Can you use a percussion vest with brittle bones & spine issues?

Posted by Melissa Nelson @melissa08, May 12, 2022

Somewhere in this discussion group I saw a reference to using a vest as part of the breathing protocols for MAC treatment. Vest usage has been suggested by my husband Bruce's pulmonologist, however there are concerns over its efficacy given his physical limitations.
He has severe curvature of the spine due to both scoliosis and spinal stenosis. His bones are very brittle and fragile in the back and rib areas, with a history of multiple bone breaks and fractures.
With those physical restrictions, and his pain levels from the spinal stenosis, Bruce has been more than a little leary about attempting the use of the vest. Are others' experiences more promising?

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@melissa08, you're questioning whether the percussion vest is advisable for your husband or not given his brittle bone status and spine curvature. I think @raney @ckscoville @thumperguy @flib @gj53 @migizii @shs @sueinmn and others will have exeriences to help to know what questions to ask the doctor whether or not. They may also have some suggestions for alternatives for people who can't use the vest.

You've been busy gathering information and getting out in front of this new diagnosis for your husband.

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Yes, that's exactly what I am trying to do. Is the vest advisable and how do we argue "intelligently" and in a way that continues to give Bruce the best treatment options available. Balancing all of the meds, breathing protocols and testing is challenging enough.
Thanks for looping others in to help us map out this option.

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@melissa08

Yes, that's exactly what I am trying to do. Is the vest advisable and how do we argue "intelligently" and in a way that continues to give Bruce the best treatment options available. Balancing all of the meds, breathing protocols and testing is challenging enough.
Thanks for looping others in to help us map out this option.

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I have degenerative disk disease thoracic and lumbar spine. I started using he Smart Vest a little over a year ago. At 1st it did no bother me, but I have lost 30 lbs+ in the last 6 months and that leaves a skinny chest. (156 lbs to 124 lbs.. I am 5 ' 5"). I also have a pacemaker.
I am using it less now and lowering the settings when I do because the pressure and the percussion has been bothering my back and area where my pacemaker is located. I do have a foam rectangle that goes over the pacemaker and under the vest, but I still feel the pressure . I have a call in to Smart Vest Consultant. She has called me back twice to discuss my issues, but calls at a time that I can't answer the phone. Next on my list is to request a telephone appointment for her call. It does help and I can breath better when I use it. But afraid of what it may be doing to the thoracic area.

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@melissa08

Yes, that's exactly what I am trying to do. Is the vest advisable and how do we argue "intelligently" and in a way that continues to give Bruce the best treatment options available. Balancing all of the meds, breathing protocols and testing is challenging enough.
Thanks for looping others in to help us map out this option.

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I do not use a percussion vest. My primary and pulmonologist both vetoed the idea because I am very small, and have arthritis and stenosis in my spine. I seem to manage just fine with stretching exercises followed by nebbing and huff coughing and or Aerobika. If I have trouble getting stuff up, I drink water then bend forward from the waist and cough.

Sue

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You might consider trying manual percussion. The vest "thumps" on the body to hopefully release stuck sputum so we can cough it up. During manual percussion, a partner thumps on the patient instead. There are videos on utube showing how to do it.

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Does your husband have success clearing his lungs without the vest? I did not and the vest has made a big difference in clearing secretions. The settings can also be adjusted to be more or less intense. That being said, that is a lot going on with your husband and I would definitely discuss it not only with his physician but also a respiratory therapist who may have more experience seeing the side effects/results once a vest is prescribed.

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@gej53

Does your husband have success clearing his lungs without the vest? I did not and the vest has made a big difference in clearing secretions. The settings can also be adjusted to be more or less intense. That being said, that is a lot going on with your husband and I would definitely discuss it not only with his physician but also a respiratory therapist who may have more experience seeing the side effects/results once a vest is prescribed.

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He does clear tremendous amounts of sputum daily. His most recent CT indicated a significant reduction in the fluid in his lungs from the previous scan taken six months prior, which was done before the MAC diagnosis and corresponding treatment/therapies began. He has another CT scheduled for early June, following a much longer period of treatment, which may show a greater amount of fluid reduction. Fingers crossed.
I agree that we need to discuss vest usage further. The potential downside of the impact on his already fragile physical state has to be considered if using the vest is to be an effective component of his treatment plan.

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@melissa08

Yes, that's exactly what I am trying to do. Is the vest advisable and how do we argue "intelligently" and in a way that continues to give Bruce the best treatment options available. Balancing all of the meds, breathing protocols and testing is challenging enough.
Thanks for looping others in to help us map out this option.

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In reply to @melissa08… i have used the vest for a few years and have found that I can use it as long as the % of pressure remains at or below 50% (depending on how many clothes I’m wearing). I am a petite person (5’2”….100lb). I also have osteoporosis and degenerative disc disease of the spine, but have had no fractures in my back (either before or after starting this tool). It is helpful for me to bring up mucus, but I would be concerned for your husband considering what you have shared. You are doing a terrific job and take care💖

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@melissa08

He does clear tremendous amounts of sputum daily. His most recent CT indicated a significant reduction in the fluid in his lungs from the previous scan taken six months prior, which was done before the MAC diagnosis and corresponding treatment/therapies began. He has another CT scheduled for early June, following a much longer period of treatment, which may show a greater amount of fluid reduction. Fingers crossed.
I agree that we need to discuss vest usage further. The potential downside of the impact on his already fragile physical state has to be considered if using the vest is to be an effective component of his treatment plan.

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There is a newer machine out called Volara, made by Hill Rom. I have tried it a couple of times and find it easier on the chest and more effective than the vest, which I’ve used for a couple of years. Apparently it’s quite a process to get it approved. Just wanted you to be aware of a possible option.

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@cayenne

There is a newer machine out called Volara, made by Hill Rom. I have tried it a couple of times and find it easier on the chest and more effective than the vest, which I’ve used for a couple of years. Apparently it’s quite a process to get it approved. Just wanted you to be aware of a possible option.

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Thank you. I did a quick Google search for the Volara system. It sounds pretty effective and, as you said, has the potential to have less of a negative impact on my husband's chest and back. The Medicare coverage info was less straightforward, but we're used to dealing with their various approval processes. And this is another option to add to our list. Much appreciated.

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