Immediately after my diagnosis of Bronchiectasis I was referred to a respiratory physio, who taught me Active Cycling Breathing. He suggested this twice a day for approx 20 mins and it would get rid of the 'gunk'.
However, no matter how many times I try this it just doesn't work. I've gone on YouTube just to double check was doing it properly and I'm following it, exactly as shown, but it doesn't have any effect. Wondering if this is normal for some people as still have a productive cough throughout the day.
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Titian8
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I couldn't manage it either, and the physio recommended my doctor prescribe a flutter device which works for me.
hi there Titian8 and welcome to the very exclusive bronch club. I have had it since I was 3 and am now 67.
We are all different. Your cycle of breathing is working if it is helping you to bring up the mucus. There are some of us like me who do this at several specific times in the day so that the bulk of it is out and I can get on with my normal activities. However, I could always cough up some to order at any time. If this is so much that I feel horrible or can’t do my normal things I know that it is time for the antibiotics. From my own experience I have always disagreed with physios and medics who tell you that a particular amount or periods of coughing up will empty your lungs completely. It helps to keep the level of infection down by getting the fluid out that the bugs lIke to breed in and it makes you feel better because you can breathe easier. But rarely will a couple of sessions get rid of it all. It is quietly producing all the time after all. Don’t feel badly if you need to get rid of some every time you pass a loo. However, If there is masses of mucus in spite of your best efforts it probably means that there is an exacerbation going on and antibiotics are needed to put the bugs in their place and reduce the volume. You will come to recognise what is normal for you.
I am new to this site and was drawn to you because of the age you were when you first became affected by Bronchiectasis.
My 13 year old son has had constant mucus production and breathing issues since he was 7 which has become increasingly worse.
It took a long time for him to be referred to a chest specialist (6 years) and only then because he underwent surgery to reset his nose and the anaesthetist was shocked by how gunked up his lungs were.
I am gradually coming to terms with my son’s lifetime condition...still awaiting a few test results to fully confirm diagnosis isn’t Cystic Fibrosis or an immunodeficiency.
How has your life been so far? Have you found it to be debilitating?
I would appreciate any advice on living long term with this condition.
Hi Titian8
I do the huffing technique..
Sit up straight, hands on your tum, inhale blowing your stomach out, exhale pulling your stomach in 5 times or until you feel like coughing,
Don’t let yourself cough!
Put your hand in front of your mouth and huff
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2. You lie down on your left side, stretch your right arm behind you, do the same breathing technique, sit up when you feel like coughing and huff to bring the mucus up
Swap sides
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3. You lie down on your back, arms stretched behind you, same inhaling technique but when you exhale bring your knees up on your chest.
Sit up when you feel like coughing and huff.
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4. These exercises will help you to expectorate, have your tissues ready, and water, if the mucus is too thick but you feel it in your throat, drink up.
I find those exercises easier to do 15mn after taking inhalers or nebuliser if you have one
I have bronchiectasis too but can't get on with the Active Cycle of Breathing at all. It gives me a sore throat and headache. I use the 'bubble-pep' method which they use with children at Great Ormond St. Hospital. A Google search will give you lots of examples. It works for me. I think it's just a matter of finding the method that suits you best. (I don't do it every day, just when I feel the need such as once or twice a week)
There's a few physio videos on this ERS soft launch Patient Priorities - Bronchiectasis which I was lucky enough to be involved with.
Each person with bronchiectasis has a preferred method of lung clearance and a preferred PEP, be that the Acapella, Flutter or Flute.
As I've had bronch all my life we had nothing other than postural draining with percussion and although it is often considered 'old hat' I can get much more up doing pd following any of the other methods. It's not good though with hiatus hernia, so I may have to have another go at autogenic.
PD, especially with percussion and shakes should really be shown to you by a respiratory physio, although to find one who will teach you this method may be fairly difficult. They no longer use it in paediatric cf or paediatric non cf bronchiectasis. When I was young that is the only method they had.
You need to incline say on a bed over pillows (do not go over the side of the bed). Hips on pillows and head on bed. Do not ever clap with a flat hand. Cup the hands and tap, which should trap the air and this is what causes the vibrations within the lungs and loosens the gunk. The acapella choice is supposed to do the same thing by blowing into it, but it’s all trial and error. Basically finding what works best for you. You really need the advice of a physio.
I spend at least 2-2.5 hours a day on it, mainly because it takes that long to dislodge the very sticky mucus sufficiently to cough anything up. I don't actually cough very much until the end, and there's still stuff there because you can never get rid of it all. I use the autogenic drainage technique, which involves breathing & huffing at different levels in order to shift the mucus from the outer recesses of the lungs up into the main airway. Even then, I have to nebulise 7% saline first, to try & thin it a bit, otherwise it's stuck solid. If I tried to rush it, I'd be awake most of the night coughing & wheezing. We're all different aren't we?
I don't think many people realise how much of our time is taken nebulising b'dilators, hypertonic and lung clearance. It is a heavy burden but at least we can do something to help ourselves. I'm gonna have another go at autogenic. For some reason I thought you did active cycle. Maybe you can give me some tips on autogenic Hanne. Nothing like hearing it from people who actually have to do it.
My experience is similar. I can’t believe I have to dedicate 2.5 hours a day on this. I also nebulize the 7% saline as without that I can’t get anything out at all. I’ve tried the PEP devices but they just don’t seem to help so much. I end up hospitalized if I rely just on my Aerobika. I use The Vest while I nebulize saline and then use various techniques to pull the mucous up and cough it out. I still get frequent infections even doing all of this but I recognize the color changes quick and they put me on antibiotics fast to avoid it progressing to pneumonia and so I don’t feel sick. My dr understands the seriousness of the condition but he’s a bit baffled at times because my Bronchiectasis is mostly mild with localized areas where it is moderate. I think the main problem is that it is diffuse so there’s a lot of places where mucous gets stuck and being diffuse it is impossible to completely clear the lungs. I also have major sinus problems and whenever I get a sinus infection it triggers a chest infection. This illness is frustrating, stressful and such a burden but all you can only do what you can do and try to live life as best you can when you are not attending to clearing your lungs.
Wow! to each and every one of you who replied to my query I say thanks so much. I have read your posts a few times, clicked through to all the links, noted the content and intend to try all suggestions, hoping to find the one which works best. I sure have a lot to learn.
The respiratory consultant was good but the extent of my treatment was x-ray, blood tests, CT scan, which showed scarring and TB when young ( but unknown to me as can't remember any symptoms of being ill) and half an hour with physio and on your way: so thought that was normal. I know nothing about nebulisers, salt pipes, devices, inhalers etc etc. However, am thinking the reason could be because my condition is mild to moderate and not severe thereby he thought I didn't need to know about these things.
Have learned more from this one post than from any medical professional and appreciate your input a lot.
It seems to be a matter of degree. Mine is fortunately mildish so I can get away with my lung clearance regime. Others have to use nebulisers and other methods. The key thing is to clear the lungs of the gunge to stop infection setting in. How you do it is personal choice.
Did you see the two things I put on your first post? I've found them really useful. Needless to say, I got them from someone on here! What a useful bunch. 😊
Yes jacmidlands thank you. Have looked at the bubble pep method and intend doing it for sure as I need to get rid of mucus every day and if that worked would be terrific. I'll give the various techniques suggested a try to find out the most effective for me.
Also read about Inclined Bed Therapy recommending to raise bed head by 6 inches and that's on my 'to do' list also.
I think we are all different - I've learned a lot reading the replies here too.
I am recently diagnosed with bronchiectasis ("mild-moderate, with near-normal lung function". Lots of gunk every day.) Have been recommended active breathing cycle and a flutter device - just home from my 2nd physio appointment.
She recommended I experiment with a combination of breathing exercises and the flutter, and use whatever works best for me - may be different on different days. So far it seems I can huff better with the active breathing; the flutter makes me cough; and if I use the flutter early in the day, I get better results with the active breathing and huffing later on.
I think this is all a work in progress.
All the best to you and to all here. Thanks for all support and wisdom.
All the comments from the answers above make me feel more optimistic that will now get a handle on being able to carry out lung clearance effectively. Excuse me as an now off to blow bubbles: decisions decisions - what colour shall I make them😁
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