Is it worth buying an OPEP device for sputum clearance for COPD?

Posted by donsasen @donsasen, Oct 20, 2021

My pulmologist, PC think opep will kinda,,, sorta,, be really mucased up,, mite work, but still would like me to spend money ,with no guareenty it will work, THOUGHTS?

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Hello @donsasen and welcome to Mayo Clinic Connect. I can certainly understand that you would like some feedback about the use of Opep before you purchase one.

I found some research articles. Here is the link to one of those articles, https://link.springer.com/article/10.1007/s41030-017-0027-5.

If you read this article you will see there was some improvement for some people.

I have personally used an expiratory muscle strengthener (EMST 150) which has helped me with swallowing problems related to a paralyzed vocal cord.

Is the accumulation of mucus your main problem?

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Well, Don, I don't have COPD, but I have two sister lung diseases, asthma and bronchiectasis. Like COPD, these both interfere with the ability of lungs to clear out mucus, which leads to opportunistic infections settling into the nice, warm, moist, dark environment that is our lungs. Many of us in the Bronchiectasis group use one daily as part of our "airway clearance" to keep infection away. (you can see a video about it here: https://www.youtube.com/watch?v=L-EHohMe7II )

What an OPEP (Oscillatory positive expiratory pressure) device does is cause vibration which loosens the mucus to make it easier to cough out. There are some relatively inexpensive ones on the market, some of them covered by Medicare Part B as a medical device. Two I have used are Aerobika and Acapella (https://www.vitalitymedical.com/acapella-vibratory-pep-mucus-removal-therapy-valve-smiths-medical.html)

I use a 7% saline neb, followed by using the vibratory device, which makes me cough up a ton of mucus. On days when I skip the process, I find myself coughing up thick mucus off and on all day long. Doing this has also kept me from getting pneumonia and bronchitis for almost 2 years (previously I could count on 3-4 bouts every year.

There are also so elaborate systems that combine nebulizing with OPEP vibration – I haven't used them, so I cannot speak to effectiveness. I'm going to invite another Don @thumperguy to talk abouthow airway clearance has helped him.

Does this help you understand what you might be able to do to breathe easier?

Sue

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@sueinmn

Well, Don, I don't have COPD, but I have two sister lung diseases, asthma and bronchiectasis. Like COPD, these both interfere with the ability of lungs to clear out mucus, which leads to opportunistic infections settling into the nice, warm, moist, dark environment that is our lungs. Many of us in the Bronchiectasis group use one daily as part of our "airway clearance" to keep infection away. (you can see a video about it here: https://www.youtube.com/watch?v=L-EHohMe7II )

What an OPEP (Oscillatory positive expiratory pressure) device does is cause vibration which loosens the mucus to make it easier to cough out. There are some relatively inexpensive ones on the market, some of them covered by Medicare Part B as a medical device. Two I have used are Aerobika and Acapella (https://www.vitalitymedical.com/acapella-vibratory-pep-mucus-removal-therapy-valve-smiths-medical.html)

I use a 7% saline neb, followed by using the vibratory device, which makes me cough up a ton of mucus. On days when I skip the process, I find myself coughing up thick mucus off and on all day long. Doing this has also kept me from getting pneumonia and bronchitis for almost 2 years (previously I could count on 3-4 bouts every year.

There are also so elaborate systems that combine nebulizing with OPEP vibration – I haven't used them, so I cannot speak to effectiveness. I'm going to invite another Don @thumperguy to talk abouthow airway clearance has helped him.

Does this help you understand what you might be able to do to breathe easier?

Sue

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Buy it…..and use it ! It may take awhile to get used to it and you have to use your abdomen to huff cough. But, do whatever your doc suggests to clear your lungs…there are some additional things that can really damage your lungs that can get imbedded in the mucus in your lungs and they will really effect your pocketbook!

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Greetings!
I am considering adding a OPEP device to my airway clearance regimen. I am wondering what device or devices deliver the best results. Has anyone had personal experience with the Aerobika and the AirPhysio? I would love to hear your opinions on these or any other devices that work best for you. Thank you!

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@melissaf

Greetings!
I am considering adding a OPEP device to my airway clearance regimen. I am wondering what device or devices deliver the best results. Has anyone had personal experience with the Aerobika and the AirPhysio? I would love to hear your opinions on these or any other devices that work best for you. Thank you!

Jump to this post

I use both the Aerobika and the Acapella devices. I haven't tried the AirPhysio. To me, it is a matter of personal preference, and I like the feel of the Aerobika better. But I keep the Acapella in my car (clean & bagged) for those times when I am on the run and have a few minutes to do clearance.
I feel that the vibration helps break loose stubborn mucus when I am producing a lot, but huff coughing plus 7% saline nebs are as effective for me most of the time. My routine – move around (house chores that involve bending, stretches, brisk walk and/or yoga/chair yoga) then neb and do airway clearance. Bending from the waist also helps bring up mucus for me.
This has worked for me both during MAC and after, I add more rigorous nebs & clearance if my asthma is bad or I have a virus/cough/cold. My devices are due for replacement after getting good use for 4 years now… In 2 1/2 years, I have only had 2 short exacerbations that required extra meds for a short time.

Can you tell me a bit about your diagnosis & history? Do you have MAC and Bronchiectasis?
Sue

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@sueinmn

I use both the Aerobika and the Acapella devices. I haven't tried the AirPhysio. To me, it is a matter of personal preference, and I like the feel of the Aerobika better. But I keep the Acapella in my car (clean & bagged) for those times when I am on the run and have a few minutes to do clearance.
I feel that the vibration helps break loose stubborn mucus when I am producing a lot, but huff coughing plus 7% saline nebs are as effective for me most of the time. My routine – move around (house chores that involve bending, stretches, brisk walk and/or yoga/chair yoga) then neb and do airway clearance. Bending from the waist also helps bring up mucus for me.
This has worked for me both during MAC and after, I add more rigorous nebs & clearance if my asthma is bad or I have a virus/cough/cold. My devices are due for replacement after getting good use for 4 years now… In 2 1/2 years, I have only had 2 short exacerbations that required extra meds for a short time.

Can you tell me a bit about your diagnosis & history? Do you have MAC and Bronchiectasis?
Sue

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Hi Sue,
Thank you for sharing your experience. And thank you for asking about my history.
I was diagnosed with MAC in 2005 at the age of 43. I have been on antibiotic treatment 3 times for MAC, stopping when sputum cultures were negative and starting again when cultures were positive. I am currently on holiday and would like to stay clear for an extended period of time. I did not hear the diagnosis "bronchiectasis" until (about) 3 years ago, although I certainly had it all along. I use a Smart Vest once per day, with huff coughing, and most days nebulize 3% saline twice. As with most patients, some days are very productive and other days not so much.
I work full time at a desk job and find all the activities to manage the disease and the sterilization of the nebulizer parts very time consuming. I understand the importance of exercise and try to work it in each day along with meal prep and other household chores. It is challenging to prioritize my health over some of the other demands and difficult to get buy-in since I don't look sick. Again, likely very typical of MAC/Bronch patients.
Thank you,
Melissa

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@melissaf

Greetings!
I am considering adding a OPEP device to my airway clearance regimen. I am wondering what device or devices deliver the best results. Has anyone had personal experience with the Aerobika and the AirPhysio? I would love to hear your opinions on these or any other devices that work best for you. Thank you!

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Hi @melissaf, I'd like to add my welcome. I moved your question to this existing discussion where @donsasen asked a similar question:
– Is it worth buying an OPEP device for sputum clearance for COPD? https://connect.mayoclinic.org/discussion/opep-and-copd-stage-3-worth-purchse/

The discussion now appears in both the COPD group and the MAC group. I did this so that you can continue to get experiences from members like @sueinmn as well as see previous posts.

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Hi, Been reading some of the messsages about a OPEP device. I was diagnosed in 2011 and have been getting along fairly well. UNTIL this past winter when I was in and out of the hospital for a copd exacerbation . Never had one of those before. Was put on steroids for my being diabetic so my blood sugar was sky high, I did a lot of coughing but unable to get any of the sputum out. My question is this , will this be happening more and more often to me as time goes on. Is there something I should be especially prepared for. I have the copd plus spinal stenosis, plus my heart isn't in great shape anymore , have a very enlarged hiatal hernia to name some. As someone once said "life is like a box of chocolates, never know what you are going to get. " Prayers for you all and God's strength to you to help you each and every day. Joan

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