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Friday, June 1, 2012

Hypertonic Saline: I'm a believer

I recently started taking Hypertonic 7% Saline. When I say recently, I mean 2 days ago. I was a skeptic at first. I work as an RT and we give it to patients when we need them to cough something up for a sputum culture (this is where your mucus gets sent to a lab to see if it's growing any bacteria. I have one every 3 months at the CF clinic) Out of the hundred or so that I have given, I had only seen a handful of them work in helping people cough stuff up. So, I thought it was bologna. I figured it was all in people's heads that they were coughing more up and thought hey, if you wanna inhale some salt water have it at, but not me. :)

It wasn't long after it came out as being indicated for CFers, that my doctor approached me about adding it to my regimen. I am very respectful to my doctors and have told them from day 1 that I will not try to be my own doctor because I'm an RT. What they say goes! They're the physicians and I let them be just that. I will do my own research on medications and therapies to educate myself as I believe everyone should. When you have a chronic illness you should be educated and actively involved in your care. Back to my CF docs. They (there are 2 main physicians) wanted to add Hypertonic Saline. The one asked me what I thought about it. Whether I would be able to make time to fit in another treatment (at this point I was not getting every treatment done on a daily basis like I do now), and if I thought I needed to add something to keep me healthy. I declined and he agreed stressing that I HAD to start doing ALL my treatments as scheduled.

About a month ago, being an RT at the hospital where my CF clinic is, paid off yet again. I had the opportunity to sit in on Pulmonary Grand Rounds (where a pulmonary physician picks a topic and discusses it). The speaker just happened to be my CF doctor and the topic just happened to be Cystic Fibrosis! It was a fascinating presentation where I learned even more about what causes the disease to "function" the way it does, more about how CF treatments work in specific detail, and all sorts of other info. For example, the average CFer coughs 600 times a day!!! That's A LOT of coughing! No wonder my abs are so ripped, jk! :) Another is that a "healthy" person who developed a pseudomonas infection in the lungs or blood would probably have 10,000,000 colony forming units of pseudomonas. After 2 weeks of antibiotic therapy the pseudomonas would be wiped out. When a CFer has an exacerbation (they get sick), they can carry as much as 100,000,000 colony forming units of pseudomonas and after 2-3 weeks of IV's, will drop to 2.5 million colony forming units.  Our bodies are constantly fighting an infection that antibiotics cannot completely wipe out. This is one reason why we can feel tired at times and eat so much without any weight gain. Our bodies expend a lot of energy fighting the infection in our lungs. Fascinating right?!

To wrap up this long post, he discussed Hypertonic Saline and the reasons it is recommended for CFers. In the lungs there's a layer of fluid that have small finger like jobbers called cilia. The cilia move the mucus layer up toward the top of the lungs where it can be expelled (coughed out). Most people swallow it in their sleep. This is how the lungs clean themselves out. With CF the fluid layer is virtually non-existent. This is because the sodium-chloride channels in the lungs that help keep the fluid layer fluid are blocked. So the fluid layer has hardly any fluid to it. These channels being blocked also causes the mucus to be very thick and sticky, which crushes the cilia. So the lungs can't move the secretions out. Which we all know is what causes all our problems. Sooooo...... Hypertonic Saline makes the fluid layer in the lungs "beef" back up so the cilia can push the secretions out! Plus, it hydrates the secretions making them easier to cough up, and in some people irritates the airway inducing a cough. It works in 3 different ways, and I have definitely been able to tell! Plus, it makes me feel like I'm at the ocean swimming every time I swallow! Mmmm, salt water :)

Moral of this post: If you have CF and aren't yet taking Hypertonic Saline I suggest talking to your CF team about it and getting on the bandwagon! It works!

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