Chest clearance is a daily task. It’s all about shifting the thick sticky mucus about, up and out of the lungs. Chest clearance is not the worst thing in the world – not even close! It’s a chore though, like doing the dishes: we have to do the dishes whether we enjoy it or not and we have to do it every day. Chest clearance is simply a chore that people without CF never have to do. Lucky people!
There are several methods to choose from: chest percussion, PEP, flutter, acapella, VEST, exercise and autogenic breathing. Choosing option D) “none of the above” is not recommended if you value life and health. Choice of treatments means most people discover an option that works particularly well for them that they’re happy to commit to doing. For those who truly believe variety is the spice of life, this choice offers them the chance to play around with a number of techniques to keep their clearance sessions fresh and interesting.
I PEP. This is a PEP. It has different sized holes that you breathe through to create positive pressure behind the mucus secretions which helps shift them along the airways and out of the lungs. Unfortunately, it is an active process which requires concentration for optimal results. I can’t zone out or I spend 30 mins blowing through a tube with nothing to show for it. I do watch TV (don’t tell my physio!) but I have one half of my brain on the TV and one half on what’s happening in my lungs. I hedge my bets.
My technique is pretty good but Dave’s is better. Well, he has had 18 years more practice than me after all! When he helps me out I receive a lot of
criticism advice about my pepping technique:
“That breath was too long”
“… too fast”
“… too hard”
“… too long, too fast AND too hard.”
“Remember: gentle breaths!”
“Take a smaller breath in.”
“Have a rest.”
“Ok, NOW you can have a cough.”
After these interactions we are both reminded of my lack of patience and that Dave is a pepping master.
Despite this, Dave is not a fan of pepping. He has chest percussion for two hours a day. Homecare workers do an hour a day and Dave takes care of the other hour himself. I have physio when admitted to hospital and if I’m feeling tragically, horribly, on-death’s-door dodgy. Even then it only takes about 10 mins before I start wriggling, sighing and muttering. I find it incredibly tedious and not worth the mental torture. Thank goodness for choice of treatments!
The merits of PEP vs physio are frequently and hotly debated between us. Ultimately we both concede that our lungs are quite different and what is best for me isn’t necessarily best for Dave and vice versa. This is one of the unexpected pitfalls of being married to someone with CF. We are both experts, we have honorary PhD’s in the subject, and usually our knowledge trumps other people’s hands down. What we forget is that my sub specialty is me, and Dave’s sub specialty is Dave. We are different.