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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@annagh

Moisture often gets in my Aerobika and causes it to fail, especially when I use it lying down (left, right and back) as my doctor instructed. But I have found that if I tap/slap the side of it against my palm or leg it "unsticks." I now have a little routine of tapping on the breath holds before each exhale. A nuisance, but better than buying more Aerobikas!
Anna

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I think moisture gets into it just using it. I know mine is very dry when I start out. First I use it sitting up. Then before using it laying down (back, left, right) I tap it onto a paper towel. You can see the moisture drops. This way it does not fail or if it does I just give it a shake or tap again. By the way I think you are the one that posted about your Dr telling you to use the Aerobika laying down in different positions. That advice has been critical for me as most of my mucus will NOT come up until I lay on my back head slightly inverted and pillow under my hips using the Aerobika. So THANK YOU for posting about that some time ago. It was a huge help for me just at the right time.

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@irenea8

I think moisture gets into it just using it. I know mine is very dry when I start out. First I use it sitting up. Then before using it laying down (back, left, right) I tap it onto a paper towel. You can see the moisture drops. This way it does not fail or if it does I just give it a shake or tap again. By the way I think you are the one that posted about your Dr telling you to use the Aerobika laying down in different positions. That advice has been critical for me as most of my mucus will NOT come up until I lay on my back head slightly inverted and pillow under my hips using the Aerobika. So THANK YOU for posting about that some time ago. It was a huge help for me just at the right time.

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Yes, Irene8, I too begin with a dry Aerobika. And yes, I am the one who posted that Dr. Winthrop recommends using the Aerobika lying down. I'm glad you found that info helpful. Thank you for letting me know. That's what this group is all about and I am so grateful for all I've learned from others.
Anna

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My aerobika and green acapella get little use since I tried using the small plastic diameter tube, which come with tabletop nebulizers. This cut down my cleaning/sterilizing time considerably. I use the tube in concert with AD app. Exhaling through the plastic tube keeps the glottis open during exhalations so that airways do too. With AD app I run through 5-6 two minute sessions in the A.M. and 3-4 in the P.M. I got the idea from the Aussie Bronch site.
https://bronchiectasis.com.au/resources/airway-clearance-videos

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@donnaturn

I also use the nebulizer and compressor made by Monaghan, the same company that makes the Aerobika. The nebulizer is the AeroEclipse XL and the compressor is the Ombra. I also have a question for others in the group. My Aerobika will be a year old in October and should be replaced at that time. I purchased it myself last year, but would like to know if anyone has had success getting one paid for by Medicare. If so, where did you purchase it (must be a Medicare provider in order for them to pay)? Thank you! Donna Turnbaugh

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I paid out of pocket for my first aerobika because I was still trying to navigate my way around with my new diagnosis and treatment. When it was time to get a replacement I had read that Medicare would pay for it. I related that information to my pulmonary staff and they sent me one. I take extremely good care of my aerobika so don't stick with the "replace in one year" rule. They are sterilized and work fine so I don't see the need to replace them. Faye

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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'm using the smart vest along with the 7% at the same time. I think using them together is best for me. I don't sterilize or wash my vest daily. I do wash my neb cups daily. I don't think it's necessary to sterilize everyday.

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Tried mucinex and AD and am hydrating and using Albuterol in addition to everything else. I have never produced mucus and have been doing this for 1 1/2 years with no luck but I refuse to give up.

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@scoop

@lvalenti Are you taking NAC or mucinex and hydrating, then using albuterol to open up airways before using 7% saline in your nebulizer? It takes some time to master the whole clearance routine, along the way figuring out what works for you. If you are doing all these things, perhaps you have "dry" bronchiectasis, which is something I don't know much about as mine is quite the opposite.

FWIW, the vest did nothing for me. Hill-Rom was nice enough to give me an extended loan and in that time I determined it was not as effective as autogenic drainage and/active cycle of breathing. Another brand vest I tried (Afflovest) seemed promising but it gave me rib pain. Not using the vest was a big time saver.

https://bronchiectasis.com.au/physiotherapy

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Sorry! I didn’t mean that I wash the vest, I meant all the other equipment.

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@scoop

@lvalenti Are you taking NAC or mucinex and hydrating, then using albuterol to open up airways before using 7% saline in your nebulizer? It takes some time to master the whole clearance routine, along the way figuring out what works for you. If you are doing all these things, perhaps you have "dry" bronchiectasis, which is something I don't know much about as mine is quite the opposite.

FWIW, the vest did nothing for me. Hill-Rom was nice enough to give me an extended loan and in that time I determined it was not as effective as autogenic drainage and/active cycle of breathing. Another brand vest I tried (Afflovest) seemed promising but it gave me rib pain. Not using the vest was a big time saver.

https://bronchiectasis.com.au/physiotherapy

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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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@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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@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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@equanimous RTs seem in short supply, like so many other positions today. I could be wrong but I thought there was a highly regarded pulmonary practice at one of the big medical centers in LA. RTs not only treat lung but also heart patients and others, so I'm surprised you can't find one. My experience is that they are difficult to get an appointment with unless you need pulmonary rehab. etc.

In the meantime could you check out Buteyko breathing, used for all sorts of things. There's a best selling book called Breathe: the New Science of a Lost Art and others, and various websites. Very interesting and possibly helpful. There are Buteyko teachers scattered about but not covered by insurance.

https://www.buteykobreathing.org
https://www.verywellhealth.com/how-do-i-perform-buteyko-breathing-200874

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