Airway Clearance |
For many, this may mean manual CPT (chest physiotherapy) where using different positions and percussion (either by hand or the use of hand-held rubber percussors) help expel the mucous, or even using something known to many as simply “the Vest”; possibly even a combination of both. The Vest is a machine that pushes air through tubing attached to a vest that you wear and vibrates in a way to mobilize the secretions and move them out of the airways. There are also many other devices and methods that can be used for this purpose (flutter, acapella, etc.). These airway clearance exercises are commonly done two to three times per day, and more often when sick. In conjunction with airway clearance, most CF patients use nebulizers and/or inhalers to open the airways (bronchodialtor such as albuterol or xopenex), thin the mucous (Pulmozyme or hypertonic saline), reduce inflammation (i.e. Pulmicort) and/or provide inhaled antibiotic treatment (like TOBI or gentamicin).
Airway clearance is very time consuming and can have a major impact on daily activities. I know that for Allison, it can take up to a few hours a day. Scheduling this takes a little juggling ~ we need to make sure it has been at least an hour since she was fed (end of her night drip or after last feeding of the day before we hook up her nighttime drip) so as not to further disrupt her reflux. It is not impossible, but it can be very cumbersome and we have very little opportunity to be spontaneous.
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