Smart Vest Programs

[Schmu]

Hi all,

I have bronchiectasis and I use my Smart Vest (shakey vest is what I call it) for about 15 minutes, twice a day for "Pulmonary Hygine" and airway clearance. I was wondering what programs others use with their compression vests?

I use one that is 10htz 40% 5:00min, 13htz, 40% 5:00min, and then 16htz 40% 5:00min.

I just made a new program with the same htz but at 45% thinking it might "hug" me tighter.

Just wondering what everybody else does?

I live in Chicago, and I am always interested in the differences between the countries.

Thanks!

Sarah

[Hidden]

IN UK that sort of thing is not prescribed on the NHS other devices such as flutter or acapella are. If any one in UK is using such a vest I am thinking they would have purchased themselves not prescribed by the doctor, but I would be interested to hear how people find it if anyone in UK is using one..

I have no idea of any programmes for the vest hope you are finding the vest works well for you.

[Schmu in reply to Hidden]

It does work well but without insurance it is cost prohibitive. The only advantage of the vest is that on the faster speeds I feel that it can loosen up stuff in the little parts of my lungs.

[Hidden in reply to Schmu]

I guess it would always be advisable to check with peoples own doctor about using a vest such as this.

[Bella395 in reply to Hidden]

You raise a good point. It didn’t cross my mind to discuss it with the doctor. The person who works for the company asked a series of questions to ensure he was ok to use the Vest.

Possibly the non specialist doctor might not be familiar with it but a respiratory consultant might be. Our unit doesn’t use Smart Vests but the bronchiectasis consultant that he now sees does know about them. She has some patients who use them but I didn’t ask her how they had been funded. She has said that his current stability is more than likely due to the device. However, he is also now on Colomycin so that is also helping.

[whit]

HI ,never heard of a smart vest, what is it, and what does it do?

[Schmu in reply to whit]

Its a compression vest that shakes the gunky mucus in your lungs so you can cough it out. It works at different speeds in order to work on different parts of your lungs...like the big tubes down to the little avioli. In the US, its covered by insurance.

[Feelingblessed2013]

I just wanted to say thank you for posting this. My husband has bronchiectasis, but has done nothing to help himself feel better. I am going to try to get him to try the smartvest.

I am glad it is working for you.

[Schmu in reply to Feelingblessed2013]

It does help a lot, as well as exercise and other pulmonary hygiene treatments.

[Feelingblessed2013 in reply to Schmu]

He gets enough exercise, but that's it.

[Bella395 in reply to Feelingblessed2013]

Katherine - new ones cost circa £7,000. TBH if your husband is not inclined to help himself I doubt whether he will comply with it. They are not particularly pleasant to use - it took my OH about two weeks to tolerate it. I had to start him off for very short periods at low frequency and gradually build both up. I thought he would send it back but he stuck with it and is now glad that he did.

Hill-Rom offer a trial but I they do have a criteria which includes asking about current clearance methods. They also insist on the support of the local physiotherapist. I had to write to ours explaining the situation and thankfully she agreed to supervise.

[Feelingblessed2013 in reply to Bella395]

We are in the states, insurance should cover most of the cost, but the pulmonologist has to prescribe it. I am going to do my best to get him to finally realize that he cannot ignore this disease. I am hoping the website for the vest will be a start. I am also hoping his new pulmonologist (when he sees him) will talk to him. His old pulmo diagnosed him, but has retired. The few pulmo's he has seen since act like it's no big deal, it's nothing to worry about.

[Bella395 in reply to Feelingblessed2013]

The Vest is very good for some people but there are others who do not find it helpful. It’s no quick fix. The mucous is loosened up and moved up the airways but there is still a lot of work to be done coughing it up. OH continues to use the Aerosure and Flutter to facilitate this. Hopefully you will be able to help him to work on keeping as well as possible.

[Feelingblessed2013 in reply to Bella395]

I am trying my best.

[Hidden in reply to Feelingblessed2013]

The possible problem with that is that the patient loses the ability to work their breathing muscles in order to expel the mucus. It is an attractive proposition to have a vest do it for you but long as a patient is not so weak that they cannot do this for themselves they should work on retaining as much of that capacity as possible. Your husband needs encouraging/bullying into taking control of the management of his condition. I have been doing this for 65 years and that is the reason that I lead a virtually normal life now. Sorry for the lecture but it is a fact of life with bronch.

[Bella395 in reply to Hidden]

It all depends on the patient Littlepom. I used to see him absolutely exhausted with the effort of coughing and trying to clear his lungs. I don’t have the impression that the Vest does the work for you but my experience is limited to one person’s use. He still has to work at clearance. It just makes it more efficient and easier. That is a huge advantage to a debilitated person.

[Hidden in reply to Bella395]

Your OH seems to be the ideal candidate for the vest and as you say, he still has to work to get out the mucus that it loosens. He has a very good attitude to his condition and in his case the vest is a useful tool to help him manage it. I am very interested to be kept up to date with how he is getting on with it.

[Bella395 in reply to Hidden]

Thank you littlepom. It has made such a difference. I think that a useful way to look at how it works is that it is akin to the physiotherapy manual percussion that you have probably had in the past, particularly in your childhood.

I once read that they think there is a shearing force that dislodges the sticky mucous from the walls of the bronchioles. There is maybe something in this because OH produces copious off white clots of mucous which he really struggled to shift. These are more easily removed using the Vest.

[Feelingblessed2013 in reply to Hidden]

He is not weak in any way, and he does expel the mucus, all the time. He wakes up multiple times in the night and spits into a small trash can that sits next to the bed. He has another can sitting next to his recliner in the living room.

I have encouraged, nudged, pushed, in an attempt to get him to start using his nebulizer, an inhaler, something to help clear his lungs. I keep telling him that he has more congestion than my father did, and he had severe emphysema.

He won't do the nebulizer because he doesn't like that it made him cough as bad as it did. What he doesn't seem to comprehend, and won't listen to is the idea that that first time was because he has so much mucus to clear, and that it won't always be that bad, that the more often he clears his lungs, the less there will be to expel. He told me that the doctors don't seem to think there is a problem, so there is no problem. He is not doing anything to manage his condition.

[Bella395 in reply to Feelingblessed2013]

Katherine - I have lost count of the number of nights sleep that has been lost due to coughing so I have an idea of what you are going through. Since having the Vest he sleeps through, not least because he is not having the frequent infections. It is wonderful to go to bed and not be woken by the coughing and distress.

I hope that you can help him to take an interest in improving matters.

[Feelingblessed2013 in reply to Bella395]

I am doing my best, unfortunately that is all I can do.

[Bella395 in reply to Feelingblessed2013]

Yes, you can do no more. Forgot to say that I was influenced by the fact that your insurance companies will supply these. I figured that they must believe they help cut costs in the long term. It seems to me that the effect is cumulative so it gets better as they continue to use the Vest. That is why I feel that compliance is key to successful intervention.

[Hidden in reply to Feelingblessed2013]

I think that he has to realise that he needs to spend at least half an hour in several sessions during the day, loossening and expelling the mucus. He needs to do this through the breathing routine, using some kind of acapella device and then huffing to get it out. This would be especially important at night so that he ( and you) can get sleep.

I was taught from a child to do this to a very strict routine. Just coughing up bits ad hoc is no good.It does not empty enough from the lungs and leaves pools for germs to grow in.

Bella’s husband is very compliant and works very hard to expel the mucus that the vest loosens, several times each day. I cannot see your husband being willing to do this is the case, a vest would be an expensive waste of money.

By the way I was also taught never to cough it out in front of anybody. wherever I have been throughout my life I have kept it private. I never coughed it up in the bedroom when my husband was there but went into the bathroom if I needed to.

It must be horrible for you and you are an amazing person to be trying to do so much to help him. Unfortunately, the hard truth is that if he won’t help himself you are wasting your very kind efforts.

[Feelingblessed2013 in reply to Hidden]

I have no intention of purchasing a vest, not until I am sure he will use it.

The first thing I need to do is get him into a decent pulmonologist. Hopefully one who will spell everything out for him, then I might have half a chance.

I would prefer he at least spit into a tissue, but it is what it is. I look at it this way...we have been through much worse. Five years ago I almost died and was sent home from the hospital with an open abdominal wound that had to be cleaned and "packed" every day. A nurse came out twice a week, my husband took care of my wound the other 5 days, along with helping me with my newly acquired colostomy bag. He has also seen me through 2 lung cancer surgeries, plus other unrelated surgeries.

I have seen him through 12 cervical surgeries.

But you are correct, until I can get him to at least acknowledge the problem, I am at a standstill.

[Hidden in reply to Feelingblessed2013]

It seems that you both care for and look after each other in a wonderful way. He should really see a physiotherapist working with a pulmonolagist. They could help him to understand that if he fully empties his lungs several times each day ( down the toilet ) he will be able to spend the time in between without spitting it out in front of people. This would be so much more comfortable for him and nicer for you. Good luck. I hope you find a way to better management for him.

[Feelingblessed2013 in reply to Hidden]

From your mouth to gods ears (as the old saying goes).

At this point I will be happy if we can find a pulmonologist who will actually acknowledge that there is a problem.

In the meantime, I know I am fighting a losing battle, but I will keep fighting.

[Bella395 in reply to Feelingblessed2013]

Katherine - it sounds as if you both have had more than enough to cope with. I can understand why your hubby is not tackling his lung disease so well at the moment. Maybe he feels it is all too much. Hope you manage to get him to a decent doctor and that he is encouraged to help himself. If he could get this under control it would make life so much easier for you both.

[Feelingblessed2013 in reply to Bella395]

I think once a doctor talks to him about getting infections in his lungs, he will start paying more attention to his lung health. He is always saying that he doesn't do infections well, he almost died from a tooth infection, and his dad died from a staff infection.

I just need to find that doctor.

[pete45]

I have two grandsons that have a genetic lung disease, PCD, (born with it) and they use the vests twice a day. It breaks up the mucus in the chest and it works. Sad to watch although being young they have just accepted it as a way of life for the time being.

[Schmu in reply to pete45]

My doctors talk about the strides that are being made everyday to help people with lung issues. They also talk about how far the medicine has come in just the past 10 years. Even though they are dealing with a rare disease, I have hope they will have better treatments soon. One of my pulmonologists, Michelle Prickett, works with adults with PCD and there is an affiliate children's hospital, Lurie, that has research going on for kids with PCD. Thanks!

[pete45]

Thanks, so few people have PCD so that makes it rough. They are being entered into some trials at a teaching hospital (UCSD) shortly so it will be interesting to say the least.

[Bella395]

Schmu - my OH has asthma, bronchiectasis, immune deficiency, heart disease and is colonised with pseudomonas. He has had the Hill-Rom 105 Smart Vest since April. It has been a blessing.

As has been said, they are not routinely used here in the UK. We only had one small demonstration and left to get on with it so I don’t know all the fine details regarding the programmes, although I looked at the book. His setting is 14Hz and he uses it for 15 minutes every morning. Often he repeats it because he is not clear. Sometimes he has another session after resting then he is usually clear for the day. Sometimes he needs a short afternoon session. He goes on again in the evening before bed. I wish we had more instructions and was able to talk to people with experience of it but I don’t know of anyone in our area who has one.

In the morning he is usually done within an hour - prior to that he was still coughing until the late morning. He’s had only one exacerbation since using the Vest and that was cleared up much quicker and easier than before. Prior to this he was having virtually back to back infections.

Smart Vests are not for everyone - there are other ways to clear. Also, compliance is essential. He goes on it religiously in order to keep on top of the mucous build up. He was allowed to trial it because he fitted the criteria. I set it in motion myself - nothing to do with the hospital although their physiotherapist supervised it because that is required. AFAIK this was her first experience of the Vest.

[Hidden in reply to Bella395]

Hi Bella, there is quite a bit on the web about how to use the vest. It might help help with the queries that you have.

[Bella395 in reply to Hidden]

Thank you.

[Beth1949]

I live in Iowa now, but got my vest while living in Northern Indiana. I love it. I have had the vest for over 10 years.

I got it from Hill-Rom (my insurance covered most of the cost). I'm impressed with the company. They give you a lifetime guarantee. After about 5 years, I needed new tubes and vest. They sent it to me free of charge. Several years later the machine was wearing out, so they sent me a new one, and I was to put the old one in the same box, and set it by the front door several days later, the UPS picked it up. At NO cost to me for the replacement machine and postage.

I use it while I use my nebulizer. I usually have it set on; 12 hrz for 12 minutes. Since you seem to use a higher hrz, I may try to increase mine.

I get the impression that in the UK, the doctors don't prescribe the vest very often. And if they do, it's at the patients expense. When we travel, I don't take the vest with us, it's too heavy, but I do take a travel size nebulizer and flutter valve.

Beth

[Bella395 in reply to Beth1949]

It’s good to hear that you appreciate the Vest as much as my OH. He is so very grateful for it.

[Schmu in reply to Beth1949]

Thanks!