Sue often mentions “airway clearance.” Is this an explicit procedure and if so what is it? Don
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Hi Don, Here's the dreaded answer ,"It depends". Airway Clearance is different things for different people.
The simplest example would be when someone with "normal" lungs jumps into the steamy shower, and the moisture loosens any mucus/phlegm caught in their throat and lungs and they cough it out. Another would be exercise – running or brisk walking can often be enough to get the lungs busy actively clearing.
People with chronic bronchitis or mild bronchiectasis (without infection) are often taught the method of "huff coughing." Use any prescribed inhaler first, then follow this procedure:
There are dozens of examples on YouTube.
The next step is the use of a PEP (Positive Expiratoy Pressure) device like Aerobika or Acapella. The philosophy is that the slight vibration when exhaling through the device vibrates the small airways in the lungs, helping to loosen stubborn mucus. Here is an example:
One caution – you need to "stiffen" or tighten your cheeks when using the device. If the primary vibration is there, there will be little vibration in the lungs.
Now we move on to more aggressive processes.
The first is to combine nebulizing with any of the above. The nebulizer may contain albuterol, or any number of other medications. Or saline solution. We'll save discussion of nebulizing saline for a different post.
Next is to combine nebulizing or using your inhaler with postural drainage. There are many methods, from simply lying with head and shoulders below the body, to a series of positions to clear specific "trouble spots", to manual percussion on the body to further loosen stubborn mucus. If your doctor or respiratory therapist wants you to do this, you should be given very specific instructions, taking into consideration exactly what part(s) of your lungs are involved AND whether you have GERD.
That said, a simple method of postural drainage if you feel like you have some mucus "stuck" on the way out, is to lean forward, either sitting or standing, and huff cough.
Finally, for those who have a lot of trouble clearing their lungs, there are percussion vests. I have never used one, but here is an explanation:
Our friend Don, @thumperguy, can describe how it works and feels.
What do I personally use?
Most days I use my inhalers, neb 7% saline, and huff cough.
If my chest is tight or my asthma is acting up, I neb an airway opener, then the saline, and use the Aerobika.
If I begin the day with some gentle Yoga and a brisk walk – the mucus often launches itself out of my lungs without any neb, Aerobika or huff coughing. The first few times it happened I scared my walking buddies – they wanted to haul me home until I assured them it was "good for me".
I invite anyone who uses a different method of airway clearance to describe their process to us.
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What a superb response. Thanks Sue.
Don, you may also want to watch the ntm info video posted by Beclear under the topic: Looking for a pulmonogist in Texas. In the video Dr McShane describes airway clearance techniques.
Awesome explanation, Sue!
Airway clearance website—
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