Using the Smartvest

Posted by lvalenti @lvalenti, Jul 7, 2023

I recently started using the Smartvest along with nebulizing Albuterol, sodium chloride, Arikayce and using the aerobika. It is very time consuming and I’m interested to know from anyone else doing the same what order they are using and how they are managing it all. Thank you.

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@marthamac

I used the Hill Rom vest for about a year and I finally returned it because I couldn’t tell it was helping me any more than the AeroBika. But I don’t think I washed, much less sterilized it, in the entire time I used it. That sounds terribly time consuming. Do you really have to do that?

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I use sterilizer bags that are very easy. 3 min in the microwave. I get them from Amazon.
https://www.amazon.com/gp/product/B000096QQ5/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1
Worth checking out.

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I also found the acapella and 3% saline resulted in more exacerbations (used in the beginning). Switched to Aerobika and 7% was better for sure.

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@equanimous

Thanks, Scoop. You are always so helpful. I have two different routines for my wet cough. I neb with 7% saline + Aerobika. Or, I do nebbing with the HillRom vest. The neb/Aerobika combo seems to bring up a lot more mucus as I am coughing throughout the session. And, I have to work at getting the mucus to come up. When doing the vest/neb, I stop it periodically during my session and do some brief huff coughing which helps brings some mucus up. I am now debating whether to d/c the vest and just go with neb/Aerobika combo. I am a bit paranoid about letting the vest go. I wish I could find a respiratory therapist to help me decide. Kaiser does not employ any and I've searched in the L.A. area for a RT with BE experience with no success. If anyone has suggestions in finding one, please let me know.

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You might ask to talk to a RT with Hillrom. I have a Smartvest but not using it much because of my history with spinal leaks. I'm deciding whether to send it back. I'm working with the RT with Smartvest and she is very good. She isn't just telling me to keep using it but helping me to work through the decision considering my history.

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@davis5663

You might ask to talk to a RT with Hillrom. I have a Smartvest but not using it much because of my history with spinal leaks. I'm deciding whether to send it back. I'm working with the RT with Smartvest and she is very good. She isn't just telling me to keep using it but helping me to work through the decision considering my history.

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I spoke to an RT from HillRom months ago about this. She said she could not help and that Hill ROM does not provide any kind of counseling about airway clearance.

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@equanimous

I spoke to an RT from HillRom months ago about this. She said she could not help and that Hill ROM does not provide any kind of counseling about airway clearance.

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That's a shame. You would think being a RT working for a vest company, she would be an expert on AC. Wonder what her job is?? I hope you find someone knowledgeable to help you.

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@davis5663

That's a shame. You would think being a RT working for a vest company, she would be an expert on AC. Wonder what her job is?? I hope you find someone knowledgeable to help you.

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I completely agree. She was very nice and professional. She came to my house and provided instruction about the vest. That was the beginning and end of her responsibility. Very surprising, indeed. But, I guess, in her defense, perhaps HillRom's RTs are not trained in BE. Seems like not many people are, including my health providers. They know the very basics and that is it.

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@scoop

@equanimous You might experiment with 7%/Aerobika exclusively and see how that goes. Your vest will be on stand by! Since bronchiectasis is a life long chronic condition, requiring daily management, trying different clearance tactics is completely reasonable and often necessary. Recently, as @sueinmn mentioned, I take NAC and mucinex together, which seems more helpful than NAC alone.

Before I became knowledgeable about lung clearance, I used .09% saline and acapella, which I am convinced contributed to frequent infections due to incomplete clearing. The bottom line to figure out a routine which results in near complete clearance. BTW, I experimented with many different clearance techniques, hours spent on YouTube videos and BE Toolbox site, taking years to figure out what worked for me. Fortunately, I found this site of kindred spirits!

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What’s NAC? I am new to daily airway clearance. Just finishing 2 years of antibiotics. Thx

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@ncalvan

What’s NAC? I am new to daily airway clearance. Just finishing 2 years of antibiotics. Thx

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@ncalvan NAC is thought to help break up mucus. Lately, I take NAC together with mucinex with lots of water before albuterol and then clearance. You can read about it here:
https://www.verywellhealth.com/the-benefits-of-n-acetylcysteine-89416

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@tinaesims

I use the vest at the same time as I'm nebulizing. 20 minutes twice a day.

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@tinasims. Like you, Tina, I now use the vest and nebulize at the same time. I learned from this forum that I could do that! It's about 35-40 min. total since the nebulizing often takes a little longer. But so much better than doing them sequentially. And the amount of mucus seems the same: small, but something. I am now intrigued by the postural drainage idea... will look into it. Thanks, @pled.

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@scoop

For a short some time I used Afflovest, but due to rib pain I had to stop. In addition to NAC, albuterol, 7% saline (no MAC drugs), I use the Autogenic Drainage app available in app stores, which I find to be efficient. Nonetheless, with cleaning/sterilizing/nebbing/clearance routine it seems I have more like 23 hours/day instead of 24.

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My ID Dr told me pain is not a symptom of MAC . Well , it is for me

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