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Listen to Dr PJ McShane's Recent Talk on Airway Clearance!
Have you had a chance to listen to Dr PJ McShane's talk on the importance of airway clearance? I'm still reviewing it, but here are some takeaways:
MUCUS
Mucus plays a vital role in lung health. It contains mucins, which act like a sponge, absorbing water and creating a gel-like substance. This gel traps dust, germs, and toxins, protecting the airways. However, in bronchiectasis, the balance is disrupted.
The excess mucins in bronchiectasis make the mucus thicker and heavier. This overwhelms tiny hairs called cilia lining the airways. Normally, cilia act like miniature brooms, sweeping mucus upwards to be coughed out. But burdened by the dense mucus, they struggle to function effectively. This leads to mucus buildup, creating a breeding ground for infections and further inflammation.
Dr. McShane offers a reassuring message. "Scientists are working on fixing this problem based on drugs that target those receptors and target the mucin. We cannot fix that by our diet, so you're not doing anything wrong. Keep living your life. And stay tuned because science is moving forward."
THE IMPACT OF DRINKING WATER AND DAIRY ON MUCUS
"With bronchiectasis mucus becomes heavy and weighs down the epithelial cells and the cilia. So now the mucus becomes stagnant.. Don't go rushing to your refrigerator and grab a bottle of water and start drinking.
I want you to understand that if this is nothing that you're doing wrong and you can't fix this by drinking your water. In fact, if you do drink more water, you're going to lower your sodium in your blood and then you're going to have symptoms and have to go to the ER and it's going to be a nightmare. So, just drink if you're thirsty. You can't fix these abnormal abnormalities in your mucus by your diet.
Many of my patients will say that (they) shouldn't have dairy products because it increases the mucus. And I'm not sure that's 100% scientifically based. I would rather my patients, get the dairy, get the protein, get the calcium from the dairy in their diet, and understand that the abnormalities of their mucus are coming from something different than just what they eat in their diet."
COUGH
Why isn't a cough enough? Why do people living with bronchiectasis need to do daily airway clearance?
During a cough, air is expelled from the lungs at high speed, clearing the airways of irritants, mucus, or foreign particles. This forceful action can also bring up mucus from the lungs.
Furthermore, coughing relies on the elasticity of the airways to manage the increased pressure. But, in conditions like bronchiectasis, the airways lose their elasticity and do not respond normally to the pressures exerted during a cough.
According to Dr. PJ McShane, "This is why you can cough your head off to the point that you're exhausted and nothing's coming out and you don't feel like it's effective, and instead you're just getting tired. So that's where airway clearance comes in. And that's why it's so important to learn techniques you can do, other than just a simple cough."
AND THERE IS LOTS MORE!!
Enjoy,
Linda Esposito
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I know many people try Mucinex. It seems to help some and not others. I heard Dr Lommatzsch respond to a question about it on a webinar. He basically said the above.
Hello, Linda, I have watched dr. Shane's video and think that the part of using sodium7% and using a vest at the same time is new to me. When she explains it it does make sense. It is different what the NJH doctors recommend. I use the inhaler first, then sodium 7% , aerobika, and the vest at the same time. Yesterday I tried to follow the steps dr Shane suggests but I was confused where to include the vest in the treatment. I watched the video again and it seems that she actually is not a big fan of the vests. Then I called my vest company, Philips, and was told to do levalbuterol inhaler, then sodium chloride and then the vest and then aerobika. Well it took me twice the time and eventually I had pain in my right lung. So if somebody follows dr. Shane's protocol, how do you do it. Please respond. I would like to do it the best way especially that according to my latest STscan the number of nodules incresed and there are new mucus plugs. With all I tried and do I do not cough up mucus- I am mostly almost dry. Thank you
Hi Liliana,
I understand why you feel confused. There’s very little research on this, if any, so there isn’t much guidance. I think National Jewish likes their approach because it takes the least amount of time and they say the best airway clearance is the one that people are willing to do. That said, if my memory serves me, Dr. McShane’s focus was on wetting down our lungs first. She thinks that’s very effective. And then she said the Texas phrase is to “go at it.” How you choose to go at it… whether you use an aerobika, vest, postural drainage, Autogenic Drainage, or as she mentioned Zumba, is your decision.
I am an educator not a clinician so I’m just telling you what I remember her saying. Of course it would be best to meet with the respiratory therapist to review your technique. However, over the years I have learned that airway clearances as much an art form as it is a science.
All the best to you and I hope this helps,
Linda
PS this is a YouTube video Idid on this issue-
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1 ReactionThank you Linda- I noticed that whatever mucus comes out for me it’s during the inhalation of saline. That’s when I also cough. Later nothing whatever I try but I do it no matter what.
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2 ReactionsThank you so much Dr McShane for your empathy, kindness and clear explanations of airway clearance. I’m following your regime, including daily 0.7% neb with Saline after the colymycin.
As a 77 year older woman new to Bronchiectasis with MAI, and reoccurring Pseudomonas, etc your calm approach has helped me accept my life with this insidious lung condition as it is now and will be.
My retirement plans to travel and enjoy the world ( after 3 years of Covid restrictions ) have been curtailed due to the daily fatigue, hospital visits, airway clearance, mucous observation etc.
I’m ‘Holding my breath’ for the recent CT lung results still 2 nodules or now in the cavities?
Hope the new drugs will be available soon. I guess having constant antibiotics aren’t good either.
So great being part of this supportive informative and knowledgeable group, thank you Mayo Clinic team.
Sr P
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2 ReactionsBe clear today -can you include the link to dr L’s response on mucinex or is it in dr. McShanes webinar? Thank you
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1 ReactionHi Liliana,
This is Dr. Lommatzsch’s talk. If you go to 52 minutes, you’ll hear what he says about taking Mucinex.
I hope this is helpful,
Linda
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1 ReactionThank you Linda
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1 ReactionGoodness, I know we are all different as to effective AC. For me drinking water at regular intervals before I feel thirsty is essential to keep my mucus "juicy" and easy to expectorate. Hydration and aeeobic exercise are s effective as my Aerobika. I also thought that the dilated bronchioles made the cilia ineffective. I am grateful to learn about ABC and am practicing this. Thank you for sharing!
I use an Aerobika and have added the Active Cycle of Breathing. Is it best to do the ACB first or use the device first? Does it matter? Thanks!
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