Another study from the MDa's website...Lisag

Study Finds Oscillation Vest Doesn't Help in ALS
A vest that delivers high-frequency chest wall oscillation failed to show benefit in a study of nine people with amyotrophic lateral sclerosis (ALS) in Hershey, Pa.

Kathleen Chaisson and colleagues, including Zachary Simmons, who directs the MDA clinic at the Milton S. Hershey Medical Center, published their findings in June in Amyotrophic Lateral Sclerosis. They added chest wall oscillation using the Hill-Rom Vest Airway Clearance System to standard care, including bilevel positive airway pressure ventilation (BiPAP), for five of the patients, while the other four received standard care alone. Those who used the vest didn’t show any difference from non-users on measures of pulmonary function or survival time.

The vest is designed to help move secretions out of the lungs. The primary problem for ALS patients is respiratory muscle weakness, which most experts believe is best treated with positive pressure ventilation.

Hi Lisa!!

Good to see you back and glad to know Gary is hanging in there.

I couldn't agree more with this article. In my opinion, the "vest" that we used for Kenny for 10-12 months was a waste of time and money. But we wouldn't trade our cough assist for anything

Lesa,
Hey lady !!! So wonderful to hear from you !!!!
The vest I actually had high hopes for because we had a caregiver her who swears by it with her CF...CF causes very thick secretions in the lungs...I am so sorry to hear it did not help Kenny..but glad to hear the cough assist helps....Lisa

Yeah, the vest may help someone by loosening up secretions (if they can still cough the stuff out), but if you can't cough, then the secretions are just loosened up and "repositioned" elsewhere in the lungs.

I'm not suprised at all by the article, and I'm glad that someone actually did a study on it.

Again Lisa, GLAD YOU'RE BACK!!

Hi All!
My brother Chris swears by "The Vest". Since having it, he has had no problems with pneumonia which he had had before. He uses it twice a day, everyday. Go figure!!!
Alison

Alison... very good to hear... although Lesa may have a point as far as strength of cough goes as far as effectiveness...maybe Chris has a stronger cough...or maybe it is more effective combined with ventilation..just guesses on my part...
Anyway...if Chris develops problems later you may wish to look into the cough assist..however if the vest is working for him at this point it may not be neccessary...
Lesa ..again very good to see you as well...How are things going for you guys ? ...

Hey Lisa,
It is probably the combination it the vest and his ventilator. Don't get me wrong, he still gets congested...the vest breaks it up and they suction it out. As far as Chris getting a cought assist machine, his pulmonologist doesn't believe in using one with him (I'm not sure why). He had one before he was vented and used it quite frequently. When his breathing crashed, my dad actually used it to help Chris breathe until the paamedics arrived. (God that feels like decades ago.) Once he was trached and vented, it was returned. I think they thought he might blow a lung out with it. And because all other methods are working for Chris (suctioning, nebulizer treatments, the vest) he is fine with not having one. It's his decision...who are we to argue it.
Alison
P.S. I wouldn't think the vest would help in keeping a PALS from being vented......I would like to know if, in the study, it did keep a vented patient from getting pneumonia....

Alison ,
I agree...if it works for him why change it...also a hole in the lung is possible if the settings are too high with the cough assist...but it is also possible to get a hole in the lung from excessive coughing against the pressure of the vent without using a cough assist especially if the PEEP is to high....
Different pulmonologists may disagree with its use once a PALS is vented..but in Gary's case with his history they feel not using it at all presents a much greater risk...for PALS in mid to late stages who are not yet vented I feel the cough assist is a vital piece of equipment..and for many PALS even once they are...
Lisa

Lisa,
As I sit and think about it, I don't think my brother "coughs" anymore. When he needs suctioning, he'll type "SUCTION" and it gets done. His cuff is always closed so saliva does sneak down and his mouth is constantly being suctioned as well. In the beginning when he was being suctioned (when he was 1st trached and vented) he sort of gagged during the process.....he doesn't do that anymore. Strange the things that pop in your mind.....anyway....
I am so glad Gary is doing well....and so glad you are back too.
Alison

Alison ..
Although Gary's cuff is inflated to the max ..stuff gets down in his lungs..it is weird but he has an overexagerated gag reflex ..and if I don't use the cough assist ...that vent would alarm ... no lie.... 50-100 times a day..due to a whimpy cough over and over again.for hours on end..
I know because after his pneumothorax we had to wait 6 weeks to use it after the chest tube was taken out..we had to wait for the chest tube wound to close completely and then have confirmation it was completely gone internally by x-ray..though most of it resolved internally before the chest tube was pulled 5 days after it was inserted while still in the hospital ..( the pnuemothorax they think was caused by too high of a peep for his respiratory drive)...so vent settings were changed...he can breathe on his own for quite awhile and at times over breathes the vent substantially..causing too much pressure to the lungs...the pulmonologist dropped him from a peep of 10 to a peep of 3......hopefully knock on wood the change of settings will help reduce the pressure when he over breathes the vent...as this is an experience he nor I care to go through again...
But not being able to use the cough assist drove me and him nuts.. I was in tears and literally a zombie from lack of sleep for awhile ...but after getting the cough assist back... he alarmed the vent again by coughing no more than 4 or 6 times a day...as the cough assist pulls clumps of stuff out at once..much more junk than I could suction without it..and we could both sleep through the night again..
As hard as it was on me..it was harder on him..he has endured so much..and is quite a fighter..Lisa