Good question, @ckscoville.

As you know, we have several discussions about percussion vests and nebulizing. Here's just a few recent ones:
- Percussion Vest and Nebulizer: Do you use both, one or the other? https://connect.mayoclinic.org/discussion/percussion-vestnebulizer/
- Percussion Vest, aka Thumper https://connect.mayoclinic.org/discussion/percussion-vest-aka-thumper/
- Bedtime Blues https://connect.mayoclinic.org/discussion/bedtime-blues/
- Vest before or after saline? https://connect.mayoclinic.org/discussion/vest-before-or-after-saline/
- Percussion Vests https://connect.mayoclinic.org/discussion/percussion-vests/
- Percussion vest https://connect.mayoclinic.org/discussion/percussion-vest/

It helps to have specific questions in the subject line/title. Would you mind if I changed the title of this discussion to "Do you use vibrating vest and nebulizer at same time?"

CKS, I applaud your curiosity about , what amounts to "how to get maximum benefit from the percussion vest". After taking delivery of my percussion vest unit over three years ago I behaved like I was hypnotized, unable to dare deviate from the 30 minute twice daily session, nebbing concurrently until the saline cup was empty. It was only recently that I began to experiment a bit, e.g., nebbing first without the vest, cranking up the vest only after the nebbing and then only for a few minutes. So far I'm pleased with the result. Though perhaps counterintuitive, it seems to lead to greater overall mucous production. btw, from the very beginning I've run the percussion unit, aka "Thumper" at 100% full throttle. I suppose because of the boisterous characteristics of the percussion unit it's probably easy to overestimate its merit in the overall treatment program. At this point if I had to chose one or the other but couldn't have both, I would chose the nebulizer with 7% saline without hesitation over the "jiggle" machine. Stay in touch. Don

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.

Rits, your final paragraph nails it; don’t know why it’s taken so long for me to discover it.

All the conversation of nebulizing and vests has been very helpful...Now I have some “meat on the bone” for discussion this week with my ID doctor. The cocktail of “3” is doing nothing for the discomfort in my lungs/chest that just refuses to go away. Again this variant of Lady Windermere Syndrome...no sputum...leaves me worried that the gunk is turning to cement down there. Thank you all for sharing.
Regina

I do all 3 at the same time and it works great. When I skip using the Vest I don't get as much up. I was told by my Dr at National Jewish the Vest works best for those who have Bronchiectasis in the lower lobes.

No, my pulmonologist said to use them separately

Hi - when I do them together I cannot get a productive cough from the 7%. Only without vest or Aerobika can I get one good productive cough after nebulizing

I think that there was a discussion here about nebulizing with the Aerobika attached. I’ve tried both ways but wonder if there was ever a concensus about whether it is more effective to use them at the same time or better to use the Aerobika after the nebulizer. It’s definitely faster but not sure if it is better to clear lungs.
Thanks in advance for any comments.