I am currently trying to get in touch with the respiratory therapist at the clinic but I thought I would seek input here. My son (15) has a cold and he doesn't seem to be coughing with much force. As another boy in the area with dmd passed away several months ago (just shy of his 15th birthday) from pneumonia this is of course on my mind. I wondered if we should be using a cough assist as a preventative to keep the cough from developing into something more serious. We have not used one at all up to this point. I did take him to the doc yesterday and his lungs sound good. He did give him an antibiotic though.

I just wanted to hear what others had to say, thanks
Janine

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He definetly should have a cough assist...That is the only way to inhale and exhale strong enough to do any good...also, when he is not sick, you can use it to keep his lungs excersised and strong...Make sure you get on asap...regardless if there is secrections or not...he could be good one hour and the next not so good...besides the DMD can mask a lot of symptoms so please be cautious...
Janine,
You definitely want to get one as soon as possible. We had one of our boys develop a head cold last year and seemed ok, but like your son, was not clearing mucus very well. He went from cold to pneumonia very rapidly and spent the next week in ICU. We utilize one daily as a preventative measure, but use it constantly when they get the slightest sign of a cold. They ask for it now if they get any secrections.
They are very expensive and you will probably get a unit which your insurance company rents on a monthly basis. It is a great piece of equipment.

Good Luck!
Ed
Thanks for the replies back. The respiratory guy at the clinic thought it was a good idea to get a cough assist. It is my understanding that he has worked with Dr. Bach. So he is aware of the advantages of non-invasive ventilation, and cough assist as a preventative measure. We just need to get in to see him so he can get it all set up. The MDA clinic is usually tomorrow so I hope they can fit us in just to see him. I just don't want to wait and then be sorry later.

Do you keep the cough assist all of the time? About how much is the rental fee?
My son is 29 and has never had pneumonia, probably thanks to the Emerson Cough Assist. .Make sure you get a suction machine with it as the spit will fly!
Could you elaborate on that a bit. Do you mean that after you use the cough assist you need the suction machine?

Ann Avery said:
My son is 29 and has never had pneumonia, probably thanks to the Emerson Cough Assist. .Make sure you get a suction machine with it as the spit will fly!
Hi Janine,

Matthew has used a cough assist daily for over three years. We have progressively increased the frequency over time and will continue to as needed. He currently does three to four cycles of five deep breaths followed by a cough twice daily. Regular use can be considered a from of respiratory physical therapy keeping the chest and diaphragm muscles loose. Matthew is rarely sick, yet when he does have a cold we use the device to loosen secretions which help him to keep his lungs and nasal passages clear. We have also used it to remove a pill that was stuck and blocked his airway.


If you have this device please use it every day. Just as limb muscles become stiff when not used the same happens with respiratory muscles. When the lungs are not used fully it allows secretions to pool at the base of the lungs leading to infection and illness.


Brian
You can see a demonstration of the cough assist with suction on YouTube, but the young man is sitting up in his chair. We mainly use the Cough Assist when aspiration of food into the lungs occurs. Aspiration pneumonia could occur if you don't clear the lungs ASAP. To do this we have to place our son on the bed and use C.A.on his side. There is always copious amounts of saliva to suction out. We also use a "clapping" method along the bronchial tree. (A respiratory therapist can teach this method.) This might require turning, clapping, and C.A. for up to one hour. My son is able to tell when the particle is out, and we can also tell by the sound of his breathing. I imagine if the C.A. is used daily in an upright position that, unless your son has a cold, there will be less or no secretions flying. Could someone who uses this daily on their son tell me if that is true? We do not use the C.A. daily. Maybe we should. We have had to bring my son home twice from work when he has aspirated, but he was able to return and finish off his work day. We also have a pulse oximeter to monitor his oxygen saturation as needed. We own the Cough Assist and suction machine, but have to rent the v-pap and his laptop vent for NIV. (non-invasive ventilation) When there is a cold we also use guaifenesin to thin the secretions so they can be expelled easier. We have also used the C.A. on a friend when he got food stuck in his throat.
Is there a recommendation as to what age the Cough Assist should be started? Or is it based on certain respiratory indicators? If so then what are those indicators?

Thank you,

Liisa
Hi Liisa, have missed you in the MDA Chats. Roy didn't get the Cough Assist until he was 21, which I think was about 3 years late for him. The Children's Hospital didn't mention it and we found out about it when R was switched to "grown-up" hospital clinic.So I am glad you are doing your homework early.Us parents need to be pro-active and learn about the "complications of muscular dystrophy" before they happen. I know you are ahead with your son and have years before you need to worry. The age would vary, but "weak cough" is the main indicator, with MEP (maximum expiratory pressure) measured by your clinic's respiratory therapist. .Roy started having yearly Pulmonary Function Tests about age 13, but I think things have changed and they do baseline tests earlier. One place you can find the standards of care is on this PPMD site: http://www.parentprojectmd.org/site/DocServer/TREAT-NMD_DMD_interim...

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