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Airway clearance successful techniques

Posted by sharonednaramsey @sharonednaramsey, Nov 24 1:40am

My flutter valve and huffing coughing worked in the beginning. It does not seem to be very effective now. Does anyone know under what conditions a pulmonary vest might be helpful ? Has anyone tried postural drainage? I know people have worse things than BE but I feel like it takes up a huge amount of my day and my lungs are still gunked up.

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clinenan | @clinenan | 2 days ago
In reply to @clinenan "@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider..." + (show)
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@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider it. I do have some OTC .9% 5mg saline vials, will that do for a starter, or does it need to be Rx/hypertonic? I will talk to my pulmo about a slower ramp up.

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Sorry, 5ml, not mg...

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Sue, Volunteer Mentor | @sueinmn | 2 days ago
In reply to @clinenan "@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider..." + (show)
Profile picture for clinenan @clinenan

@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider it. I do have some OTC .9% 5mg saline vials, will that do for a starter, or does it need to be Rx/hypertonic? I will talk to my pulmo about a slower ramp up.

Jump to this post

@clinenan The vials would be a great place to start - and you need not use the entire 5ml - just until the mucus starts to move.

My process - Symbicort, wait 10 minutes or so, neb saline, exercise -and the mucus starts moving on its own. Maybe even try this waiting/exercise before the vest to really move the mucus?

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clinenan | @clinenan | 1 day ago
In reply to @sueinmn "@clinenan The vials would be a great place to start - and you need not use..." + (show)
Profile picture for Sue, Volunteer Mentor @sueinmn

@clinenan The vials would be a great place to start - and you need not use the entire 5ml - just until the mucus starts to move.

My process - Symbicort, wait 10 minutes or so, neb saline, exercise -and the mucus starts moving on its own. Maybe even try this waiting/exercise before the vest to really move the mucus?

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@sueinmn, sounds like a good plan, thank you!

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becleartoday | @becleartoday | 1 day ago
In reply to @susanocl "@bbeers I have never done the Big 3. Two years of CT scans and two broncoscopy..." + (show)
Profile picture for susanocl @susanocl

@bbeers I have never done the Big 3. Two years of CT scans and two broncoscopy and never a definitive diagnosis. It "looked" like MAC with tree in bud nodules but 2 broncs were negative. Third bronc and first sputum test this May 2025 were both positive for MAC. (I'd had double pneumonia twice in Feb. and March). Met with Infec. Dis Dr at Mayo and he said it wasn't severe enough to treat at this time. Side effects could be worse. I'd started airway clearance 2x per day in May and after mtg with ID in July I upped to 7% saline (based on my research and request to ID - who relayed that to my pulm). The nebulizing is part of the airway clearance routine. Mine includes nebulizing levalbuteral (doesn't make me as shaky as albuterol), neb saline 7%, and then Bevespi inhaler. That all takes some time but I do it while watching TV at night and got a 2nd of everything to keep at work and do it while reading email and catching up on Teams in the mornings. Fortunately I have an office where I can close the door. Yay for you for no LC!!! Prayers for continued positive there! I've recently backed down to 1x per day on some days.... when busy. Praying my next sputum test this week will stay negative. Takes 45 days to "grow" and get results. I did push my ID to do sputum test every 3 months... he wanted to go 6 or 12. I want to make sure I stay negative or very low bacteria load.

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@susanocl you might want to think about adding an OPEP device, such as an Aerobika. Also, if you’re able to cough up sputum for an analysis, there shouldn’t be a need for a bronchoscopy.

Warm regards,
Linda Esposito

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mariegrace | @mariegrace | 1 day ago
In reply to @clinenan "@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider..." + (show)
Profile picture for clinenan @clinenan

@sueinmn, @scoop, thank you for your great advice. I thought about using albuterol beforehand, will consider it. I do have some OTC .9% 5mg saline vials, will that do for a starter, or does it need to be Rx/hypertonic? I will talk to my pulmo about a slower ramp up.

Jump to this post

@clinenan
.9 saline works ok too. I cant use anything higher, it burns my throat and stomach

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1 reply
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bbeers | @bbeers | 1 day ago
In reply to @susanocl "@bbeers I have never done the Big 3. Two years of CT scans and two broncoscopy..." + (show)
Profile picture for susanocl @susanocl

@bbeers I have never done the Big 3. Two years of CT scans and two broncoscopy and never a definitive diagnosis. It "looked" like MAC with tree in bud nodules but 2 broncs were negative. Third bronc and first sputum test this May 2025 were both positive for MAC. (I'd had double pneumonia twice in Feb. and March). Met with Infec. Dis Dr at Mayo and he said it wasn't severe enough to treat at this time. Side effects could be worse. I'd started airway clearance 2x per day in May and after mtg with ID in July I upped to 7% saline (based on my research and request to ID - who relayed that to my pulm). The nebulizing is part of the airway clearance routine. Mine includes nebulizing levalbuteral (doesn't make me as shaky as albuterol), neb saline 7%, and then Bevespi inhaler. That all takes some time but I do it while watching TV at night and got a 2nd of everything to keep at work and do it while reading email and catching up on Teams in the mornings. Fortunately I have an office where I can close the door. Yay for you for no LC!!! Prayers for continued positive there! I've recently backed down to 1x per day on some days.... when busy. Praying my next sputum test this week will stay negative. Takes 45 days to "grow" and get results. I did push my ID to do sputum test every 3 months... he wanted to go 6 or 12. I want to make sure I stay negative or very low bacteria load.

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@susanocl

Hi, just saw your response. Thank you. I think I will talk to my Pulmo Dr. about starting the airway clearance etc. on the 17th. He didn't think I needed to do it last March when I saw him, and then when I developed the two new nodules, it wasn't mentioned. More focused on determining whether it was cancer or not. I feel like I am walking around with a ticking time bomb in me, wondering when all of a sudden I won't be able to breath or get the mucus out. Since I am 77, he said he felt confident that I would probably die with MAC in me but wouldn't die from MAC. Enjoy your Holidays!!

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clinenan | @clinenan | 1 day ago
In reply to @mariegrace "@clinenan .9 saline works ok too. I cant use anything higher, it burns my throat and..." + (show)
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@clinenan
.9 saline works ok too. I cant use anything higher, it burns my throat and stomach

Jump to this post

@mariegrace, very good to know, thanks!

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susanocl | @susanocl | 1 day ago
In reply to @becleartoday "@susanocl you might want to think about adding an OPEP device, such as an Aerobika. Also,..." + (show)
Profile picture for becleartoday @becleartoday

@susanocl you might want to think about adding an OPEP device, such as an Aerobika. Also, if you’re able to cough up sputum for an analysis, there shouldn’t be a need for a bronchoscopy.

Warm regards,
Linda Esposito

Jump to this post

@becleartoday Thank you Linda! Thanks to this forum I learned I can connect my Aerobika to my nebulizer to cut down time (and it helps me not skip that step). The huff coughing works pretty well for me. I watched a You Tube video from respiratory therapist on how to do it properly. I just did another sputum test and will have to wait for results. I took my Aerobika with me. Hoping they got enough to test. I’m happy I don’t have much to cough up!

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paxmundi | @paxmundi | 11 hours ago
In reply to @mariegrace "@ejr Because I have gastritis,, i only can use NS, cannot use 7% it burns my..." + (show)
Profile picture for mariegrace @mariegrace

@ejr
Because I have gastritis,, i only can use NS, cannot use 7% it burns my throat and stomach but its supposed to be best

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@mariegrace It hasn’t worked for me though helpful initially. Nebulizing 7% also caused frequent hemoptysis episodes that have really set me back. 7% is NOT for everyone. Now for two months I have been unable to tolerate even 3%, which I could tolerate previously.

AND I never found a big difference in sputum production with nebulizing, though it helped me tolerate more solid foods. My hope is to get back to 3%, which many people find to be just as effective as 7%. I have a friend that doesn’t get anything up at all with 7%, so the point I am making is that we are all different and one size does NOT fit all.

I have often gotten more up doing my yoga practice with coordinated breathing and breath holds than my nebulizing. Even an Aerobika can be done too aggressively. Listen to how your lungs are reacting at every turn since our disease presents quite differently in each of us. Hope this helps.

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