Pari eRapid/eFlow first impressions

Posted by bronchiectasaurus @bronchiectasaurus, Aug 14 8:41am

Wow. Salty!

I washed and sterilized all the parts last night per instructions, and just had my first session. It is indeed rapid! A big hit of salt (7% solution, 4ml vial) with every breath.

It's not breath-actuated, unlike the AeroEclipseXL I'm accustomed to, so salt mist blew everywhere when I exhaled. I soon manually de-activated it while exhaling, using the power button, and re-activated on inhale. I was near my computer and didn't want salt to get all over my electronics. (Next time I'll try it in my kitchen or living room.) Even with the starts and stops, the session was very fast, under 10 minutes. I will time my next one.

My young cat jumped on me while I was nebbing, disconnecting the cord from the cup. Nothing leaked and I reattached it easily. Clearly I need to find a new location to use this system. It's faster so I don't need to be seated or distract myself with online scrabble, as I do with my usual system.

The concentrated salt made me cough at first, but I got the hang of it by the end. It brought up a lot more mucus than usual! All clear, all good. My usual neb sessions have brought up hardly anything lately, so I found this refreshing.

Afterwards I rinsed the parts and soaked in soapy water per instructions. Question: If I boil after every use, do I have to soak in soapy water first? I skip that step with my AeroEclipse/Aerobika setup and just rinse and boil.
(For anyone curious, this is how I have been nebbing/cleaning for the past several months: https://youtu.be/gRUAIu1nO1w?si=fRSz6DvohTN4SXKw )

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Profile picture for bronchiectasaurus @bronchiectasaurus

Out of curiosity: have you used the (optional) "EasyCare" device to clean the aerosol heads?

If the soap soak is to keep the aerosol heads clog-free, I might skip that and just rinse-boil/sterilize and use the EasyCare every couple days, or even every day. I add distilled water, turn it on, walk away for a few minutes and when I come back it's done. Then I put the cleaned head and the EasyCare in my bottle dryer and walk away again.

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I would call Pari before I skipped the soap step, unlike water alone, it actually breaks the surface tension that holds substances on the parts - I know they are microscopic but my experience with previous mesh nebulizers from Philips taught me it takes very little to mess them up (that is why Philips quit making them.)

I used the pause button tonight for the first time - that was helpful too.

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Profile picture for Sue, Volunteer Mentor @sueinmn

I would call Pari before I skipped the soap step, unlike water alone, it actually breaks the surface tension that holds substances on the parts - I know they are microscopic but my experience with previous mesh nebulizers from Philips taught me it takes very little to mess them up (that is why Philips quit making them.)

I used the pause button tonight for the first time - that was helpful too.

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Thanks, understood.

Maybe I could get away with just soaking the aerosol heads in soapy water instead of everything, then boiling everything. Would require a much smaller soaking container and less double rinsing.

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My technique continues to improve, insofar as I'm hardly ever setting off the air purifier now, getting very agile with the pause button, and acclimating to the intensity of the saline so I usually only cough on the first breath.

I have been only nebbing once per day recently but today I did a second session because I went to a movie and had to take my mask off because laughing kept fogging up my glasses (it was the new Naked Gun, highly recommend). I didn't finish the whole second vial; I stopped after about 6 minutes, while a full 4ml vial takes about 12 minutes using my technique of pausing flow on the exhales, and holding my breath a few seconds after the inhales, and stopping to spit out mucus and drink water occasionally.

This device has given me back an hour a day. Worth every penny.

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I still cough a lot while nebulizing 7% NACl. I tried sue’s method with the tongue which helps a little. I am still not good but getting better. It’s speed is such time saver.

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I am using my new eRapid and absolutely loving it! It only takes five minutes and is completely silent. Game-changer! Even though it leaves one ml of 7% behind, it clearly aerosols deeper which leads to better productivity for me. The mouthpiece is interchangeable with my LC sprint so that’s good to know. Curious if it can be hooked up to the Aerobika, but haven’t tried that yet.
There is an excellent video on using it and what each part does. It explains that the blue gasket serves as an expiratory function, with valves on each side that stop the incoming flow of medicine when you’re exhaling, so you’re not wasting too much medicine. The expiratory valve on the mouthpiece allows your exhale to exit. It seems to be appropriately and efficiently set up to help restrict the flow while exhaling to save the medicine. I seem to be getting enough as I am more productive than I was with any other equipment. The video is very informative about a few things, so was worth the watch.
https://share.google/UZA0vnOFN0O9Sl6rr

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Profile picture for jnvt @jnvt

I am using my new eRapid and absolutely loving it! It only takes five minutes and is completely silent. Game-changer! Even though it leaves one ml of 7% behind, it clearly aerosols deeper which leads to better productivity for me. The mouthpiece is interchangeable with my LC sprint so that’s good to know. Curious if it can be hooked up to the Aerobika, but haven’t tried that yet.
There is an excellent video on using it and what each part does. It explains that the blue gasket serves as an expiratory function, with valves on each side that stop the incoming flow of medicine when you’re exhaling, so you’re not wasting too much medicine. The expiratory valve on the mouthpiece allows your exhale to exit. It seems to be appropriately and efficiently set up to help restrict the flow while exhaling to save the medicine. I seem to be getting enough as I am more productive than I was with any other equipment. The video is very informative about a few things, so was worth the watch.
https://share.google/UZA0vnOFN0O9Sl6rr

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Thank you - the video helped me figure out what I was doing wrong with the cap - now it stays in place.
Still loving it almost 3 weeks in.

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I have had it for about a month and am loving it. I like that the nebulizer is easy to take apart for cleaning— I am now thinking that the others I had did not last as long as I though they should have due to the difficulty of accessing and thoroughly cleaning the mesh. I also like that most of the electronics are not near the liquid medications and thus stay dry. I think this will also be a factor in extending its lifetime over the other brands I used.

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Hi e-flow users,
I kept meaning to throw in here ... I have been using the e-flow for 11 months to deliver Arikayce or placebo, as part of a study (along with ethambutol and Azithromycin). The study protocols have us boiling the parts for 5 minutes in DISTILLED water after soaking in hot tap water with a couple of drops of dish detergent (any clear variety of any color but not the white or lotion-resembling types).
It occurred to me that the distilled water may help with not building up mineral deposits on the mesh.
Again this is for a med or placebo, not saline. I would think the saline is harder on the mesh.
Interested in all the initial experiences here.

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Profile picture for jnvt @jnvt

I am using my new eRapid and absolutely loving it! It only takes five minutes and is completely silent. Game-changer! Even though it leaves one ml of 7% behind, it clearly aerosols deeper which leads to better productivity for me. The mouthpiece is interchangeable with my LC sprint so that’s good to know. Curious if it can be hooked up to the Aerobika, but haven’t tried that yet.
There is an excellent video on using it and what each part does. It explains that the blue gasket serves as an expiratory function, with valves on each side that stop the incoming flow of medicine when you’re exhaling, so you’re not wasting too much medicine. The expiratory valve on the mouthpiece allows your exhale to exit. It seems to be appropriately and efficiently set up to help restrict the flow while exhaling to save the medicine. I seem to be getting enough as I am more productive than I was with any other equipment. The video is very informative about a few things, so was worth the watch.
https://share.google/UZA0vnOFN0O9Sl6rr

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This is what I was given to use during my Clinical trial thru NJH. I used it for a year and found it very easy to use and clean. Disappointed when I had to turn it in after the study was completed.

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Profile picture for Sue, Volunteer Mentor @sueinmn

@bronchiectasaurus Yes - Salty - Wow! And I just learned to slow the flow by placing my upper lip on the blue flap on the top of the mouthpiece, which keeps from wasting so much saline. And with theopening a little farther back in my mouth, I cough a little less. This is harder to describe, then to do). And I turn the compressor off if I start coughing a lot.

I too am a new user of the Pari eRapid, and I only boil after 2-3 uses. But, this is not my first mesh nebulizer, and trust me when I say the mesh screens are very delicate and can clog easily, so I don't skip the thorough prerinse, detergent soak, or post rinse because the screen (in the head) is pricy to replace.

My routine - use my Symbicort inhaler (used to use Levalbuterol) and wait 15 minutes, neb saline, dismantle nebulizer and rinse, soak (with kitchen timer running), rinse again in filtered water at my tap. On boiling days, I drop the pieces in pot to boil & set the timer for 10 minutes (how long it takes my pot to come to a boil), check the heat and reset timer. When the final timer rings, I turn off the burner and let the water cool.
While I have that going, I do some of my PT or house chores, then start airway clearance when I start the pot. I usually finish about the time the last timer rings. (I reuse my now sterile distilled water several times, leaving it in a covered pot on the stove.

Not nearly as onerous as it sounds, and since the mucus comes up quickly, the whole process is 35 minutes & I have managed some of my PT or tidying up in the meanwhile.

So far 2 weeks in, I am loving it. As it is both smoke and allergy season, it is getting a good workout. As a stable bronchie, with no infection, I usually use saline 2-3 times a week. At this time of year it is daily. I haven't needed to use any of my "other drugs" for an exacerbation yet, so can only say how fast and effective the saline is. But I may ask my pulmo if there is a nebulized version of the Symbicort that may be more effective than the inhaler for this tricky time of year.

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Interesting, Sue. I seem to remember that while you don't produce the amount of mucus that I do you seem to have a similar mix of Be and asthma. I am currently on a trip from Perth and spending time in Queensland where I have had very scary sob all the way down
the coast. It seemed to be connected to sugar cane burning, high humidity, low cloud cover. Telephone consult with my GP had her guessing it was an asthma flair, which I don't recall ever having before in WA. She has put me on Symbicort 2puffs, 2xday for 2 weeks. This seems to be addressing the problem. I am hoping that the sob won't return when I stop the Symbicort. From memory you take the Symbicort on an ongoing basis before nebbing, don't you? I used to take the Ventolin puffer before nebbing, but have now swapped for the Symbicort...and may just continue with that while over here to prevent another attack. I know we have discussed LMP and I agree in finding what works for us individually.

I am still bringing up large volumes of mucus, and seem to, in recent months, only have an hour or two where I am not coughing and spitting...it is now seeming to impact much more on my life.

I am interested to hear peoples response to Pari eflow. ..I decided to have the Pari Trek shipped via a friend to Australia rather than the expense of the eflow...for this long overland trip.

I would be interested in your thoughts on the above, Sue.

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