Always keep on top of your nebulizing equipment. I am currently treating PAP with inhaled GM-CSF through a vibrating mesh nebulizer; the Pari eRapid system to be exact. Over the last few months, I barely noticed the degradation of my treatments as it occurred over such a long period of time. Yet recently, my nebulization time was nearing 10 minutes, which I knew was dramatically longer than when I first purchased my equipment. I finally replaced my nebulizer's vibrating mesh head and my nebulizing time (for 1.5ml of saline + GM-CSF) was only 2 minutes! Despite regular cleaning and sanitization, vibrating mesh nebulizers degrade and experience significant performance declines. I have now set up my calendar to automatically remind me every 6 months to replace my nebulizer's vibrating mesh head.
I just wanted to emphasize how important, vital, it is to use your supplemental oxygen if your O2 blood saturation rates (SATs) are low, usually less than <90. My PAP was very aggressive. Even after being lavaged, my SATs improved but still remained low. My vanity kept me from using my oxygen. When I almost passed out in the grocery store I decided it was less embarrassing to use my oxygen than to be known as the guy who "Needed Clean Up in Aisle 5" of the local grocery store! I was on continuous oxygen 24/7 for over 4 years. Sometimes I needed as much as 15L to keep me at 90. I started with compressed air tanks, which proved way too inconvenient. I switched to liquid oxygen hi-flow portables which gave me much greater flexibility and portability. The hi-flow liquid O2 portables allowed me to work and play. I played golf and hunted big game with these hi-flow portables. When I was resting at home I used a concentrator. The supplemental O2 made me feel much better and I was able to get about my life. It also helped keep my body healthy while fighting off PAP. So, please use your supplemental oxygen if you need it! Steve Park - VP for Development, PAP Foundation