<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>mneville</b></i>
Amy- Warwick also told me about NAC which I have put on my list of questions for our CF visit next week. I have no idea how much a two year old would take?
On another post, you mentioned the 97.9 number of the Minnesota Center and how great it was. It really is compared to our center in the low 80's for lung function between 6-17. But after visiting Warwick for five hours, the only difference I really notice is their strict adherence of an hour of the VEST daily. We have been doing this diligently since our son has been 19 months old. There is nothing else I can figure out that they do to make their numbers so high?? Have you? Besides MucoMyst...Whatever it is, I want to do it.
Overall Minnesota (CF or not) has the second highest life expectancy age in the USA. It must be good air? Megan</end quote></div>
I think the Vest can make a huge difference. If you are able to mobalize sputum I think you can truely make a large difference in lung function. I can only use myself as an example (other than clinical studies) but I know the few times that I haven't done the Vest I feel awful the same day.
So you may have answered your own question "the only difference I really notice is their strict adherence of an hour of the VEST daily." This center has had the Vest years longer than any other center because Warwick was the one that invented it. I think extra years of the Vest can improve FEV1's and prolong life.
I think at the end of the day, centers that innovate are going to have better CF clinical outcomes than centers that simply follow others.
We've seen it over the past 20 years with CF therapy - life expectacny has more than doubled. Has there been some miracle drug? No. Small improvements in therapies, Pulmozyme, the Vest, and improved nutrion (as the rest of the World gets fatter, CF patients keep more weight on as well) has led to dramatic increases in CF life expectancy.
So I think centers that innovate will see dramatic increases in clinical outcomes as well. Small tweeks in CF therapy add years. And those who have access to those small therapy tweeks later won't have as great clinical outcomes as those who have access earlier.
Innovation is the name of the game at Minnesota. And I think that's a large reason (although not the only) as to why they do so well.
In terms of air quality - I know many places in the US with good air quality. I think the correlation between FEV1's and air quality is pretty low, funny enough.