Airway clearance not working?

Posted by @ling @wangling, May 1 11:38pm

Hi community,
Since I frequently have flare ups, I have to examine my airway clearance techniques to see if I am doing them right.
The following is what I do twice a day these days:
1. inhale levalbuterol + 7% saline;
2. autogenic drainage, lying down with my right side up, since my problem is the upper right lobe, then huff cough;
3. aerobika, first lying down, then sitting up, then huff cough;
When inhaling saline, it makes me cough a lot. It seems I get more mucus out while inhaling saline.
Autogenic drainage, aerobika and huff coughing help me to get a little mucus out, but never a lot.
Sometimes, not long after I finish the clearance, I start coughing and the cough will get more mucus out.
Question:
Is it normal that autogenic drainage and aerobika and huff coughing do not get much mucus out, but afterwards the coughing would get more out? If I don't cough, that means I did not clean out my mucus completely, right?
Please share your experience with me. You are the people who can help me. I feel desperate. I hope I made myself clear.
Many thanks!
Ling

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Profile picture for @ling @wangling

Hi @formergardener,
Do you use any steroid inhalers? I use Breyna because I feel it helps to clear mucus better, otherwisee I feel mucus sticky to my airways. Do you have a similar feeling? You have been so helpful.

Thanks!

Ling

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Hi, @ling. No, zi never use steroid inhalers. I do use Levalbuterol at two puffs prior to nebulizing. Sometimes I only use one puff. I don’t like the way it makes me feel, but it opens the airways. I think that the Guaifenesin and NAC with drinking plenty of water help to thin my mucus.

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Profile picture for formergardener @formergardener

@reneemc, the recovery is going well. I read about massaging the scars to prevent adhesions and to soften the scars. It said that, although vitamin E containing oil is recommended, it has not been shown to be more effective than simple massaging. A u tube video showed circular, up and down, back and forth gentle massage. I found that doing this several times a day increased range of motion and did ease any remaining discomfort. I am four weeks out of the hospital as of this morning and see the surgeon for a follow up in early June, as well as my pulmonologist for a new baseline PFT and low dose CT. I am able to exercise as I did prior to surgery but still avoid most upper body until I get the doctor OK. I do notice that I still tire a little more easily.

Yesterday, I did something and apparently tore my left medial meniscus in the knee and will see an orthopedist next week. That is quite painful and limiting, but I was able to do the stationery bike, although I cannot put weight on the leg or bend it. Definitely disappointing after successful lung surgery!

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Don't try to exercise that leg after tearing your meniscus! Been there done that many years ago. The surgery should be much easier now days. Take it easy till then.

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Thank you, @irenea8.

Yes, I had a bad fall 8 yrs ago and had 30% of my lateral meniscus is removed. The knee has arthritis, and with the right meniscus now badly torn, they may want to do a knee replacement. Unfortunate timing!

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Profile picture for formergardener @formergardener

Hi, @ling. I have never been to NJH, as I live in central Texas, and the logistics are difficult. However, I have been fortunate to be treated at UTHSC in Tyler, TX. I was given hands on airway clearance during my first visit there, and Dr. McShane also posted U Tube videos about airway clearance. I had read about clearing the smaller airways, then the medium, and then the larger.

I was using garlic even before I was diagnosed. I have allergies and found myself having more drainage, and the garlic helped to clear me. Grating the garlic and letting it sit for a bit before eating helps to retain and increase benefits. I also find that when I make stir fry with lots of fresh ginger, I also clear more sputum.

I have been culture negative for 19 months and was due to stop meds in April, but since I had the lung surgery to remove the upper and lower lingula, I was told to continue the meds for three more months. The pathology cultures were also negative, but they showed a stubborn lateral left lung area with thick, white mucus that I was never able to clear. This was due to the varicoid bronchiectasis in that area. Other areas of bronchiectasis are mild. My right lung is barely affected, although it does have some bronchiectasis.

I should add that I always mask at the grocery store and in public places to protect myself. I believe that this helps to keep me free from infections. I also boil my drinking water and use Lifestraw pitcher water for tooth brushing and for cleaning vegetables and fruits. I no longer garden because I believe that this was the source of my Mycobacterium intracellulare infection.

I think that meds alone cannot control MAC, since it is everywhere. I avoid showers and instead take shallow baths and wash my hair under running water while masking. Sometimes I use a nose clip and remove it periodically to refresh my breath while hair washing.

This is time consuming and inconvenient, I must admit, but if it can help to keep me off of meds and to prevent more lung damage, I will do it. I am so grateful to have been able to have surgery four weeks ago that will lower my future risks, as long as I maintain airway clearance and precautions. I recognize that I must take these precautions for the rest of my life.

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I am so inspired by your dedication, discipline and artfulness in structuring your protocol. You give me something to aspire to! So many thanks. 💛

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Thank you,@paxmundi. I am sure that there are many out there doing more than I am. I do believe that it helped to convert me to negative, and I hope that it will prolong my time as negative, once I finish the meds.

Whenever I feel tired of the routine or resent its intrusion on my life, I am always inspired by the tenacity and determination of members on this site. They offer answers and encouragement that only others dealing with this can.

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Profile picture for formergardener @formergardener

Hi, @ling. I have never been to NJH, as I live in central Texas, and the logistics are difficult. However, I have been fortunate to be treated at UTHSC in Tyler, TX. I was given hands on airway clearance during my first visit there, and Dr. McShane also posted U Tube videos about airway clearance. I had read about clearing the smaller airways, then the medium, and then the larger.

I was using garlic even before I was diagnosed. I have allergies and found myself having more drainage, and the garlic helped to clear me. Grating the garlic and letting it sit for a bit before eating helps to retain and increase benefits. I also find that when I make stir fry with lots of fresh ginger, I also clear more sputum.

I have been culture negative for 19 months and was due to stop meds in April, but since I had the lung surgery to remove the upper and lower lingula, I was told to continue the meds for three more months. The pathology cultures were also negative, but they showed a stubborn lateral left lung area with thick, white mucus that I was never able to clear. This was due to the varicoid bronchiectasis in that area. Other areas of bronchiectasis are mild. My right lung is barely affected, although it does have some bronchiectasis.

I should add that I always mask at the grocery store and in public places to protect myself. I believe that this helps to keep me free from infections. I also boil my drinking water and use Lifestraw pitcher water for tooth brushing and for cleaning vegetables and fruits. I no longer garden because I believe that this was the source of my Mycobacterium intracellulare infection.

I think that meds alone cannot control MAC, since it is everywhere. I avoid showers and instead take shallow baths and wash my hair under running water while masking. Sometimes I use a nose clip and remove it periodically to refresh my breath while hair washing.

This is time consuming and inconvenient, I must admit, but if it can help to keep me off of meds and to prevent more lung damage, I will do it. I am so grateful to have been able to have surgery four weeks ago that will lower my future risks, as long as I maintain airway clearance and precautions. I recognize that I must take these precautions for the rest of my life.

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Hello Again
I did not know that we both were seeing Dr. McShane.
I find doing ginger and cinnamon tea helps as well as garlic tea. I have always taken garlic and zinc, especially if I had an infection. I am now somewhat careful about how much/ how often I do the zinc. Just a couple of times a week. And yes, me too, stir fry with lots of garlic and some ginger.
My MAI infection has been stable for over a year. I have not started the antibiotics. Overall I feel fine and mucus and mucus plugs come up with AC/Postural Drainage (Wedge Pillow)/Percussion Clapping/Autogenic Breathing and then the huff coughing. Good eating habits, as we all know, along with some exercise helps to keep the immune system up and helps with sleep.
Yes, masking when out in public, out in the yard doing small minimum things, showering and washing hair. Yup, nose clip when washing my hair. I allow the shower head and shower hose to dry out completely by shaking it to get as much water out as possible from the hose and shower head and then letting it hang and sit in a position such that it can drain, before showering again. Yes, boil the drinking water. I still have to secure a LifeStraw Pitcher. So much of what we use in relation to what we have to use and do for ourselves with BE is plastic and all this plastic is new to me and I'm not happy about it. Hope the LifeStraw is mostly glass.?
Sounds like we found our way to doing some of the same things with the help of McShane, her knowledge and with her 'team' in Tyler. Mayo Connect has been another huge help.
Yes, for the rest of our lives as BE patients......continued precautions along with all we do to clear our compromised lungs.
Good to hear your success with the antibiotics and as well that your surgery went well. That is really nice to hear and encouraging.
Are you continuing with Tyler? I had a visit in April with Dr. Jung at Baylor and I liked the visit with him. I may continue with Baylor and Jung. It will also save me an extra two hour drive from OKC.
Barbara

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I am a relative newbie, but I have read here and elsewhere that many have more mucus come up hours after their AC practices. I have noticed that also in my own case at times.

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