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 Directed Cough & Autogenic Clearance ****
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Dave-OH
Administrator

USA
3874 Posts

Posted - Feb 24 2009 :  9:27:20 PM  Show Profile  Reply with Quote
While in the hospital, I learned a new way to clear lung secretions (mucus, gunk, etc.). I will be posting a series on information on this technique. I can tell you it works. The CF director was covering one of the weekends I was in the hospital (I was there 2 weeks) and it was her suggestion I try it to get the impacted mucus that showed up on my CT scan. I can tell you it works. It works much better than more expensive and time consuming lung clearance techniques including the Vest and the IPV.

One of the Respiratory Techs from the PFT lab came up to teach me these techniques. It took about a half hour in all to learn them.

It may sound hard, but a few tries, and it should work.


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Dave-OH
Administrator

USA
3874 Posts

Posted - Feb 24 2009 :  9:28:44 PM  Show Profile  Reply with Quote
THE HUFF COUGH TECHNIQUE

Coughing is one of the most important lung defense mechanisms, and unfortunately it is significantly impaired in COPD. While the nasal passages provide a mechanism to warm and humidify the incoming air, and trap dirt particles and germs, inevitably some undesirable foreign material penetrates down into the lungs. Coughing is needed to clear undesirable material from the bronchial tubes. This module will teach you a more efficient way to do a COPD cough, called "Huff Coughing." To understand Huff Coughing you first need to have some understanding of normal coughing.

The Normal Cough

With normal coughing you take in a deep breath, then close the vocal cords in your throat "Voice Box" (called the "Glottis") to shut off air flow from the lungs. Then, straining with your chest and abdominal muscles you build up a high expiration pressure in your lungs. At this juncture the "Cough Center" in the brain initiates an abrupt opening of the Glottis, which then produces an explosive blast of air from the lungs that propels the mucus (called "Phlegm" or " Sputum") out as an expectoration.

The Impaired Cough of COPD and Emphysema

Unfortunately with COPD / Emphysema the cough is typically weak. Not only are the muscles building up pressure usually weakened, the airways are narrowed and distorted. Therefore the necessary explosive rush of air for effective mucus clearing cannot be generated. In addition, and very important, your airways are particularly prone to premature collapse. High pressure straining therefore causes rapid and excessive bronchial closure, further impairing the rapid blast of air flow necessary for an effective cough. The Huff Cough technique will teach you a new and more efficient method of coughing.

The Huff Cough for COPD and Emphysema

In contrast to the normal cough, Huff Coughing is a low pressure cough, which uses a series of several "mini-coughs" instead of a typical single big cough. Here is how it is done.

First, it is crucial that you get an adequate volume of air deep into your lungs, past the mucus or phlegm. Without an adequate preparatory volume of air deep in the lungs and behind the phlegm, to force the phlegm out, your cough isn't going to move much. To get a good breath in, remember the basic rule, that every breath of air must begin by first getting the old stale air out of your lungs. Here there is a special need to get an adequate breath in, though it is not necessary to take in a maximal inspiration breath for coughing. A comfortably large breath should be adequate. If you are feeling the need to cough, it is commonly associated with the condition of lung overinflation. This is why it is particularly important for you to first have a good exhalation, and then take in that initial deep breath of air for the Huff Cough.

In addition, these deep inspirations and expirations have a massaging or "milking" effect on the bronchial tubes, to further loosen-up and dislodge the phlegm, and prepare it for the Huff Cough to finally remove it from the lungs.

The Huff Cough Technique

To deflate the excess air from your lungs, slow your breathing way down, and do a gentle and prolonged exhalation over three or four breaths. In doing this series of preparatory deflation breaths, don't breathe in a full breath, or you will re-inflate your lungs again. Breathe in only about 75 to 80% of a normal inspiration breath. "Breathing Belt" exercises and the "Respiratory Squeeze" technique, described elsewhere, may be used to advantage here.

Now, take in a slow, comfortably deep breath (but not a maximum deep breath).

At this juncture you must now concentrate on keeping your Glottis ("Voice Box") open, and with your mouth open and shaped like a loose "O." With the Glottis and above-glottis structures now kept open, it is impossible to build-up a high pressure cough.

Now, give a short, abrupt, relatively gentle "mini-cough" by a sudden contracting of your upper abdominal muscles. Try to imagine contracting centrally, from just below your ribs down to your umbilicus. If you do this correctly you should produce a soft exhalation sound like word "huff," hence the name Huff Cough. You should not speak the word Huff, but rather make the "huff" noise. Note how different this is from the typical sharp, barking, explosive sound of a normal cough. The character of the huffing sound is a good indication to you and your caregivers as to your effectiveness in performing the technique properly.

Remember, the moment you produce the Huff Cough you will also initiate some excessive bronchial compression, which will immediately impair phlegm clearing. This is why the Huff Cough must be kept very short. But this bronchial compression is not as bad as with a traditional hard cough, particularly if it is a repetitive cough, as this "normal" cough will cause much more dynamic bronchial closure, and therefore wasted energy with little further mucus production.

Now, at the end of the Huff, take in a quick partial breath of air, and try to feel this being sucked into the bottom of your chest. This is to again put some air out past the offending mucus, and to open up the collapsed airways, in preparation for the next Huff Cough. Do not take in a deep breath as you did at the beginning of this exercise.

Now, repeat the Huff Cough a second time, this time with this smaller breath.

Again, abruptly take in a still smaller partial breath, and repeat the Huff Cough for a third time. Some times patients may feel difficulty in getting-in that third Huff Cough, and if so then do only two Huff Coughs.

At this juncture, at the end of the Huff Cough sequence, with progressively smaller cough volumes, you should feel that most all of the air is out of your lungs. This is because you were not taking in the same sized deep breaths between the Huff Coughs. Note that by doing this series of decreasing lung volumes you will help to further "milk" and squeeze phlegm from your lungs.

Next, take in a forced, full (but not maximally full) breath of air deep into the bottom of your lungs.

Now, keeping the Glottis open, give a single, hard, FORCED Huff Cough. This forced breath should result in phlegm being produced to where it can be expectorated.

What has happened here is, the two or three (preferably three) Huff mini-coughs have loosened peripheral small bronchial mucus, and progressively brought it into the large bronchial tubes, and the single larger FORCED HUFF cough results in final expectoration.

Failure to finally expectorate your phlegm

Sometimes the final forced Huff Cough brings sticky mucus only part way up, where it "hangs-up" in your large airways and causes a further coughing attack. This can be hard to control and very distressing. If you are in this situation, don't panic and try to force the phlegm out with a series of hard coughs.

Stay calm, and try to suppress your coughing spasms. Concentrate on doing slow, deep breaths with a long expiration time. You may also do Pursed Lip Breathing to help your dyspnea. Rest yourself, and regain your strength. A sip or two of water often helps with cough control.

Almost always this situation produces a temporary state of lung overinflation, so it is very important for your recovery that you concentrate on lung deflation as noted above. Then, repeat the Huff Cough sequence as needed.

As sticky phlegm is often the culprit causing this problem, increase your clear fluid intake for the next few days, until your urine becomes consistently less yellow, as an indication of adequate general hydration. This is done to moisten the phlegm and encourage looser sputum.

Remember, always immediately examine your sputum at least twice a day, and particularly the first morning sputum. This should be done in a tissue to enable close inspection. If you suspect you are developing a "Chest Cold" bronchial infection you should examine all of your phlegm for signs of progressive infection.

It is very important that you know what your "normal"phlegm looks like. This must be done to permit recognition of early bronchial infections. Examine all sputum if it is suddenly getting less in amount, or thicker or stickier, or if it becomes slightly opaque, or dirty yellowish or greenish appearing. This may be the warning signal of early bronchial infection, a so-called "Bronchitic Exacerbation." This may require prompt medical attention to prevent a more serious bronchial or lung infection. More on this important topic in another module.

Huff Cough technique Summary

In summary, the sequence of the Huff Coughing technique is:

* Lung Deflation (several breaths, or with Breathing Belt and/or Respiratory Squeeze assist).
* Deep breath in.
* Huff Cough #1, with lung deflation, followed by rapid partial inspiration.
* Huff Cough #2, with further lung deflation, followed by rapid partial inspiration.
* Huff Cough #3, with still further lung deflation, down to near the bottom of your lungs.
* Deep breath in.
* Single abrupt FORCED HUFF cough, for final expectoration.
* Repeat as necessary after a brief rest if clearance is not complete.
* Examine your sputum in a tissue, at least twice a day.

Dave, Forum Administrator
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rpj3
Rookie

18 Posts

Posted - Feb 24 2009 :  11:18:27 PM  Show Profile  Reply with Quote
Thank you for the very clear instructions ... most usefull. Richard (aka rpj3)
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Jad-NV
Rookie

USA
18 Posts

Posted - Feb 25 2009 :  02:54:43 AM  Show Profile  Reply with Quote
Good coverage of preventing anticipated difficulties. Thanks, Dave...Jad
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Dave-OH
Administrator

USA
3874 Posts

Posted - Feb 25 2009 :  1:32:09 PM  Show Profile  Reply with Quote
It is simpler than it sounds. Huff out for your cough a few times. It causes me to cough and then move mucus that other clearance methods do not produce.

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Dave-OH
Administrator

USA
3874 Posts

Posted - Feb 26 2009 :  11:38:50 PM  Show Profile  Reply with Quote
Bump it to keep it on top. I was a doctor today, and discussed this again. His partner who is the CF director was covering the hospital, and she was the doctor who told me about it. He was not familiar. A RT came up to teach me the techniques. I was so impressed that I had to share them. There is more to come.

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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 01 2009 :  1:15:51 PM  Show Profile  Reply with Quote
I have added a series of articles on Autogenic Drainage. It works, but takes time to perfect. There are two guides on how to do it.


Autogenic Drainage:

Autogenic drainage shares a similar rationale to active cycle of breathing, with special emphasis on creating high airflow in different generations of bronchi without allowing airway collapse. Controlled breathing clears secretions from small to large airways by gradually increasing the total amount of gas left in the lungs after a resting expiration. For people with cystic fibrosis or bronchiectasis, the full sequence can take up to thirty to forty five minutes to complete, but it is less burdensome when combined with activities such as nebulizing drugs or watching television. For other patients, length of treatment is shorter and flexible, control of the speed of inhalation and exhalation is the key.

Autogenic drainage is particularly suited to people with chronic hypersecretory disease, but selected components can be used for the acute hospital patient, postoperative patients who are anxious about pain and stitches, people with haemoptysis or asthma or for those at risk of panic attacks. For breathless people, short sessions are required, with modifications as necessary to avoid upsetting the breathing pattern. Adolescents appreciate that autogenic drainage can reduce their hyper inflated chests so long as they do not start inhalation before fully breathing out.

Patients choose their position. Most sit upright, although some prefer supine. For facilitation of abdominal movement, some patients find prone helpful. During teaching, the physiotherapist’s hands can be used to assess secretions and facilitate exhalation. Face muscles, shoulders and arms remain relaxed throughout. The mouth, throat, and glottis are kept open and the neck is maintained in slight extension because any obstruction prevents free laminar flow of air. Upper airway closure and air swallowing are less likely if there is little movement of the larynx.

The nose is blown if necessary, and the throat cleared of secretions to reduce resistance to airflow. The location of secretions is identified by the patient exhaling until the rattle of secretions is heard. The later the rattle on exhalation, the more peripheral are secretions.

Dave, Forum Administrator
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 01 2009 :  1:18:31 PM  Show Profile  Reply with Quote
AUTOGENIC DRAINAGE

A breathing technique designed to “milk” or squeeze air out of the lungs
Steps in Autogenic Drainage
Composed of 3 breathing phases
• Phase 1: (Unsticking) Patient breathes in normally but exhales each breath close to RV (5-9 cycles)
• Phase 2: (Collection) Breathes in slightly above normal Vt but exhales normally (5-9 cycles)
• Phase 3: (Evacuation) Breathes in close to VC but exhales normally (5-9 cycles)
• All 3 Phases are repeated as necessary

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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 01 2009 :  1:32:33 PM  Show Profile  Reply with Quote
Autogenic Drainage

There are a variety of breathing techniques that have been developed for use in patients with cystic fibrosis and other breathing related disorders to help clear mucus from airway passages in the lungs. These techniques include:

* Drainage and percussion
* Positive expiratory pressure methods
* High-frequency airway oscillation
* High-frequency chest wall oscillation
* Autogenic drainage

There are three phases to autogenic drainage that begin with breathing first at low lung volumes, and advancing to mid-high lung volumes. You should try not to cough during the first two phases. If necessary, modify the cough to a huff.

* Phase 1: Unsticking—Loosen the mucus in the small lower airways.
o After a deep breath, exhale fully and take slow breaths.

* Phase 2: Collecting—Move the mucus into the middle airways
o Take slightly deeper breaths than normal and exhale normally for 10-20 breaths.

* Phase 3: Evacuating—Move the mucus out by breathing and huffing
o Take 10-20 breaths at higher lung volumes.

While practicing this exercise:

* Get comfortable in a position that allows your diaphragm to work easily.

* Use slow, diapragmatic breathing. (Breathe in through nose and out through mouth.)

* Begin phase one, two and three.

* Try not to cough during phase one and two.

* Practice cough control: in through the nose and out through the mouth

Dave, Forum Administrator
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 01 2009 :  1:33:30 PM  Show Profile  Reply with Quote
Autogenic Drainage

Autogenic drainage is a self drainage technique which utilizes controlled expiratory airflow (Tidal Breathing) to mobilize secretions consisting of 3 phases:

1)Unsticking the peripheral secretions by breathing at low lung volumes (slow deep air movement). 2)Collecting the mucus from central airways by breathing at low to mid lung volumes (slow mid-range air movement). 3)Evacuating the mucus from the central airways by breathing at mid to high lung volumes (shallow air movement).

The velocity (or force) of the expiratory airflow must be adjusted at each level of inspiration so that the highest possible airflow is reached in that generation of bronchi, without being high enough to cause the airways to collapse causing coughing. Autogenic drainage does not utilize postural drainage positions but is performed in a sitting position.

Step 1. Sit upright, slightly inclined or lie down, relaxed, with the neck slightly extended.

Step 2. Clear the upper airways by "huffing" or blowing the nose. Avoid coughing.

Step 3. Breathing IN: a) SLOWLY breathe in the necessary volume of air, keeping the upper airways open. Use the diaphragm and/or the lower chest if possible. b) Hold the breath for approximately 2-3 seconds to improve the ventilation to all lung parts, getting enough air behind the secretions. c) Depending on where the mucus is, in peripheral, middle, or large airways, the tidal volume needed will be low, medium, or high, respectively. d) Low requires the deepest breath; medium slightly less; high requires a shallow breath.

Step 4. Breathing OUT: a). Breathe out through the mouth, keeping the upper airways (glottis, throat, mouth) open. Do not slow down the expiratory flow. IN low lung volume breathing, expiration should be down to as near residual volume as possible. b). Breathing out in the proper way, the mucus can be heard distinctly. Putting a hand on the upper chest, on can also feel the mucus vibrating. The frequency of these vibrations give an idea where the mucus is. High frequencies mean that the secretions are in the small airways, low frequencies mean that the mucus is located in the large airways. This "feedback" makes it possible to adjust the technique.

Step 5. Breathe in again as before. Inhale slowly avoiding the mucus going back using the diaphragm and lower chest muscles. Continue to breathe until the mucus starts to collect by moving upwards. As the mucus begins to move upward, the level of the ventilated tidal volume should be gradually raised. Thus the breathing evolves from a lower to a higher lung volume breathing. Finally the collected mucus plug arrives in the trachea where it can be evacuated by a stronger expirations or a high lung volume huff. (The higher the lung volume breathing the more forceful (but yet still controlled and even) movement of air is needed to actually move out the secretions).

Step 6. You have now completed one cycle; the cycles are repeated throughout the session.

Please note: The duration of an AD Session depends on the total amount and the viscosity of the secretions. Experience individuals drain their lungs more quickly. AD may be done throughout the day. Everyone develops a personal technique.

Dave, Forum Administrator
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 04 2009 :  12:06:47 PM  Show Profile  Reply with Quote
Any questions or comments?

Dave, Forum Administrator
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Susan-NY
Member

USA
41 Posts

Posted - Mar 06 2009 :  12:21:14 AM  Show Profile  Reply with Quote
quote:
Originally posted by Dave-OH

Any questions or comments?



I tried this and it really helped. Thank you! I developed a chest cold last week and, even though I started Levequin right away, it isn't getting any better. (First and hopefully last cold of the year). I am so glad you posted this before I got sick because I already knew what to do.
Questions: what do you mean "airway collapse" and should I be worried? What should I do if it happens? Thanks again, Sue

suzq960
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 09 2009 :  10:38:58 AM  Show Profile  Reply with Quote
No you should not be worried about airway collapse. If it happens get immediate care.

Dave, Forum Administrator
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Turtle
Member

USA
41 Posts

Posted - Mar 12 2009 :  5:01:39 PM  Show Profile  Reply with Quote
I noticed a print out of the Huff Cough technique, at my Rehabs information and library, coffee, water, room.

Leah
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Dave-OH
Administrator

USA
3874 Posts

Posted - May 02 2009 :  12:23:31 AM  Show Profile  Reply with Quote
Bump

Dave, Forum Administrator
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 13 2012 :  6:07:24 PM  Show Profile  Reply with Quote
Bump

Dave, Forum Administrator
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Dave-OH
Administrator

USA
3874 Posts

Posted - Mar 21 2012 :  6:32:11 PM  Show Profile  Reply with Quote
Here is the article I mentioned.

http://copdforum.portalone.us/topic.asp?TOPIC_ID=1382&SearchTerms=huff,cough

Dave, Forum Administrator
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Sarah
Member

USA
49 Posts

Posted - Mar 22 2012 :  11:56:36 AM  Show Profile  Reply with Quote
Thanks Dave, that was most informative. Maybe now I can get them goobers up and out.
Sarah
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chgorich
Rookie

3 Posts

Posted - Aug 04 2013 :  08:18:53 AM  Show Profile  Reply with Quote
Dear Dave,

I am so very grateful to have found your messages this a.m. about new ways to help us / me clear our phlegm and deal with a chronic cough that never seems to quit. In addition to severe emphysema, I also have a Non Tuberculosis Mycobacterium Infection (NTM). My pulmonologist was initially treating me back in January for pneumonia with common anntibiotics. The pneumonia never went away for FIVE months. Finally they diagnosed me with a Mycobacterium xenopi infection...one of the more difficult to treat. I will be on strong antibiotics for at least 6 months and mIe a year. The fact that I have the underlying severe emphysema only complicates my prognosis.

So this a.m. and for the past few days when my cough is so bad and I get really fearful that I am going to choke to death, I prayed that I would find some help and direction as to how to deal with this. My pulmonologist is not really hands on for this, so I am thinking that a respiratory therapist would be of help??? I see my Pulmonologist and my Infectious Disease Doctor on Tuesday (in 2 days) so I will mention this to both of them.

Thanks Dave and everyone else for being here for me and for each other.

Richard J.
Chicago
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Dave-OH
Administrator

USA
3874 Posts

Posted - Aug 04 2013 :  09:52:25 AM  Show Profile  Reply with Quote
On my site there is some information on surviving your lungs including clearance. I really need to make time to update it.

Dave, Forum Administrator
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dhvcabs
Member

USA
162 Posts

Posted - Aug 21 2013 :  5:16:11 PM  Show Profile  Reply with Quote
Post removed as off topic. Do a search and you will find that this has been discussed many times.

Donald
********************************************
There is wisdom in the council of many - Proverbs 15:22
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Roadrunne98
Member

USA
167 Posts

Posted - Mar 10 2014 :  01:48:54 AM  Show Profile  Reply with Quote
I am so glad I couldn't sleep from the tea I had. Also listening to myself wheeze and my dog even barked at my last cough it sounded so thick and yet when I do get it out its only like a thick mucous. I have to learn how to do this. I was trying it and I started to hard cough all of a sudden. But practice will help. Also this doctor said for my husband to keep tapping my lower back while I lay on each side to loosen the mucous. Have you heard of that? He said come back on Tuesday depending on how I'm doing. PS I have to say this. My previous doctor died . He saved my life in the ER by checking up on me before going back to the office. How do you find a Dr. that you can have confidence in. He is dead 5 years, and I get scared these other Dr's don't seem to care anymore. Any ideas to help let me know. Thank for listening. I will practice some more tomorrow.
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Dave-OH
Administrator

USA
3874 Posts

Posted - May 02 2014 :  1:44:35 PM  Show Profile  Reply with Quote
Bump

Dave, Forum Administrator
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JD69-uk
Rookie

United Kingdom
1 Posts

Posted - Sep 02 2014 :  11:58:36 AM  Show Profile  Reply with Quote
Hi, I would like to thank Dave about reminding me of the huff technique which I totally forgot about. I also wish I had read this 2.5 months ago when I developed a bad chest infection and to this date have not been cared for properly by my local G.P as they know I have severe C.O.P.D. but do nothing to help and am very ill indeed where I have to remain in bed all day as I cannot breath. The only thing I do is feed my pets and when finished struggle back to bed as I feel like I am going to pass out from lack of oxygen. I've not had a chest x-ray in almost 4 years and am not even under a C.O.P.D consultant. They basically refuse to give me any medication until I give them some sputum, which is usually very difficult. This infection started in May, I had to wait 2 weeks before I could get them a sample and by then the infection had really taken a hold of me. They give me a 5-7 day course which does almost nothing and when I ask for another they say no as I have just taken a course and to wait to see what happens. Hasten to add this is why now I am in severe pain in my chest and when I breath it's like I am breathing glass. To make matters worse I have bad generalised Fibromyalgia a heart condition and 1 week ago was diagnosed with Diabetes. So.....I am now depressed and totally fed up with it all. It will be nice to be able to talk to people with at least one of my ailments as I barely talk to anyone about it. I was diagnosed about 15 years ago when I was 30, I thought I had years before anything like this would affect me.

J Davis
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jarca
Member

USA
25 Posts

Posted - Jan 21 2015 :  7:05:30 PM  Show Profile  Reply with Quote
great information!
i need to learn the coughing techniques so thank you for posting this info!
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Therinueng
Rookie

USA
2 Posts

Posted - Jan 29 2015 :  11:33:29 PM  Show Profile  Reply with Quote
Airways collapse is not a serious issue.. It can be cured immediately.
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Dave-OH
Administrator

USA
3874 Posts

Posted - Jan 29 2015 :  11:49:52 PM  Show Profile  Reply with Quote
What type of idiot are you - it is a very serious issue that can result in a trip to the ER.

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JoJo AL
Rookie

USA
3 Posts

Posted - Feb 08 2015 :  11:22:26 AM  Show Profile  Reply with Quote
Hi y'all. I'm a new member. Been diagnosed with COPD, not on O2, Albuterol twice daily and PRN, and Spiriva once daily. Over the past 4 months I've had a nagging, mostly dry, cough. In December I was in the hospital after an episode of "Smokers Hemoptysis", which scared the dickens out of me. The Bronchoscopy showed no malignancy and the biopsy didn't show any MAI, but a sputum specimen did. I occasionally take Delsym 12 hour for control, along with eating Hall's and using Tiger Balm to try to control it. It always gets worse when I lay down for a nap during the day. I have 4-5 drinks at night, and I guess the alcohol does the trick because I don't cough during the night. Anyway, glad to have the resource of this forum, and thank the Lord for each breath...

Semper Fidelis
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JustMe-CY
Rookie

1 Posts

Posted - Apr 26 2015 :  03:27:35 AM  Show Profile  Reply with Quote
Hi All, a 72 year old rookie
quote:
Therinueng - Airways collapse is not a serious issue.. It can be cured immediately.

Dave-OH - What type of idiot are you - it is a very serious issue that can result in a trip to the ER.


Well said Dave-OH. I am End Stage and use a nebuliser for Salbutamol and Atrovent every six hours and double dose of Flixotide every twelve hours. Four large cylinders of oxygen. With all this I sometimes have an ambulance trip to A&E and land up in hospital, once it was ITC (ICU). Let's hope Therinueng never suffers the same.
THE HUFF COUGH TECHNIQUE sounds interesting.
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gaga-pa
Rookie

USA
7 Posts

Posted - May 05 2015 :  6:32:01 PM  Show Profile  Reply with Quote
quote:
Originally posted by Dave-OH

While in the hospital, I learned a new way to clear lung secretions (mucus, gunk, etc.). I will be posting a series on information on this technique. I can tell you it works. The CF director was covering one of the weekends I was in the hospital (I was there 2 weeks) and it was her suggestion I try it to get the impacted mucus that showed up on my CT scan. I can tell you it works. It works much better than more expensive and time consuming lung clearance techniques including the Vest and the IPV.

One of the Respiratory Techs from the PFT lab came up to teach me these techniques. It took about a half hour in all to learn them.

It may sound hard, but a few tries, and it should work.



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gaga-pa
Rookie

USA
7 Posts

Posted - May 05 2015 :  6:33:58 PM  Show Profile  Reply with Quote
Dave, this is such important information. I feel that my stuff lasts much longer because I find it so hard to cough the mucus out of my lungs. I am going to try your methods. Thank you and know that you are appreciated.
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SteveinMechanicsburg
Member

38 Posts

Posted - Feb 24 2016 :  3:29:07 PM  Show Profile  Reply with Quote
Hello all. I did a search on this page to find "Aerobika" and "Acapella" and noted no reference to either. Aren't these devices in wide-spread use? I certainly use them.
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Dave-OH
Administrator

USA
3874 Posts

Posted - Feb 24 2016 :  6:00:45 PM  Show Profile  Reply with Quote
http://www.smiths-medical.com/products/respiratory/bronchial-hygiene/acapella-vibratory-pep-therapy-system

I have used an Acapella for years. I have never heard of Aerobika, and none of my doctors have offered it.

I returned lots of topics on 2 pages when searching for Acapella

http://copdforum.portalone.us/search.asp?mode=DoIt

My doctors just gave me a new device, a RC-Cornet from Curaplex.

https://www.tri-anim.com/oscillatory-pep-system-rc-cornet-curaplex-oscillatory-pep-introducer-t-piece-1-way-valve-pharm-29703-3729.aspx

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
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Rita1
Senior Member

541 Posts

Posted - Mar 02 2016 :  6:26:25 PM  Show Profile  Reply with Quote
www.aerobika-therapy.com

I was given one by a pulmonologist who checked on me when I was hospitalized following surgery for something unrelated to my lungs. I like it better than the acapella which works on a magnet and has a metal piece that rusts. The aerobika is all plastic.

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Jan-KS
Member

USA
58 Posts

Posted - Apr 05 2016 :  04:21:21 AM  Show Profile  Reply with Quote
Thank you so much for posting this. So timely for me and will read and re-read religiously until I'm confident I can handle any crisis like this. I recently went to the ER after a few attacks of not being able to clear secretions (even post nasal drip) from my bronchial tubes to the point of temporarily blocking my breathing. Thought I was managing panic attacks nearly 100% of the time - but when you can't breathe and see your O2 sats drop slowing - you need some help and the panic attacks are back in full-bloom. Including fear of showers, fear of leaving the house etc.

At home I NEARLY have everything I need to manage my disease without a hospital (I'm so lucky) but I can't suction my own lungs (yet). My mother had an open tracheotomy and would squirt saline down into her lungs to cause the most violent coughing spells I've ever witnesses - that woman was so tough - yet she knew it cleared secretion quickly. Once she actually coded - and I'm yelling at the hospital personnel to get saline and suction out before she dies but they had to wait for the pulminologist. I'm not sure how those of us that are non-neck breathers could do this (how to direct the saline into the lungs on your own?) but she got really good at it and I'm sure it saved her life more than once. REturned a week later to the ER even sicker and so I agreed to be admitted.

Spent 2 days in the hospital only thing demo'd was the "Huff cough" which I figured out years ago on my own (like pursed lip breathing) I have the big green monster and an occopella - both not particularly useful. But I have this HUGE vibrator that could probably crack rib if used to long and while I feel stuff rattling around in there when I use it, I'm not ever strong enough to cough it up unless it's so copious it's just pouring out of me.

My biggest fear is suffocation - that I'll cough stuff up and it will block my breathing and I won't be strong enough to get it all up. Went to see my PCP today (as required by my insurance company) and she could just pat me on the back and say how sorry she was. I am also "end=stage" but I sure don't seem to have as much loose mucus as many reported here - in fact, unless I'm sick I never cough. I do, however, choke constantly on liquids (another problem inherited from my mother) so sometimes it's not mucous I'm trying to get out but water, coffee, pop ect. That CAN'T be doing my lungs any good. (besides the fact my mother got throat cancer ( a 3 almost 4 stage) so they had to take her vocal cords after 1-2 YEARS of the poor woman complaining about the chocking problem!

They did a CT scan with contrast on me and I half expected to find partially digested meals, gum, hard candy etc) at the bottom of my lungs but nothing showed up.

Since I HAD cleared the mucous on my own prior to arriving at the ER so I wasn't all in a panic like they are used to seeing me - all I wanted was supportive care and advice in case I choked from mucous, water, food whatever. I assume THEY can suction your lungs if they need to. Since I couldn't produce any green or brown sticky stuff they were utterly disappointed - and while they did admit me - they just tested me for the flu (negative thank god), gave megadoses of IV prednisone and IV antibiotics and kept me 2 days. It didn't happen again those entire 2 days so now I suspect they think I'm psycho or attention seeking. Perhaps I am. I just know I went to the ER on one Friday and a week later was WORSE (thought perhaps I had caught the flu) - my dr's office had tried the vest (they don't fit me because of my huge waste and very tiny shoulders and back) and I was having breathing blockages "mucous plugs" multiple times per day.

The responses I'm getting from the Hospitalists (not pulmonologists which I rarely get to see any longer because I stabilize so fast) is that "this is something I'll just have to learn to live with". And they discharge me. I suppose that's the most honest answer but frankly I think "this is something I'll just have to die from" someday and am terrified. Again - thanks so much for the post.

Jan C
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Jan-KS
Member

USA
58 Posts

Posted - Apr 05 2016 :  04:38:00 AM  Show Profile  Reply with Quote
Oh and get this - on weights - my "normal weight" is about 115-125lbs I've gained about 70 or so pounds in the two years due to multiple hospitalizations and high doses of steroids and my own poor self-control (this month easter and girl scout cookies). I have been watching it since I hit 200 lbs. 1st night in the hospital I weighed 194 lbs. Second night I weight 206 lbs (this is on a diet 1/2 a roast beef sandwich and a fruit cup and veggies for lunch and dinner and coffee, tea or water. I skipped breakfast) Before I left the hospital I weighed 212 lbs. At home this morning I weigh 204 lbs (we have a high tech scale due to my husband's heart issues), which I suspect is correct given the time and circumstances. Today at the doctor's they weighed me at 226 pounds. My doctor assumed it was a typo but I saw the PCT take it. I am on diuretics but they seem to manage any extra fluids quite well, At 226 water should be pouring out of my feet. My husband has CHF - so I kNOW what that kind of swelling is. I had full-scale eclampsia with my only pregnancy and was like the Pillsbury doughboy. I'm NOTHING like either of those conditions - if it take of my socks there is no noticeable swelling. Oh well final rant tonight - love and peace.

Jan C
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