Hi Amy!

Would this patient be able to learn autogenic drainage or active cycle breathing technique?  Might be helpful to get her through those 7 days.  Place more emphasis and effort on more huffing for mucus removal to minimize coughing or to allow her to still (try) to remove mucus with gentler coughing efforts to reduce generating as much intrathoracic pressure to protect her eye?

Also, would acoustic airway clearance be OK?  Maybe the vibralung by Westmed?  Access might be the challenge with this device but maybe could get it as a trial for this time period and then you might inadvertently discover a new form of ACT for this lady?  Pair that with ACB or AD too.

Tough situation!  Good luck! Let us know how it works out.

Happy 4th of July


Dabney M. Eidson, BS, RRT-NPS
Pediatric Cystic Fibrosis Center

Augusta University Children's Hospital of Georgia 

Pediatric Respiratory Care BT-2823

1446 Harper Street

Augusta, GA 30912

phone (706) 721-3712

fax (706) 721-5251

pager (706) 721-7243-1230

From: CF Respiratory Therapy <[log in to unmask]> on behalf of Amy Nelson <[log in to unmask]>
Sent: Tuesday, July 3, 2018 9:57:02 AM
To: [log in to unmask]
Subject: [EXTERNAL] Radiation implant and airway clearance?

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Wondering if anyone has had a similar experience and you could share your work around....

CF patient (in her 60's, baseline FEV1 high 30's-low 40's) has recently been diagnosed with malignant melanoma of the eye. They are planning to place a radiation implant/capsule into the eye for 7 days, then will remove it. During that time, she will be at home, with limited (6 foot radius) exposure to others. Her main airway clearance is Vest. Her Oncologist/Ophthalmologist are concerned over the vibration from the Vest, even from an oscillatory PEP like the Aerobika. Since her husband will not be able to be near enough, manuals are out as well. My thoughts go to PariPEP or similar, but not sure that will be enough for her. Any other ideas/thoughts/guesses???

Amy Nelson, BS, CRT, CPFT, AE-C
Respiratory Therapist
University of Minnesota Cystic Fibrosis Center

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