1. < MAC & Bronchiectasis

Are both flutter valve and nebulizer necessary?

Posted by Elle @ellen1944, Feb 14, 2023

My husband was recently diagnosed with both MAC and Bronchiectasis. Do others with these diagnoses use both the flutter valve and the nebulizer?Do these devices serve different purposes? We aren't sure about this and I can't find an answer online!

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bethfjohnson33 | @bethfjohnson33 | Jul 25 11:07am
In reply to @scoop "Common "flutter" choices with link to manufacturers site below. Aerobika seems to be the most preferred/commonly..." + (show)
@scoop

Common "flutter" choices with link to manufacturers site below. Aerobika seems to be the most preferred/commonly one used. Probably because NJH started recommending it a few years ago.

It's really personal preference, trial and error. Until recently, I used aerobika during 7% saline neb. Now I don't use a flutter device at all. I neb hypertonic saline directly into lungs per Dr. McShane's recent talk. I do not miss the flutter and it's one less item to clean/sterilize. Fortunately, I can get the gunk out through autogenic drainage and ACB (active cycle of breathing.)

PARI O-Pep
https://www.pari.com/us/products/airway-clearance-devices/pari-o-pep-us/
Acapella Choice
https://www.icumed.com/products/airway-management/respiratory/bronchial-hygiene/acapella/
Aerobika
https://www.monaghanmed.com/product/aerobika-opep-device/

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Thank you for the information!

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becleartoday | @becleartoday | Jul 26 5:04am

The nebulizer helps to wet the airways down and liquefy mucus. An Aerobika or similar device opens the airways similar to blowing into a balloon. And then the vibration feature helps to shake the mucus off the airway walls. This combined approach to clearance makes it easier to get mucus out.

Regards,
Linda Esposito

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1 reply
cwal | @cwal | Jul 26 5:40am
In reply to @becleartoday "The nebulizer helps to wet the airways down and liquefy mucus. An Aerobika or similar device..." + (show)
@becleartoday

The nebulizer helps to wet the airways down and liquefy mucus. An Aerobika or similar device opens the airways similar to blowing into a balloon. And then the vibration feature helps to shake the mucus off the airway walls. This combined approach to clearance makes it easier to get mucus out.

Regards,
Linda Esposito

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Linda, this video seems to indicate doing Autogenic breathing by only letting a small amount of your intake breath out before taking another breath in. The other videos I've seen only indicate to breathe out after each intake. This respiratory therapist did a good job with her presentation by actually performing the instructions and not just talking about them. Her instructions for autogenic breathing starts around 1:16:36 into the video. I'm not sure it makes any difference if the breaths are done the way she seems to be teaching it or not but I wonder why her method is the only one I've seen given the instructions this way.

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1 reply
becleartoday | @becleartoday | Jul 26 5:53am
In reply to @cwal "https://www.youtube.com/watch?v=KWnBlT12Cho Linda, this video seems to indicate doing Autogenic breathing by only letting a small amount..." + (show)
@cwal


Linda, this video seems to indicate doing Autogenic breathing by only letting a small amount of your intake breath out before taking another breath in. The other videos I've seen only indicate to breathe out after each intake. This respiratory therapist did a good job with her presentation by actually performing the instructions and not just talking about them. Her instructions for autogenic breathing starts around 1:16:36 into the video. I'm not sure it makes any difference if the breaths are done the way she seems to be teaching it or not but I wonder why her method is the only one I've seen given the instructions this way.

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I know many of us wish that there was one way to do airway clearance. Unfortunately, there is not. Even when it comes to different breathing techniques including active cycle breathing and autogenic breathing, there are many varieties. What’s most important is to perhaps learn one of them and get comfortable with it. And then see if overtime see if it gets the job done. If not, switch to a variation on it or a different technique. And then of course, there’s combining different modalities in one session such as nebulizing, using an opep device like an Aerobika and let’s not forget postural drainage 🙂 I guess I’m saying the bottom line is airway clearance is as much an art form as it is a science. I hope this is helpful and not confusing, Linda Esposito

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1 reply
cwal | @cwal | Jul 26 12:52pm
In reply to @becleartoday "I know many of us wish that there was one way to do airway clearance. Unfortunately,..." + (show)
@becleartoday

I know many of us wish that there was one way to do airway clearance. Unfortunately, there is not. Even when it comes to different breathing techniques including active cycle breathing and autogenic breathing, there are many varieties. What’s most important is to perhaps learn one of them and get comfortable with it. And then see if overtime see if it gets the job done. If not, switch to a variation on it or a different technique. And then of course, there’s combining different modalities in one session such as nebulizing, using an opep device like an Aerobika and let’s not forget postural drainage 🙂 I guess I’m saying the bottom line is airway clearance is as much an art form as it is a science. I hope this is helpful and not confusing, Linda Esposito

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That is so true about it being an art form as well as science.

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km6 | @km6 | Jul 28 7:01pm
In reply to @angeles31 "Thank you . I was prescribed an acapella but given no instructions. I was not bringing..." + (show)
@angeles31

Thank you . I was prescribed an acapella but given no instructions. I was not bringing up anything
The omron nebulizer with 3% saline solution wasn’t really bringing up much at the beginning.
Does anyone get a sore throat from bringing up mucus ?

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I was told to use 7% saline. Everyone gets different info

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1 reply
angeles31 | @angeles31 | Aug 9 9:37am
In reply to @angeles31 "Thank you . I was prescribed an acapella but given no instructions. I was not bringing..." + (show)
@angeles31

Thank you . I was prescribed an acapella but given no instructions. I was not bringing up anything
The omron nebulizer with 3% saline solution wasn’t really bringing up much at the beginning.
Does anyone get a sore throat from bringing up mucus ?

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Yes, I get a sore throat.
Pulmonologist prescribed throat lozenges.

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judytpt | @judytpt | Aug 10 10:24am
In reply to @km6 "I was told to use 7% saline. Everyone gets different info" + (show)
@km6

I was told to use 7% saline. Everyone gets different info

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I use the 7% saline as well. I have so much respect for my pulmonologist's expertise and this is what he's recommended. A previous pulmonologist had me use budesonide and Albuterol/IPRO with the nebulizer. It caused me to feel agitated and I my current doctor suggested that we discontinue it and just use the saline.

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1 reply
narelled23 | @narelled23 | Aug 11 7:17pm
In reply to @judytpt "I use the 7% saline as well. I have so much respect for my pulmonologist's expertise..." + (show)
@judytpt

I use the 7% saline as well. I have so much respect for my pulmonologist's expertise and this is what he's recommended. A previous pulmonologist had me use budesonide and Albuterol/IPRO with the nebulizer. It caused me to feel agitated and I my current doctor suggested that we discontinue it and just use the saline.

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I discontinued salbuterol because it further weakened my LS muscle and neb simply with the hypertonic saline. My mucus is relatively loose anyway, so it seems to be working fine for me.

You could try it and see how you go.

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