@mimdavidson Hi Mim, Not Shari here, but..."airway clearance" is the term applied to using nebs, exercises, or devices (or a combination) to get as much sputum as possible out of the lungs to keep it from becoming a safe harbor for nasty germs to grow.
Nebulizing with saline solution (I use 7%, prescribed by my doc) thins the mucus to make it easier to get out. Some people are instructed to neb with a bronchial dilator medication depending on their specific condition.
Clearance devices include Acapela and Aerobika - they are little hand-held machines you blow into, and there is a flutter valve that causes the air to vibrate as it comes out of your lungs. This is supposed to break up the mucus clots. After a number of exhalations, you perform a series of "huff coughs" to bring up the mucus. Sometimes mine comes up right away, often it's stubborn, and I find myself coughing it up a half hour or more later.
Other ways of airway clearance include use of a percussion vest like cystic fibrosis patients have used for a number of years. Maybe @thumperguy can tell us more about this. Or manual thumping by another person. Or a process called postural drainage where you lay down in specific positions during or after nebbing and try to cough up the secretions.
Everyone here is different, with different symptoms, other challenges, and responses to treatment.
Here is my usual routine:
Neb with saline in the nebulizer attached directly to my Aerobika device. I used tha Acapela first, but Aerobika + nebulizer gets two things done at once. You will find people here using various strengths of saline - I have MAC in my cultures, and there is some evidence that 7% can inhibit growth of that particular bacteria, so that is what I use.
Pause every few minutes during neb to "huff cough" and try to bring up junk.
After neb, huff cough several times in the next half hour.
I do this once a day, twice if my chest feels tight or I have any evidence of respiratory issues like shortness of breath. OtherwisesI try to use the Aerobika by itself a second time later in the day. (My doc says up to 4 times a day if having a cold, cough, or asthma exacerbation- haven't had to do that yet.)
All of this was demonstrated to me by my pulmonologist, pulmonology nurse, and/or their respiratory therapist. I found that VERY helpful.
Did you get demonstrations and coaching from your doc or medical staff when they were treating you before?