Need Help - New to Using Vest: Pseudomonas & Bronchiectasis

I am 83 years old, and I was diagnosed with Bronchiectasis one year ago. When other methods failed to give me the relief I needed, my pulmonologist ordered a Hill-Rom compression vest for me that I use twice a day. He instructed me to do the nebulizing (Duoneb followed by Acetylcysteine 20%) all WHILE using the vest. Then, he suggested that I use the vest AFTER completing the nebulizing in addition. Pause for coughs when suggested and when routine is completed, do the huff cough routine.
Good luck! Jan

I think most of us nebulize while using the vest unless directed to do otherwise . I don’t think there are any issues eating when finished with the vest. Most that I’ve heard is not to use the vest soon AFTER eating. After nebulizing, using the vest, and huff coughing, I’m usually ready to eat too.

I was diagnosed with Pseudomonas 7 months ago. After changing pulmonologists 5 months ago from a group in the Denver Metroplex to National Jewish Health in Denver, I have received the care I had been needing since my Bronchiectasis had been progressing.
National Jewish has a team of excellent therapists who teach you what you need to know to manage BE. I use vest therapy (the SmartVest by Electromed). Before therapy my pulmonologist set out this plan: use levalbuterol inhaler, then use vest for 20 minutes (five minutes at 10hz, 40%, then 5 min at 11hz, 5 min at 12 hz, and 5 min at 13 hz, all of these minutes at 40%). And while using the vest I nebulize 7% saline solution, and use the Arobika device. After the vest, I use the lowest dose of Symbicort, a steroid inhaler.
It seems that National Jewish does not treat asymptomatic colonized Pseudomonas. I did take a course of Cipro seven months ago which did not eliminate the Pseudomonas. Pulmonologists at National Jewish prefer to just keep the Pseudo knocked back with the above therapy.
This has been my experience since joining National Jewish Health in November of 2023. They are the leading Pulmonary Hospital in the US. And I believe because they treat Cystic Fibrosis patients, their guidance in managing Bronchiectasis is excellent.
It is not easy to find a pulmonogist with the expertise to treat Bronchiectasis.
Please let me know if I can answer any questions for you and your husband.

Also, SmartVest by Electromed in its leaflet says to not eat 30 minutes before and 30 minutes after using the vest.
There should be an 800 number you can call from your vest company that will answer questions.

And I must add that the information I gathered from the National Jewish Lecture Series (a yearly event) is that the most important thing you can do if you have NTM or Bronchiectasis is Airway Clearance!
Conferences on Bronchiectasis can give you answers to your questions and educate you on staying healthy.
There is an upcoming Bronchiectasis conference in San Diego May 16 and 17 that you can register for and attend virtually.

Thank you for your reply. The CLL doctor says blood tests show he now has hypo gamma globulin anemia. They started him on IVIG replacement therapy and want him to continue it monthly. The doctor is thinking this is why he cant irradicate the Pseudonomas with Cipro. He has the first infusion last Wednesday and is still feeling very tired. Have you heard of this being offered as treatment for Pseudonomas? Thanks for your help!

I haven't heard of IVIG replacement therapy for Pseudomonas treatment . I do know, according to National Jewish, that Pseudomonas is difficult to eradicate, and sometimes even if eradicated with Cipro, the Pseudomonas will come back.
It's so good that your husband is being treated for his anemia.
Best of luck to him.

Hi Mirsy, I have a similar method i.e. nebulizer and then the vest. I never eat before and have had no problem eating afterwards. As you know, the whole goal of these treatments is to expel mucus from the lungs. Airway clearance, aside from the nebulizer and vest, is a way to help your body to get mucus up and out of your lungs. It does take work for some of us, such as myself! Here is a link to some videos about airway clearance that may be helpful since you are getting little direction from your doctor. Best of luck to you and your husband.
https://bronchiectasis.com.au/resources/airway-clearance-videos

HI Mirsy,
I just started using the Smart Vest so I don't have much opinion as of now, but also have Pseudomonas (colonized) since October, 2023. My Infectious Disease doctor also told me I have gammaglobulinemia, but not on infusions as of now. The pseudomonas made me extremely fatigued for several months, plus the anemia I am sure. I am intolerant of Cipro so my doctor started me on IV antibiotics, then nebulizing Tobramycin for 7 months until I couldn't tolerate that. The good news is I'm finally beginning to feel a bit better. I hope the treatments help your husband. Re: the Vest, I never eat 2 hrs. before and wait an hour after using the vest. There is lots of help on this Forum for which I am so grateful. The goal is to keep the lungs as clear as possible so hopefully the vest will help. The best to you and your husband.