2006 Notebook

Hypertonic Saline

A week ago I called my doctor for a refill prescription for hypertonic saline, which is saline solution with extra salt. I nebulize and inhale it to help with my cystic fibrosis. The stuff is cheap, but sometimes it can be very hard to get. There appears to be only one manufacturer, who lets it go out of stock often. So, when I called my doctor, I wasn’t surprised to find that neither of the two local pharmacies I use could get it.

While talking to a nurse at my doctor’s office, trying to brainstorm what to do next, he offhandedly said “You can make this yourself. Would you like the recipe?”. I was momentarily dumbfounded. For years I’ve had problems getting this stuff, and you’re only offering the recipe now? “Yes,” I said with remarkable calm. “Let me get a pen.”

Hypertonic Saline


  • 1 cup water (I use distilled)
  • ½ tsp salt without additives (kosher, pickling, or sea salt)
  • ¼ tsp baking soda


Boil the ingredients together, then seal in an airtight container. It will keep for a week at room temperature. For a larger amount, double the recipe.

The next time I speak with him, I must remember to ask the nurse whether he has the recipe for the digestive enzymes that cost about $250 per month.


Addendum, 2006-01-20: Two days after I posted this, hypertonic saline suddenly became newsworthy. Most of the articles I read made it sound like a breakthrough, missing the fact that hypertonic saline’s been part of some people’s therapy regimens for years. Even worse was this quote from an article in USA Today: “The Cystic Fibrosis Foundation estimates the cost to be about $110 a month, less than one-tenth the cost of other drugs.” That $110 figure isn’t a typo; it’s what the CF Foundation Pharmacy currently charges for hypertonic saline. Yet I can make a year’s worth for $10. Perhaps there’s a good explanation, but it sure looks like someone’s getting fleeced.

Addendum, 2006-01-25: I asked the CF Foundation Pharmacy about their price for hypertonic saline:

Hi folks. The recent news about hypertonic saline’s efficacy for CF
treatment prompted me to check your price for it:

Hypertonic Saline Kit (3% Saline, 10% Saline & Syringes)    1   $111.80

(from https://www.cfservicespharmacy.com/ProductsandPrices/)

Why the high price? This seems amazingly expensive for a mixture of salt,
water, and baking soda. Granted, syringes aren’t free, but they’re not that
expensive. I want to believe the CFF Pharmacy offers good value to its
customers, but I can’t help but wonder at the high price for something that
CF patients can -- and do -- make themselves. What am I missing?

Mark Irons

Their response (I can’t call it an answer):

Thank you for contacting CF Services.

The pricing for Hypertonic Saline was decided on by our executive management
due to contents involved.  Not these items are sold separately and condensed
into a kit.

If you have any additional questions, e-mail us at comments@cfserv.com or
contact our Customer Support Department at (800) 541-4959.

The question of whether they’re ripping off their customers remains open.

Talking about Talking

Today’s Rule: when the subject of a forum turns to the forum itself, it’s time to leave. The creative phase of the forum is over.

This rule is a paraphrase of one of my favorite quotes, from Larry Marder: “If I knew anything from the history of art, it’s that when artists start writing manifestos, that means the movement is as dead as a doornail.”.


Fortune and Luck

While talking with a friend during a long car ride, we discovered that I make a distinction between fortune and luck. It’s a bit hard to put into words, but I’ll try. To me, fortune is something that plays out on the large scale, something that you have no hand in. Being born into a good family is an example of good fortune; you have no choice in the matter at all. Luck, on the other hand, is something that’s more local, something you ostensibly affect. Picking a winning lottery ticket or making a good die roll are examples of good luck. In that sense, luck is local, fortune global.

The obvious objection to this distinction is that your participation in “lucky” events is minimal, as the whole point of both fortune and luck is that events are not in your control. I’m still trying to work that into my conceptual model.


Last updated 18 June 2007
All contents ©2006 Mark L. Irons

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