had taken Spirva since its US introduction. One of the issues with all drugs we take is the side effects. The Atrovent family of drugs have a drying effect, making the secretions harder to move. Since all of us are different and our disease is different, we should be aware of the issues that come with our medications.

In the last several years I had impacted mucus in my lower left lungs and the area was growing. My doctor had me consult a 3rd doctor in the practice and she recommended that I try to get by without the Spiriva. Well it worked. Three months alter (actually 6 weeks later with the first doctor) an area of my lungs that was not moving air (no breath sounds, and she described it as sounding like Darth Vader) was again moving air. Still reduced but noticeably increased. My FVC, DLCO and Lung Volume had increase - slightly less than the amount that is significant, but 14% is always good.

I think my FEV1 is still reduced as the Spirva helped that, but we intend to do another PFT in 90 days, and a CT scan after that. I hope that by the end of the summer that my FEV1 was move up about 20% - I am at 32%, so that would but me at about 38%. For someone with reduced lung function, that is a huge increase.

The point is that if you are taking an Atrovent class of drugs and have a problem with getting the gunk (a very technical term) out of your lungs, talk to you doctor about changing your medication. It was much easier to cut the drying agents than to use thinning agents like Mucamyst (awful and somewhat dangerous) and Mucinex.

You still need to move the mucus. I find moving the total body one great way to get the stuff up, and as little as a short walk will move it out. I use an Acapella and Huff Cough to get it out. They both work.

If you have more questions, please ask.

Dave, Forum Administrator
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CarolCA
Contributing Member

USA
3139 Posts

Posted - Apr 18 2010 :  2:53:15 PM  Show Profile  Reply with Quote
Have you ever used just plain saline in your neb? I find that it works very well and is used by people with cystic fibrosis. I get it on line in the little vials. Same stuff they mix themeds with. I have always felt that ATrovent by neb made my nose stuffy. I still use in on occassion but after a couple days I realize it is doing it again.
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Dave-OH
Administrator

USA
3367 Posts

Posted - Apr 18 2010 :  4:39:54 PM  Show Profile  Reply with Quote
Yes, I use normal saline in the little read tubes with Albuterol for clearance. I also sometimes use 3% saline. My new doctor is the Adult CF director, and Cincinnati is one of the training centers for CF Doctors, with our Children's Hospital one of the CF Centers of Excellence.

Dave, Forum Administrator
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LindaParker
Rookie

USA
3 Posts

Posted - Apr 18 2010 :  8:39:44 PM  Show Profile  Reply with Quote
Dave,

Not knowing any better I suspect I just replied to your comments re PAs in the Trash Can again. I think I'd best go back to the beginning and try to learn how to use this wonderfully informative forum.

Thanks,
Linda
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Dave-OH
Administrator

USA
3367 Posts

Posted - Apr 18 2010 :  8:59:17 PM  Show Profile  Reply with Quote
I moved the topic to where it belongs and him the trash can as it was supposed to be.

Dave, Forum Administrator
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CarolCA
Contributing Member

USA
3139 Posts

Posted - Apr 18 2010 :  9:19:29 PM  Show Profile  Reply with Quote
I wonder why more doctors don't recommend the saline for neb. I did it on my own and found it also helped my nasal passages. I asked my doctor if he had a problem with it and he asked if it helped and I said yes so he said OK. Now he is board certified in Pulmonary/ Critical care so why isn't this ever suggested? Its better than using Albuteral more often.
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neenee33
Member

USA
39 Posts

Posted - Apr 27 2010 :  6:19:55 PM  Show Profile  Reply with Quote
That's very interesting about using saline in the nebulizer. If it helps as much or at least almost as much, as the prescription drugs, why are drugs used?

I now have a bottle of water that hooks on to the compressor, as I was getting frequent bloody nosebleeds. I had a serious one a couple of weeks ago, and ended up in the ER, as I couldn't get it to stop.
Last week I had that side of my nose cauterized, and hopefully won't run into that problem again. But, that is the reason I am questioning the saline - I'm going to ask the new Dr. I will be seeing in a couple of weeks, about that.

Arlene
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CarolCA
Contributing Member

USA
3139 Posts

Posted - Apr 27 2010 :  8:20:10 PM  Show Profile  Reply with Quote
Arlene, it doesn't open up the bronchial tubes but I guess just moisturizes them. I use it sometimes after I use my Albuteral and sometimes I use it alone to help clear the airways. I don't know much about it except that it is used for Cystic Fibrosis for airway clearance.
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coxp967
Rookie

7 Posts

Posted - May 31 2010 :  3:29:27 PM  Show Profile  Reply with Quote
quote:
Originally posted by Dave-OH

Yes, I use normal saline in the little read tubes with Albuterol for clearance. I also sometimes use 3% saline. My new doctor is the Adult CF director, and Cincinnati is one of the training centers for CF Doctors, with our Children's Hospital one of the CF Centers of Excellence.

I am new, so learning how to reply. Can I find out the particulars on using saline solution for stuffy nose. Mine so stuffy all the time have to put oxygen nose piece in mouth. I use ipratropium Bromide and Albuterol mixture in neb. could this be causing stuffy constant stuffy nose. I have use a Omron Micro Air nebulizer. can saline solution be used in it?
Also, where do you get the vials of saline?

Edited by - coxp967 on May 31 2010 3:38:38 PM
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CarolCA
Contributing Member

USA
3139 Posts

Posted - May 31 2010 :  5:58:17 PM  Show Profile  Reply with Quote
Iprotropium gives me nasal congestion and yet the Ear, nose and throat doctor recommended a Iprotropium spray for my nose. Atrovent. I think the safest thing to use is the NeilMed Sinus Rinse which you can buy at any drug store. The bottle comes with the packets. I don't like the Simply Saline spray as I feel it is too powerful and too salty compared to the Neil Med.

Saline can be used with the Omron. I have an Omron for travel but the one thing I don't like about it is that it gets in my eyes more than a regular neb. For the neb I use the 3ml 0.9 Addipak. If you google that you will get different websites that sell it. I just pick the cheapest place. it is the red/pinkish vial. Check Amazon. Just to be clear the NeilMed goes into the sinus passages and the neb goes into the mouth since we are talking about a couple different things here.
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Dave-OH
Administrator

USA
3367 Posts

Posted - May 31 2010 :  11:59:41 PM  Show Profile  Reply with Quote
I have used the nasal rinse for years. I also use nasal Atrovent for the drying action. The doctors want to dry the nose, not the lungs. Right now Costco has a deal on Neilmed.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
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