+40/-40?!?, was: Re: Re: Cough Assist machine settings?

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Well, that was my first reaction to the +40/-40 answers I got both

times. :-)

I tried using it with the mask. Sheesh. +5 didn't do much of anything

and took forever to fill my lungs. +10 did better, but my cheeks shot

out, and I was having trouble keeping my airway open what with the back

of my tongue blocking it off. The other thing is that at +10, I thought

maybe I was going through a Dizzie Gillespie moment (remember how his

cheeks blew up every time he played the trumpet? -- his cheeks really

popped out of his face). Too bad he isn't with us anymore, as he sure

was nice to listen to. Well, anyway, that's what was happening to me.

When we cranked it up to +15, my airway totally blocked off, and I

though my face was going to blow off! That was enough of that.

So, next we tried hooking it up to my trach. That worked a lot better,

and we eventually cranked it up to +30/-40 to try to dislodge a plug I

had been trying to get rid of for a month. All we succeeded in doing was

forcing it deeper into the airway, and I had sharp pains in parts of my

lung past that spot that I didn't even know was there. We quit using it,

and the sharp pain in that part of the lung didn't get better for a

couple of weeks. Also, every time I laid down, I would get a sharp pain

where the plug was. That lasted about another two months...

So today, we tried itout, and this time it went much better -- we used

it on the trach, bumped the pressures till we were at something like +

25/-30. Got a bunch of gunk up this time. Went to bed, and the Phlem

Gates of Hell opened up. and goo and gunk had to be

B wrote on 05/04/07 10:04:

> Most of the children I know with SMA are coughed at 40/-40, so I don't think

> -40 is unsafe.

>

> Think about a natural cough - it's probably much stronger than that. If you

> use lower settings, you're not going to get the desired results - namely,

close

> simulation of a natural cough to maintain clarity of the airway.

>

>

>

>

>

>

>>I have been trying to come up with some suitable settings on this thing.

>>

>>I can't seem to get much of an exhale without going to -40 for the

>>exhale, which I was told not to exceed. I'm wondering if -40 isn't too

>>strong a setting for safety. Any comments?

>>

>>About the best I have been able to achieve is a medium exhale with it

>>(hooked to my trach). Anywaything less than -40 turns into a slow exhale.

>>

>>Is the cough machine better for helping to draw secretions out to a

>>location where they are more easily coughed out by more normal means?

>>

>>Does anyone have any idea if the effectiveness of the machine is better

>>for people with smaller lung capacity? Mine is about 3 liters (breathing

>>on my own), and if I remember correctly, mine is something like 50 or

>>60% of what it is supposed to be.

>>

>>What about some of the other settings?

>>

>>Inhale pressure

>>

>>Inhale time

>>

>>Exhale time

>>

>>Also, it's not like I'm trying to force all this through a tiny trach --

>>I use a size 8. That's not the biggest they are made in, but I hear it's

>>at the upper range of sizes.

>>

>>I sure would be interested in comments from anyone else.