In need of up!

….This is my P.E.P. device….

I’ve been using a Pari P.E.P. device as part of my lung treatment for several years now. I’m currently not enjoying this pred taper and am coughing like a trouper due to the dampness now it is almost October plus I’m being affected by whatever leaf mould is flying around and it’s been very wet recently.

I generally use it attached to a neb, as shown, but it can be used with a separate non venting mouthpiece as a breathing device to help with air trapping. But if I’m being honest here, I’ve lost the mouthpiece, so that’s why it has to be attached to my neb these days! Anyway, the principle of the device is this: When you exhale into the device it provides you with Positive Expiratory Pressure (hence P.E.P.) This in itself can help to splint open the airways, (much in the same way that BiPap therapy does this when in hospital and severely unwell). It can also help disperse and shift the mucus and secretions that many of us with chronic lung disease have. I’ve got a wet lung syndrome and always, always have something to cough. This does help me.

I’ve found that by using my P.E.P.device when nebbing bronchodilators, I have a better chance of opening up my airways, maintaining my best lung volumes and increasing my ability to cough and exhale properly-the biggie problem at the moment- as I am really air-trappy again today. So it looks like I’m going to be back on the P.E.P. now instead of my usual come what may approach-or 10-20 breaths on the thing when I can get around it to (I’m a lazy P.E.P.per, I admit!)

If I’m very coughy, gunky, I switch to using a Flutter device-but that’ll be another post!

So this is why it is so hard to exhale when using one of these things:

There is a sequence of 8 little holes on the top of the device -(my Drs have determined which one to use), it has to be aligned with the big hole on the main body of the device. I use the second to largest! I would love to think I can train and strengthen the lung percentage I have to exhale through the smaller holes-it almost gives me a headache to blow against this type of pressure as it is!

I spoke to my physio today and am now supposed to be using the P.E.P. four times a day, to help me get through my Pred taper air trapping symptoms and this level of SOB that I’ve got going on. I’ve been truly uncomfortable this week. This morning I started coughing-the sort of cough where there is no air coughing out and you still feel there’s a bunch of air stuck. Really rotten stuff for me, as  I was teaching a Year 7 rhythm session and I really needed to cough or vomit or something to clear that feeling of being totally stuffed with concrete lungs.

….So yep, I need up and I hope this works, it’s a miserable feeling….


5 Responses to In need of up!

  1. Emz says:

    Cheer up 😥 hope you feel better!
    My friend has to use a flutter thing..showed me how it worked!Xx

  2. Steve says:

    Hi Sus, Sorry to hear you’re having such a tough time right now.

    You’re one of the few asthmatics I know of who uses one of those things. We used to use them a lot on post surgical patients who were having a hard time coughing stuff up. Maybe you need some good old fashioned chest percussion like they do on cystics.

    I hope the PEP works for you. Nothing worse than the feeling of being hyperinflated and unable to exhale easily. Air -trapping sucks.

    • Thanks Steve-It’ll all even out, I’m just going to be gentle with myself. Too much pushing in all directions, school, swimming, trying to have a life!

      Oh yes, I do PD with my physio when I’m really gunky, but I’m not gunky at the moment-just normal, although if you had a listen you’d probably think there was a lot of muck in there-bit of a stock phrase-but it’s my normal, I’ve got a bit of bronchiectasis. PEP therapy is pretty normal here-but I’m an asthma plus something else patient-don’t know if any of my asthma clinic peeps use it!
      Sorry about your post dinner walk ‘epi’ splat. Yep-that’s how I go off when doing something stupid. Never without my yellow pens. Hang in there too! x

  3. Sara C. says:

    Mariella uses an acapella device, which works on a similar concept. Her lungs behave much like a CFer (she always has stuff to cough up too) Right now she’s on 4 times a day (or whenever I hear her junk from the other room-she used it 3 times last night)

    Apparently, I can hook hers up to the neb as well, but the pari doesn’t have a good fit with the acapella, and with the acapella, she has to hold her breath for a count of 3 before exhaling…and I feel like she’s wasting medicine that way…so she’ll neb, then acapella.

    I’m glad you’re on the mend, and that the PEP is doing it’s job. I’ve never a PEP device that hooks onto the neb like that before…it’s kind of cool.

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