Humidification and non-invasive pressure support

[jfaidley]

Hello! Would be grateful for any input. My husband is having a real struggle with respiratory stuff -- especially phlegm. A huge struggle to get it up...don't think I have to go into detail for this group, right? Anyway, we've found a system that sort of keeps it under control, involving Sudafed, twice daily albuterol/ipratroprium nebs, and, most importantly, making sure the humidifier is on for the Trilogy. The once or twice I've forgotten, he's had a really bad "attack" as soon as he takes the mask off.

So, thinking ahead...at this point, he only uses the pressure support when he's in bed. (Definitely needs it more, but refuses -- so basically just keeps it in the bedroom and takes a nap whenever he needs help breathing). But the humidifier has a cord, so am wondering what we will do when he really can't be without the Trilogy? Would hate to see him confined to the humidifier cord length -- I can only imagine me running around like a crazy woman unplugging and re-plugging. But then what if we went out? Respiratory therapist says there is no such thing as a humidifier unit with a battery to be used with non-invasive respiratory support -- that these are only available for invasive ventilation. But thought other caregivers might have different info? Thank you so much!

 

[Nuts]

Ask your RT about an HME--heat moisture exchanger. Ours suggested using one if hubby needed humidification while wearing the trilogy in his PWC. Apparently they are normally used for trach patients, but if you need it, you need it.

 

[jfaidley]

Thank you! Appreciate the info, and will ask the RT.

 

[Narrowminded]

HME's can help, but for DH with the trach/vent, he did not feel that it gave enough moisture. It's basically a sponge that collects the moisture on your breath out and then resends it back to you on your breath in. It doesn't hurt to try and there are several different types, I think we tried close to 10 different ones for DH. Give it a go, hopefully it will work for you.

Hugs,

Sue

 

[jfaidley]

Yes, looked it up online and got the impression that it does not deliver the degree of humidification that you get from the reservoir. But will have to see if it helps enough for short jaunts. Can I clarify, though, my understanding that if he does choose the invasive option (trach/vent), there ARE other devices to allow one to be away from an electrical outlet and still have humidification? Or is the HME the only non-electrical alternative? I find it hard to believe that no one makes a humidifier that operates by battery Maybe my husband's experience -- where using the respiratory support without the humidifier causes a huge outpouring of mucus and the related distress -- is not very common? Ugh. Try to prepare for what's coming down the pike, which is never pleasant! Appreciate the feedback!

 

[soonerwife]

Do you have a stand that the non invasive vent and humidifier attach to? We just got one a few weeks ago and it makes moving them so much easier.

 

[jfaidley]

Not a separate stand, but the power chair we have has a platform on the back where you could put the vent. Don't think the humidifier would fit there, though, even if we could figure out how to plug it in.

 

[KateEmerson]

Our RT suggested filling the sponge inside the HME with water and shaking out any excess to help increase humidity. We would do this when away from home as no one mentioned a battery operated humidifier and I never thought to ask if there is one available. My husband is on a trach/vent and started off with an HME on his wheelchair vent but we had to add a humidifier to it as he needed the extra humidity to help clear secretions. The other critical item for keeping his secretions thin is plenty of fluid, in fact if his secretions are getting too thick we up the fluid intake and it really makes a difference. We literally measure all his fluid intake per day. And the third item is using the cough assist a number of times a day. I believe these three items are the reason he has only had one lung infection, treated at home, in almost 3 years. I wasn't clear on whether the issue with your husband was too thick secretions to cough up or not but I hope this is of some help. I would also avoid any men's that " dry up " secretions.

 

[Vincent]

Has no one tried running the air through water. Works with bongs. Just for clarification, I read about this somewhere. Not that I have any experience with bongs.......
Vincent

 

[jfaidley]

Did some research to figure out what a bong is (ha) and think this could work. Actually, it is the very concept that home-use oxygen concentrators use to humidify -- just bubbling the air through a room - temp water reservoir. So maybe worth considering -- seems like it would be a potential DIY solution, at least worth a try. Thanks for sharing!

 

[jfaidley]

Thank you, Kate. Good suggestion. My husband is quite a fanatic about hydration, so think we have that covered. Also, I will keep thinking about the "drying up" thing. Had considered it, and ipratropium (in the nebs) is actually a drying agent. But his problem seems to be coming from the nose (probably due to use of a nasal mask, which he likes a lot better than the face one because it doesn't feel like such an obstruction). There's nothing in the lungs that I can hear with my stethoscope, and he says he experiences it as intense, post-nasal drip. Plus, it's more of a quantity thing -- the secretions are always thin. For this same reason, the cough assist wasn't helpful. Though part of that is his significant frustration level--seems it takes some experimenting to get it right with the cough assist, and he tends to become angry and resistant to any new procedure that does not immediately improve his comfort level. A work in progress...

 

[affected]

Dictionary: bong - a low-pitched, resonant sound of the kind made by a large bell.

 

[Narrowminded]

Jfaidley - DH has been on the vent 6.5 years now and as far as I know, through talking with RT's there isn't any battery operated humidifiers. The stand will help you roll about in the house and unless he really needs the heat, you wouldn't have to plug it in all of the time. However, that doesn't work for traveling outside the home. In that case we used the HME, but DH was never really comfortable with it and would not stay out long due to the lack of moisture. If I think of something, I will let you know.

Hugs,

Sue