Neb order during treatments...

[CaliSally]

Congratulations on keeping up treatments - that is AWESOME!!!!

Others are right - <u>you need to get a new neb</u>.
Are you with a CF approved clinic? If so, they should be on the ball about seeing that you get a new one. Ours always asks how old my neb is...if it's more than 2 years, they will rx a new one.
In order for the meds to be effective, they are supposed to be administered within a certain time frame. So if a med is taking you twice as long as it should, it may not be AS effective.

I don't use tobi so I don't know where it fits in, but otherwise I do the same order as you. (so, alberteral, pulmo, hts) I know there are varying thoughts on when to use the pulmo - do you do it last, so it can sit in there and not be coughed out...or during, so it can loosen things up before the hts, to make it easier to cough out. Well, I guess that's matter of your coughing habits (who knows...)
Personally, I don't have a productive cough during nebs. It's not until hours later when I lay, propped up, that the junk starts to move. So for me, I don't think it would matter if I moved the pulmo to the very end.

Also, they used to say to do the nebs first, and then the vest. Now they are saying it's ok to do the vest at the same time.

Best wishes

 

[CaliSally]

Congratulations on keeping up treatments - that is AWESOME!!!!

Others are right - <u>you need to get a new neb</u>.
Are you with a CF approved clinic? If so, they should be on the ball about seeing that you get a new one. Ours always asks how old my neb is...if it's more than 2 years, they will rx a new one.
In order for the meds to be effective, they are supposed to be administered within a certain time frame. So if a med is taking you twice as long as it should, it may not be AS effective.

I don't use tobi so I don't know where it fits in, but otherwise I do the same order as you. (so, alberteral, pulmo, hts) I know there are varying thoughts on when to use the pulmo - do you do it last, so it can sit in there and not be coughed out...or during, so it can loosen things up before the hts, to make it easier to cough out. Well, I guess that's matter of your coughing habits (who knows...)
Personally, I don't have a productive cough during nebs. It's not until hours later when I lay, propped up, that the junk starts to move. So for me, I don't think it would matter if I moved the pulmo to the very end.

Also, they used to say to do the nebs first, and then the vest. Now they are saying it's ok to do the vest at the same time.

Best wishes

 

[CaliSally]

Congratulations on keeping up treatments - that is AWESOME!!!!

Others are right - <u>you need to get a new neb</u>.
Are you with a CF approved clinic? If so, they should be on the ball about seeing that you get a new one. Ours always asks how old my neb is...if it's more than 2 years, they will rx a new one.
In order for the meds to be effective, they are supposed to be administered within a certain time frame. So if a med is taking you twice as long as it should, it may not be AS effective.

I don't use tobi so I don't know where it fits in, but otherwise I do the same order as you. (so, alberteral, pulmo, hts) I know there are varying thoughts on when to use the pulmo - do you do it last, so it can sit in there and not be coughed out...or during, so it can loosen things up before the hts, to make it easier to cough out. Well, I guess that's matter of your coughing habits (who knows...)
Personally, I don't have a productive cough during nebs. It's not until hours later when I lay, propped up, that the junk starts to move. So for me, I don't think it would matter if I moved the pulmo to the very end.

Also, they used to say to do the nebs first, and then the vest. Now they are saying it's ok to do the vest at the same time.

Best wishes

 

[CaliSally]

Congratulations on keeping up treatments - that is AWESOME!!!!

Others are right - <u>you need to get a new neb</u>.
Are you with a CF approved clinic? If so, they should be on the ball about seeing that you get a new one. Ours always asks how old my neb is...if it's more than 2 years, they will rx a new one.
In order for the meds to be effective, they are supposed to be administered within a certain time frame. So if a med is taking you twice as long as it should, it may not be AS effective.

I don't use tobi so I don't know where it fits in, but otherwise I do the same order as you. (so, alberteral, pulmo, hts) I know there are varying thoughts on when to use the pulmo - do you do it last, so it can sit in there and not be coughed out...or during, so it can loosen things up before the hts, to make it easier to cough out. Well, I guess that's matter of your coughing habits (who knows...)
Personally, I don't have a productive cough during nebs. It's not until hours later when I lay, propped up, that the junk starts to move. So for me, I don't think it would matter if I moved the pulmo to the very end.

Also, they used to say to do the nebs first, and then the vest. Now they are saying it's ok to do the vest at the same time.

Best wishes

 

[CaliSally]

Congratulations on keeping up treatments - that is AWESOME!!!!

Others are right - <u>you need to get a new neb</u>.
Are you with a CF approved clinic? If so, they should be on the ball about seeing that you get a new one. Ours always asks how old my neb is...if it's more than 2 years, they will rx a new one.
In order for the meds to be effective, they are supposed to be administered within a certain time frame. So if a med is taking you twice as long as it should, it may not be AS effective.

I don't use tobi so I don't know where it fits in, but otherwise I do the same order as you. (so, alberteral, pulmo, hts) I know there are varying thoughts on when to use the pulmo - do you do it last, so it can sit in there and not be coughed out...or during, so it can loosen things up before the hts, to make it easier to cough out. Well, I guess that's matter of your coughing habits (who knows...)
Personally, I don't have a productive cough during nebs. It's not until hours later when I lay, propped up, that the junk starts to move. So for me, I don't think it would matter if I moved the pulmo to the very end.

Also, they used to say to do the nebs first, and then the vest. Now they are saying it's ok to do the vest at the same time.

Best wishes

 

[Ratatosk]

I thought tobi was supposed to be last, otherwise with the HTS and pulmozyme, it's just coughed out ? We don't do HTS, but DS does do Tobi & Pulmozyme. I was getting too confused, so we do Pulmozyme at night (10 p.m.) after duoneb (albuterol/atrovent). We do tobi at 6 a.m. and 6 p.m. after the duoneb.

I bought a new devilbiss pulmoaid after I realized that treatments on the 2 year old pari proneb ultra were taking forever -- duoneb about 25-30 minutes, tobi was taking 45 minutes. We have a 14 year old devilbiss from DH's cousin who had asthma and it still works like a charm -- don't make them like they used to, which we use as a spare if we're visiting the outlaws.

With the devilbiss' takes about 15 minutes for the duoneb and 20 minutes for tobi.

 

[Ratatosk]

I thought tobi was supposed to be last, otherwise with the HTS and pulmozyme, it's just coughed out ? We don't do HTS, but DS does do Tobi & Pulmozyme. I was getting too confused, so we do Pulmozyme at night (10 p.m.) after duoneb (albuterol/atrovent). We do tobi at 6 a.m. and 6 p.m. after the duoneb.

I bought a new devilbiss pulmoaid after I realized that treatments on the 2 year old pari proneb ultra were taking forever -- duoneb about 25-30 minutes, tobi was taking 45 minutes. We have a 14 year old devilbiss from DH's cousin who had asthma and it still works like a charm -- don't make them like they used to, which we use as a spare if we're visiting the outlaws.

With the devilbiss' takes about 15 minutes for the duoneb and 20 minutes for tobi.

 

[Ratatosk]

I thought tobi was supposed to be last, otherwise with the HTS and pulmozyme, it's just coughed out ? We don't do HTS, but DS does do Tobi & Pulmozyme. I was getting too confused, so we do Pulmozyme at night (10 p.m.) after duoneb (albuterol/atrovent). We do tobi at 6 a.m. and 6 p.m. after the duoneb.

I bought a new devilbiss pulmoaid after I realized that treatments on the 2 year old pari proneb ultra were taking forever -- duoneb about 25-30 minutes, tobi was taking 45 minutes. We have a 14 year old devilbiss from DH's cousin who had asthma and it still works like a charm -- don't make them like they used to, which we use as a spare if we're visiting the outlaws.

With the devilbiss' takes about 15 minutes for the duoneb and 20 minutes for tobi.

 

[Ratatosk]

I thought tobi was supposed to be last, otherwise with the HTS and pulmozyme, it's just coughed out ? We don't do HTS, but DS does do Tobi & Pulmozyme. I was getting too confused, so we do Pulmozyme at night (10 p.m.) after duoneb (albuterol/atrovent). We do tobi at 6 a.m. and 6 p.m. after the duoneb.

I bought a new devilbiss pulmoaid after I realized that treatments on the 2 year old pari proneb ultra were taking forever -- duoneb about 25-30 minutes, tobi was taking 45 minutes. We have a 14 year old devilbiss from DH's cousin who had asthma and it still works like a charm -- don't make them like they used to, which we use as a spare if we're visiting the outlaws.

With the devilbiss' takes about 15 minutes for the duoneb and 20 minutes for tobi.

 

[Ratatosk]

I thought tobi was supposed to be last, otherwise with the HTS and pulmozyme, it's just coughed out ? We don't do HTS, but DS does do Tobi & Pulmozyme. I was getting too confused, so we do Pulmozyme at night (10 p.m.) after duoneb (albuterol/atrovent). We do tobi at 6 a.m. and 6 p.m. after the duoneb.

I bought a new devilbiss pulmoaid after I realized that treatments on the 2 year old pari proneb ultra were taking forever -- duoneb about 25-30 minutes, tobi was taking 45 minutes. We have a 14 year old devilbiss from DH's cousin who had asthma and it still works like a charm -- don't make them like they used to, which we use as a spare if we're visiting the outlaws.

With the devilbiss' takes about 15 minutes for the duoneb and 20 minutes for tobi.

 

[AnD]

Yes, Tobi (or any other inhaled antibiotic) is always the last neb...


<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mom2lillian</b></i>


I know the peak effectiveness of the pulmozyme is 4-5 hours and I wonder how that is impacted by HTS use.



Also, does anyone know why my HTS that is compounded for me expires in one month? Doesnt it seem it should be stable a bit longer htan that?

</end quote></div>


Do you have a source you can post about the peak effectiveness of Pulmozyme? I read that here (probably was you! <img src="i/expressions/face-icon-small-wink.gif" border="0"> ), but I couldn't find it and would like to have it for my files, in case the dr and I get in a discussion about it <img src="i/expressions/face-icon-small-wink.gif" border="0"> . That is one of the reasons I decided to see if doing the Pulmozyme after the HS would work better <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

It seems like all the compounded HS's seem to be different. The one I have says it is good for 90 days refrigerated. Others I have read have to keep theirs in the freezer, and thaw it out 2 weeks worth at a time...I have no idea!

 

[AnD]

Yes, Tobi (or any other inhaled antibiotic) is always the last neb...


<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mom2lillian</b></i>


I know the peak effectiveness of the pulmozyme is 4-5 hours and I wonder how that is impacted by HTS use.



Also, does anyone know why my HTS that is compounded for me expires in one month? Doesnt it seem it should be stable a bit longer htan that?

</end quote></div>


Do you have a source you can post about the peak effectiveness of Pulmozyme? I read that here (probably was you! <img src="i/expressions/face-icon-small-wink.gif" border="0"> ), but I couldn't find it and would like to have it for my files, in case the dr and I get in a discussion about it <img src="i/expressions/face-icon-small-wink.gif" border="0"> . That is one of the reasons I decided to see if doing the Pulmozyme after the HS would work better <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

It seems like all the compounded HS's seem to be different. The one I have says it is good for 90 days refrigerated. Others I have read have to keep theirs in the freezer, and thaw it out 2 weeks worth at a time...I have no idea!

 

[AnD]

Yes, Tobi (or any other inhaled antibiotic) is always the last neb...


<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mom2lillian</b></i>


I know the peak effectiveness of the pulmozyme is 4-5 hours and I wonder how that is impacted by HTS use.



Also, does anyone know why my HTS that is compounded for me expires in one month? Doesnt it seem it should be stable a bit longer htan that?

</end quote></div>


Do you have a source you can post about the peak effectiveness of Pulmozyme? I read that here (probably was you! <img src="i/expressions/face-icon-small-wink.gif" border="0"> ), but I couldn't find it and would like to have it for my files, in case the dr and I get in a discussion about it <img src="i/expressions/face-icon-small-wink.gif" border="0"> . That is one of the reasons I decided to see if doing the Pulmozyme after the HS would work better <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

It seems like all the compounded HS's seem to be different. The one I have says it is good for 90 days refrigerated. Others I have read have to keep theirs in the freezer, and thaw it out 2 weeks worth at a time...I have no idea!

 

[AnD]

Yes, Tobi (or any other inhaled antibiotic) is always the last neb...


<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mom2lillian</b></i>


I know the peak effectiveness of the pulmozyme is 4-5 hours and I wonder how that is impacted by HTS use.



Also, does anyone know why my HTS that is compounded for me expires in one month? Doesnt it seem it should be stable a bit longer htan that?

</end quote>


Do you have a source you can post about the peak effectiveness of Pulmozyme? I read that here (probably was you! <img src="i/expressions/face-icon-small-wink.gif" border="0"> ), but I couldn't find it and would like to have it for my files, in case the dr and I get in a discussion about it <img src="i/expressions/face-icon-small-wink.gif" border="0"> . That is one of the reasons I decided to see if doing the Pulmozyme after the HS would work better <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

It seems like all the compounded HS's seem to be different. The one I have says it is good for 90 days refrigerated. Others I have read have to keep theirs in the freezer, and thaw it out 2 weeks worth at a time...I have no idea!

 

[AnD]

Yes, Tobi (or any other inhaled antibiotic) is always the last neb...


<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mom2lillian</b></i>


I know the peak effectiveness of the pulmozyme is 4-5 hours and I wonder how that is impacted by HTS use.



Also, does anyone know why my HTS that is compounded for me expires in one month? Doesnt it seem it should be stable a bit longer htan that?

</end quote>


Do you have a source you can post about the peak effectiveness of Pulmozyme? I read that here (probably was you! <img src="i/expressions/face-icon-small-wink.gif" border="0"> ), but I couldn't find it and would like to have it for my files, in case the dr and I get in a discussion about it <img src="i/expressions/face-icon-small-wink.gif" border="0"> . That is one of the reasons I decided to see if doing the Pulmozyme after the HS would work better <img src="i/expressions/face-icon-small-smile.gif" border="0"> .

It seems like all the compounded HS's seem to be different. The one I have says it is good for 90 days refrigerated. Others I have read have to keep theirs in the freezer, and thaw it out 2 weeks worth at a time...I have no idea!

 

[Alyssa]

I didn't really read everyone's replies - sorry if this is a repeat, but here is the theory behind what I have been told

1)First you want to open up the airways - so dilators come first (albuteral etc)

2)Also dilators help H-Saline to work better, so do the H-Saline next
-- also since saline can cause cough it's good to do this before Pulmozyme or antibiotics

3) You want as much gunk out of your lungs as possible before you start putting the medication that you want to stay in there -- like your pulmozyme & tobi or other antibiotics, so they come last.

H-Saline should be in the 5mL range and only done for 10 minutes. Get a new compressor. If insurance is an problem buy it outright if you can, they are about a $100. or less - you can get them online or even on eBay sometimes.

 

[Alyssa]

I didn't really read everyone's replies - sorry if this is a repeat, but here is the theory behind what I have been told

1)First you want to open up the airways - so dilators come first (albuteral etc)

2)Also dilators help H-Saline to work better, so do the H-Saline next
-- also since saline can cause cough it's good to do this before Pulmozyme or antibiotics

3) You want as much gunk out of your lungs as possible before you start putting the medication that you want to stay in there -- like your pulmozyme & tobi or other antibiotics, so they come last.

H-Saline should be in the 5mL range and only done for 10 minutes. Get a new compressor. If insurance is an problem buy it outright if you can, they are about a $100. or less - you can get them online or even on eBay sometimes.

 

[Alyssa]

I didn't really read everyone's replies - sorry if this is a repeat, but here is the theory behind what I have been told

1)First you want to open up the airways - so dilators come first (albuteral etc)

2)Also dilators help H-Saline to work better, so do the H-Saline next
-- also since saline can cause cough it's good to do this before Pulmozyme or antibiotics

3) You want as much gunk out of your lungs as possible before you start putting the medication that you want to stay in there -- like your pulmozyme & tobi or other antibiotics, so they come last.

H-Saline should be in the 5mL range and only done for 10 minutes. Get a new compressor. If insurance is an problem buy it outright if you can, they are about a $100. or less - you can get them online or even on eBay sometimes.

 

[Alyssa]

I didn't really read everyone's replies - sorry if this is a repeat, but here is the theory behind what I have been told

1)First you want to open up the airways - so dilators come first (albuteral etc)

2)Also dilators help H-Saline to work better, so do the H-Saline next
-- also since saline can cause cough it's good to do this before Pulmozyme or antibiotics

3) You want as much gunk out of your lungs as possible before you start putting the medication that you want to stay in there -- like your pulmozyme & tobi or other antibiotics, so they come last.

H-Saline should be in the 5mL range and only done for 10 minutes. Get a new compressor. If insurance is an problem buy it outright if you can, they are about a $100. or less - you can get them online or even on eBay sometimes.

 

[Alyssa]

I didn't really read everyone's replies - sorry if this is a repeat, but here is the theory behind what I have been told

1)First you want to open up the airways - so dilators come first (albuteral etc)

2)Also dilators help H-Saline to work better, so do the H-Saline next
-- also since saline can cause cough it's good to do this before Pulmozyme or antibiotics

3) You want as much gunk out of your lungs as possible before you start putting the medication that you want to stay in there -- like your pulmozyme & tobi or other antibiotics, so they come last.

H-Saline should be in the 5mL range and only done for 10 minutes. Get a new compressor. If insurance is an problem buy it outright if you can, they are about a $100. or less - you can get them online or even on eBay sometimes.