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My ntm doctor told me that I could do all three, saline, aerobika and vest at the same time but I physically can not. I was doing the saline at the end because I thought the vest and aerobika would shake it loose and the saline would wash it out. However. my copd pulmonogist recently told me to do the saline first. Apparently, the saline liquifies the stuck sputum so that the aerobika and vest can shake it loose. My treatment takes about 45 minutes plus 5-10 minutes after to catch my breath. Then there is the clean up so it's over an hour twice a day. Sigh.

The saline is the most effective treatment to get the stuff out for me and if I were to have to shorten the time, I would leave out the aerobika and vest.

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That's very interesting, because I also found that I cannot do the Aerobika and nebs at the same time or I get so short of breath I get dizzy. Often I cough up so much from the saline alone I cut back on the Aerobika. I have arthritis in my spine, and vibration often gives me vertigo, so my pulmo is holding off an any kind of vest unless I absolutely need it. So far the saline has been the key.

Thanks for explaining the reason for saline first. Even though I use the VibraLung, which only takes 10 minutes, instead of the vest (and I attach my Aerobika to my neb as my pulmonologist showed me), I’ve been doing the VL first. I’ll change the order. But I’m still resigned to an hour twice a day. Sigh.

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