Bulbar Polio Survivor now having Post Polio Syndrome,
Moderate to Severe Dysphagia, Chronic Obstructive Pulmonary Disease (COPD),
Bronchiectasis and Hypertension, dated June 2004
CAUSE of my lung condition: There is a remote history of polio and chronic dysphagia.
DIAGNOSIS: There is minimal focal bronchiectasis and scarring in the posterior bases of the left lower lobe. The same is seen in the right middle lobe.
There is no evidence of pneumonia. There are no lung nodules, or enlarged
IMPRESSION: Right middle and left lower lobe bronchiectasis.
PRESENT LUNG BEHAVIOUR according to My Respirologist
1 TOTAL LUNG CAPACITY 70% of normal (Spirometry).
2 AIR EXPELLED IN FIRST SECOND (FV1) is 35 to 40% of normal
3 COUGHING POWER: Between 220 and 250 L/min (Using Cough Meter).
4 MAXIMUM ALLOWABLE NEGATIVE PRESSURE (VACUUM) IN PHARNYX:
-28 cms H2O (50% of Normal) Am not able to inhale much air.
LUNG HYGEINE As recommended by a respiratory physical therapist
The following procedure is to be carried out twice a day
1 Inhale through a personal steam vaporizer for ten minutes
2 Exhale twenty times into an Acapella Vibratory Positive Expiratory Pressure
(PEP) device. Set at mid resistance
3 Inhale twenty times through a Treshhold Inspiratory Muscle Trainer Device
Set at 7 cms H2O and increase very gradually. This device is to insure that I will
be able to inhale air down to the bottom of my lungs in order that I can get air
below the mucus to cough it up.
4 Deep breath using diaphragm muscle and keep neck muscles relaxed.
5 Do trunk exercises and move.
6. Coughing: Use two swift abrupt and strong coughs in stead of one long
Acapella Vibratory Positive Expiratory Pressure System
acapella® combines the benefits of both PEP therapy and airway vibrations to mobilize pulmonary secretions and can be used in virtually any spatial orientation. Patients are free to sit, stand or recline. It improves clearance of secretions, is easier to tolerate than CPT, takes less than half the time of conventional CPT sessions* and facilitates opening or airways in patients with lung diseases with secretory problems (COPD, asthma, Cystic Fibrosis). Color-coded units (green for high-flow, blue for low) help customize treatment based on clinical needs. You can adjust acapella's frequency and flow resistance simply by turning an adjustment dial.
Threshold Inspiratory Muscle Trainer
Boost your performance! Increase your endurance! ...And do it without leaving the comfort of your easy chair! Just inhale through the Threshold® Inspiratory Muscle Trainer... Studies show that training at 30% of maximal inspiratory pressure for two months will increase max. inspiratory pressure, improve endurance time, and increase the distance walked in 12 minute trials.
The Threshold® Inspiratory Muscle Trainer (IMT) provides a constant and specific training workload, regardless of how fast or slowly you breathe. The adjustable (and calibrated) spring-loaded valve blocks air flow until you can produce enough inspiratory pressure to overcome the spring force. Inspiration muscles work harder and get stronger over time.
The IMT is easy to use. With the mouthpiece removed, twist the control knob so the indicator points to a low pressure number (around 10 is a good starting point for most people). Use the nose clip (included) to insure that you are breathing entirely through your mouth. Start training at 10 to 15 minutes a day. If your current setting is too easy, increase the setting to the next calibration mark. (The calibrated IMT is marked every 2 cm H2O from 7 to 41.) After a while (6 to 8 weeks) you will notice a training effect -- What you can now do is much more than what you could do initially!
The IMT is also very easy to care for... just rinse in warm soapy water. Flush with clear water. Shake out excess water, and air dry.