Biwaze cough assist

[chai]

Hi,
I wanted to ask if anyone has tried biwaze cough assist ? My mother was disagnosed with bulber onset MND few years ago and I wanted to get your opinion on this.

Thank you!

 

[lgelb]

For someone who needs the combination of an oscillating vest (to loosen secretions) and a cough assist (to get them out), the Cough System could be a good machine.

 

[chai]

Thank you for your feedback .

 

[Mana]

Our respiratory therapist has encouraged my husband to use his Phillips cough assist every day and to think of it as exercise for his alveoli. She says it should have a different name for ALS patients, who seldom have mucous in their lungs. He says it takes a lot of his energy just to use it, though, and doesn't feel helpful. Perhaps this has nothing to do with Biwase version.

 

[lgelb]

Some PALS stop using the Cough Assist "preventively" for that reason, and others stop using it entirely because it is more irritating than helpful. It does take both energy and muscle mobilization to use.

Your husband should feel free to stop, informing the RT, if that is what he feels.

 

[KevinR]

I use a Philips cough assist that has two modes. One with just forced air and then suction on the exhale. It also has a flutter valve function where it feels like I’m getting percussion therapy. I use this in conjunction with my nebulizer and it can sometimes cause emesis along with the mucous. But it works great for clearing secretions. Make sure do on empty stomach. Like Insais it can cause emesis.

 

[Marieb425]

We just received the BiWaze Cough assist on Friday. My husband dutifully used it twice a day like the RT recommended, but he declined using it today. Maybe he’s feeling what Laurie mentioned in her post above. His feedback to me was that it wasn’t doing anything. I wasn’t sure . But take my reply with a grain of salt because we just got it! Positive feedback - it is easy to use.

 

[chai]

On daily basis , we manage her airways secretions using mucinac and nebulization . We use suction pump only when required since it’s pretty invasive . We keep her diet nutritious with protein, fat and carbs ..lately we decided to remove dairy. Please let me know in case you have suggestions on how we can help her keep her aiways clear.

We are hoping this cough device does help her. How would you typically configure the cough assist device – Min/Max pressure ? Pause time ? Cycles ? Do oscillations help ?

Thank you

 

[lgelb]

Just as with the BiPAP, would advise to start low on pressure and work your way up. Pause time and cycles should allow for recovery and avoid breathlessness. Oscillations are an individual thing that you can try and see what the response is -- too much for some.

RTs tend to "prescribe" a set regimen but they are not trained to recognize the metabolic aspects of ALS and reduced lung capacity/use of accessory muscles that could make this difficult or counterproductive.

Oatmilk and cashew milks are examples of dairy alternatives that are increasingly available in puddings, ice cream, yogurt, milk, creamer, etc. But many PALS can and do fine with traditional dairy, so I wouldn't cut it out unless there's a reason -- there is usually more protein there than in the alternatives.

For some people, citrus and/or spices are triggers for mucus, so you can track that.

For prevention of buildup, warm liquids and/or papaya or pineapple juice, or papaya tablets, help some people, in part because they contain bromelain.

A whole food (less processed) diet with good fats and as you say plenty of high-quality protein could include easy-to-digest foods like pureed meats, eggs, applesauce, canned fruit/veg, dairy or dairy alternatives, avocado, etc., while avoiding raw seeds/kernels/skins.

 

[chai]

Thank you . This is very helpful. I agree, RTs are trained for respiratory related issues but don't necessarily understand the issues faced by ALS patients.

We are trying to rule out anything that aggravates her mucus issue ... until now her diet was rich in dairy ….. whey protein, cheese, milk , butter ... but lot of folks blame dairy for excess mucus … therefore very recently we decided to remove dairy from her diet and see if it helps her .

 

[Mana]

thanks, Laurie!