Acapella -versus- The Vest

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arabeth

Guest
Hi All...

I was wondering if someone could share with me some opinions on the acapella versus the vest, if anyone has used both. My reason for asking is that we just recently moved from MN to TX and my daughters have both always used the vest. That is the only form of CPT they have ever had (with the exception of when they were too small and we just did manual CPT). In MN it is pretty much the vest all the way...they really don't offer any other options. They are huge believers that the vest is by far the best form of CPT... Anyway, so now we are in TX and we had our first visit with the CF Center last week and she gave my daughters both an Acapella to use. It isn't that they recommended it over the vest, but that it would be of equal value. My daughters both hate doing the vest....it's so time-consuming and they say it hurts because it is to tight. The Acapella is so much easier, they don't fight me with it like they did the vest, and honestly it seems to be producing more coughing than the vest ever did. However, being ingrained in the belief that the vest is best, I'm scared to risk completely switching. I've been having them do the Acapella in the mornings and the vest at night. They would much prefer to use the Acapella all the time. Just wondering if anyone has some really good Acapella stories that may make me feel better about it.

Thanks much!!!
Renee

PS. I'm also stuggling with some medication issues as the new dr wants to switch some of their meds as well.... I'll be posting that question soon...man, change is so frustrating sometimes...lol...
 
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purpleangel28282

New member
The acapella is just like the flutter isn't it? I thought it was good to use the vest and the flutter together, not just using one over the other.
 
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anonymous

New member
We live in Texas and my husband and I recently took my kids to the Minneapolis clinic for a second opinion. From my experience, the Minneapolis clinic bases their recommendation on studies they have conducted and by observation. Could that be why the Minneapolis clinic has the highest average life expectancy? They are willing to change drugs/treatments if they see it doesn't work, even if the majority of cf clinics do not agree. For example, they don't prescribe Pulmozyme because their study indicated a drop in lung function. Our clinic here in Houston doesn't seem to give much thought into what they prescribe. I am not even sure if their CF doctor knows what CPT therapy my kids uses, they never ask me about it.

Just make sure you understand their REASONING why they are switching your children's medications.
Sharon, mom to Sophia, 3.5 and Jack, 1.5 both with cf
 
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anonymous

New member
Am I understanding it correctly that their study indicates that using pulmozyme causes a drop in lung function? In what way? Thanks! Jo Ann
 
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anonymous

New member
Hi - Jason uses the accapella in the am before school and the vest at night usu. He is in the middle of tune up currently and while he was in the hosp., they would do either the percussor or vest and then the accapella. Since Jason's secretions are really moving currently, we are having the greatest amount of success with the accapella at each of the four breathing treatments now that we are home. When we asked the resp. therapist in clinic, they said that the important thing is that they do at LEAST one or the other and both is ideal. We go to AI Dupont in Delaware. Hope some of this helps. One of the things that I learned during our hospital stay was even though all of the cf patients in our hospital go to the same clinic, they all seem to do things a little different. Maybe based on when they were diagnosed and how things apply to them as individuals. I got upset and confused at first, but I guess it sort of makes sense. JO Ann
 
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anonymous

New member
Their observation shows that Pulmozyme only benefits 1/8 patients who try it. Here is the study:

<a target=new class=ftalternatingbarlinklarge href="http://thorax.bmjjournals.com/cgi/content/full/53/12/1014
">http://thorax.bmjjournals.com/cgi/content/full/53/12/1014
</a>
Both of my kids still use Pulmozyme. They haven't been to clinic since I learned this.
Sharon, mom of Sophia, 3.5 and Jack. 1.5 both with cf
 
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arabeth

Guest
Hi again...

It's funny that you (Sharon) bring up the Pulmozyme issue because that is precisely the medication I was referring to when I said they were thinking of switching some of the girl's meds. Dr Milla at the Minneapolis clinic is not that big on Pulmozyme, as you stated. He is, however, a firm believer in Mucomyst. The doctors in San Antonio, our new clinic, are exactly the opposite. They immediately wanted to stop the Mucomyst and start both girls on Pulmozyme. (my older daughter is already on Pulmozyme but the younger one, age 6, is not and has never been on it). I put off the change by saying that I was uncomfortable with making changes this soon. The move has been stressful enough and I'm not ready to make a bunch of medication changes. They did already change the girl's enzymes. Kaitlyn was on Creon 10, 7 with meals, 5 with snacks. Kacie was on Creon 5, 5 with meals, 4 with snacks. Dr. Milla felt that it was better to keep them on the smaller strength as it is more readily absorbed by the body. The dr here disagrees and said it's better to take fewer Creon 20's than to take a bunch of smaller pills. I'm confused becase of all the disagreements between CF Centers. You would think they would all follow the same basic routine. I have found that is not the case. It's frustrating because I just want to do what's best for the girls but it's hard to know what that is when so many "experts" disagree. We've been to 4 different CF Centers in all, by far the longest time was in Minneapolis. All the CF Centers do things differently. I'm really glad we have sites like this to hear from people who actually live the lives of people with CF so we know how different things effect different people. Thanks for the comments so far and I look forward to hearing from more of you.
 
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luke

Guest
Renee,

the studies I have seen are inconclusive to which is better or worse. I do know that the acapella is a good alternative for CPT and is much more user friendly for some. I do believe in doing whatever works, if your kids fight the vest and will use the acapella correctly, then switch it. The comparitive studies are supposed to be apples to apples, so if they aren't using the vest correctly but are using the acapella correctly, then it would clearly be the better choice.



hope this helps,


luke bailey, MBA RRT 29/cf
 
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anonymous

New member
For those who use acapella, how do you do it? Our routine was just changed. Now it's 10 blows, followed by a huff-cough, and then repeat that 9 times. (So 100 blows total and 10 huff coughs.) Every year they seem to have a new method for huff coughing. Makes one wonder if they know what they're doing . . . .

With the vest, do you use the full vest or the short vest? The new short vest gives my child a stomach ache, but the doctor says it's more effective.
 
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anonymous

New member
Hi - My son was just in for a tune up and they are still having him do the accapella the same way as when they taught him 2 years ago. It is set on 5 now though. He blows ten times for 5 seconds and then 2 huffs or however many more he needs to clear secretions. He does this three times. We do not count a blow unless it lasts more than 4 completed seconds. Hope this helps. Jo Ann
 
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anonymous

New member
as far as the vest goes, I personally love it. it took about a week and a half to get my daughter used to it. now she likes it. we did have to lower the settings and build up. if it is too tight then back off and then bring it back up over time like a few weeks. its easy to adjust. movies with singing help make the time go by easier and after a few infections i thank God for the vest. im a stay home dad and it became too monatonous for me four times a day. also i have never heard anything negative with pulmazyme. we use it and so does everyone in our center. if it doesnt help then i still look at it as making her lungs a little wetter to help get it up, so what can it hurt? i know this is a nerve racking disease but look at all options equally. try it till you know it hurts or doesnt work. every one is different so you child is going to handle only the way she should. watch her and listen to all. then judge only for yourself. hope that helps. just remember to give it a try and keep an open mind.
 
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anonymous

New member
I was the one who made the post about pulmozyme possibly not working. The doctor who did the study I referred to said exactly what you did "making her lungs a little wetter to help get it up, so what can it hurt?." So it does have benefits.
Sharon, mom of Sophia, 3.5 and Jack, 1.5 both with cf
 
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