Posiciones de drenaje postural para bronquiectasias en hombres mayores de 70 años

I am a 70+yr old man of generally good health who now needs to carry out some chest exercises using postural drainage positions to clear phlegm as a result of bronchiectasis.

What if any home made aids can any one recommend to put me easily in the correct position (very polite version!!!) bottom above head.

I appreciate that a pillow under my hips may do the job but as I am just starting these exercises/positions I wish to arrange something that will be permanent; I am concerned a pillow will sink and not always give me the correct slope.

Any.all advice on this matter will be appreciated.

Hola Quintain,

También tengo más de 70 años y fui diagnosticado hace varios años. Después de entender finalmente el problema de drenaje, compré una mesa de inversión. Esto fue hace 2 años, y desde entonces no he tenido infecciones. Dreno dos veces al día. Inversión completa de 180 grados, aunque tuve que ir aumentando gradualmente. Los resultados son excelentes...mejor que cualquier otra cosa que he probado. Hago esto varias veces en cada sesión hasta que no se pueda expulsar nada más. Probablemente toma 10-15 minutos en total.

Muy recomendable.

Hola guintain, prueba un saco de frijoles, mi mamá me hizo un gran saco de frijoles con una funda de almohada vieja, es perfecto, mucha suerte para encontrar algo cómodo y mantente bien 

Joanne 

Hi quintain,

I always use two firm pillows but I have also lay on my stomache and hung over the edge of the bed, so my top half is upside down. Not possible for everyone to do this I know but quite effective. I also use a salt pipe or a steam inhaler beforehand which loosens up the phlegm to begin with.

 

Hi Quintain,

​Simiar to Gary I use an inversion table.  Intially purchased for back issues but I've found that it really does help with clearance.  I no longer go full 180 and do something like120 degrees which is more than enough.  More is cleared using this than any other method I've tried.  May be worth keeping an eye on ebay for a decent second hand table as they aren't overly cheap new.

​Cheers

Dave

Varón de 66 años de salud generalmente buena aquí con bronquitis diagnosticada durante los últimos 3 años.

Personalmente, no veo la necesidad de inclinar mi cuerpo y mi fisioterapeuta del equipo de defensa pulmonar del Hospital Papworth no me aconsejó más que acostarme boca arriba y tomar una serie de respiraciones profundas y exhalaciones (3 o 4 de cada una) seguidas de un período igual de respiración tranquila. Si exageras con la respiración profunda sin ningún período de calma, podrías sentir mareo. Recuerdo que las chicas de mi escuela secundaria local, cuando yo era un niño de escuela gramatical, solían hacer una respiración pesada extraña para obtener una especie de éxtasis por desmayo. Después de tomar las respiraciones profundas, si reaccionas como yo, obtendrás algún "estruendo" en la parte inferior de tu pulmón y un deseo natural de toser o expulsar la flema. Quizás unas exhalaciones más cortas ayudarán a llevarla a la trayectoria de eyección o quizás la tos la lleva hasta arriba. Intento no sobreexigir mis pulmones, así que intento moverla suavemente por los pulmones con una serie de toses suaves; a veces, sin embargo, tengo que darle una tos profunda y rápida para sacar la flema.

Suelo encontrar que el proceso es más productivo si lo hago después de comer, no necesariamente inmediatamente después de comer. Es como si el proceso de comer hiciera un poco de desplazamiento natural del esputo. Quizás un poco de caminata rápida o natación también haría lo mismo. Suelo ir a nadar después de mis ejercicios de tos y luego vuelvo a intentarlo cuando he completado mis 50 largos (pero he tenido la suerte en la vida de tener los recursos para mudarme a un clima cálido y construir una piscina de 15 metros en el jardín trasero).

A veces, si siento que aún hay mucha sustancia que no sale fácilmente, cambio de estar boca arriba a cambiarme a un lado u otro y luego vuelvo a estar boca arriba. No encuentro que estar boca abajo me funcione bien.

Todos somos diferentes, así que no critico a aquellos que encuentran útiles otras posiciones extremas (¿colgándose de las lámparas?) o aquellos que necesitan artilugios como acapellas y chalecos vibratorios para mover las cosas. Lo mejor es empezar con lo simple y solo avanzar si sientes que no funciona.

No me pongo paranoico por intentar sacar hasta la última gota de flema de mis pulmones (y no me preocupo demasiado si me resulta difícil encontrar la privacidad para hacerlo y, por lo tanto, tengo que saltarme un día; pero si me salto dos días, empiezo a sentirme peor al respirar), pero eso no es una recomendación, solo una observación personal. Sospecho que escupirla largo y fuerte es un beneficio neto, pero nunca he puesto a prueba esa opinión con mi neumólogo o fisioterapeuta pulmonar. Mi "sesión" (muy ocasionalmente, podría hacer una adicional por la noche si me siento broncoespasmático o congestionado) suele durar entre 10 y 20 minutos, a menos que me quede dormido en medio. Escucho música rock mientras lo hago.

Oh, sí, y encuentro que un mucolítico diario (fluidificador de esputo) funciona bien para ayudar al drenaje postural. Habla con tu especialista. Carbocisteína o acetilcisteína (dependiendo de tu país o farmacéutico) parecen ser los dos fármacos de elección. Son similares y, en mi opinión, no tienen efectos secundarios.

Steve, folks who are prone to paradoxical reactions often have them to mucolitics.  After a small kitchen fire and 6 months ahead of the BX, my gp put me on N-acetyl cisteine, AKA muco mist.  After 4 months I noticed that I was very angry all the time.  I googled the stuff and low and behold, some folks here in the States are using it as a mood stabilizer.  Red flag for me, as I had terrible problems when put on a mood stabilizer  solely to control migraines.

Now I use tablet guafenisin but I have to take periodic breaks from it.

Shorter version?  There's not a drug made to which someone has not had a terrible reaction.

I am in my 70's and do drainage once a day before lunch (empty stomach).  The postion that works well for me is bottom part of body on the sofa and my head on a cushion on the floor, it is a good slope which clears the mucus quickly. I do one side, then the other, then the middle, takes around 10-15 mins. I read a magazine or newspaper to pass the time.

 

Thank you everyone

Without being to selective in the replies to date (swinging form the chandeliers?) is a v very wonderful thought provoking attraction but perhaps more related to other discussions, albeit I consider it would have major mutual beneficial results.

I will further study all responses even more but each to date appears to be helpful.

Thank you for your responses to date and please forward any other ideas.

I have done post. drainage since I was 14 and have just turned 70. My method is to use a padded stool (put a pillow on top if you want extra height), drape myself over it and lean on a padded foot stool (more comfortable than elbows on the floor). Another method is to use a foam wedge on the bed (the type used to prop yourself up in bed if you don't want to sleep flat) and put a pillow over that for a bit more height. Also, always do it several hours after food if you want to avoid acid reflux.

 

Thank you again every-one.

If you will alow it I would like to ask about breathing procedures while lying for the 10++ minutes in my 'Postural drainage position'.

Should I be using the Active cycle of breathing technique while I am lying (in my case) with my shoulders below my waist or do I allow the gunk to naturally drain downwards towards my upper chest area for the 10++ minutes I am in that position and then carry out the deep breathing and huffing etc procedures.

I appreciate your advice could readily be "try all procedures and use what is best for you" but your expertise and experiences will give me a head start.

Hi Quintain

All disease/condition-related questions are always welcome here, so you ask away freely.  We may not know all the answers, but somebody usually knows something.  We also understand that sometimes we need to vent and have that vent be heard by folks who thoroughly understand our disease and the social/emotional effects thereof.

That said, someone else has to help on the substantive part of your post as I cannot do much postural drainage.

Hi,

I gave you my 2 methods and I use both. First I use the stool and the tip is steep enough for gravity to bring the rubbish up. With the wedge and pillow on the bed, I lay sideways over them (both sides in turn)  for as long as you feel necessary.  I'm not good at huffs so don't them but I do pummelling on my sides as I lay over the wedge. The more you do it the better you will be and find out what works for you. I feel the several positions I use gets to different parts of the lungs. Hope this helps. I've looked at the inversion table - looks good but a bit precarious.

Regards, Gill

Thanks again every-one

I carried out my 1st treatment session yesterday; armed with all your procedures and advise.

With hips slightly but definately above shoulder and lying on my right hand side towards my back.

Almost instantly I could feel the gunk moving; accordingly I went into the actve breathing cycle and dealt with a load fof gunk which I swallowed.

This was repeated about a handful of times in 10minutes expelling smaller amounts of gunk on each occasion.

My breathing following the procedure was somewhat better but the rattling in my throat was considerably eased.

I will carry out the procedure later today and try to get my hips higher than yesteday.

Thank you all for your help...my personal characteristics is to research all procedures where posible, talking with professionals and experts to try and get my procedures efficient before putting them into practice.

With the marvellous help from this forum I believe I have identified the best way forward for me.

Thank you all again for your invaluable help.

 

Quintain,

Please do not swallow the gunk. Either spit into a tissue or use something like a small empty yoghurt

pot and swill the stuff away down the bathroom sink. Sounds revolting but better than swallowing.

Use a new receptacle regularly, say every week.

Hi, glad that you are mastering the art of postural drainage! Probably better to spit the gunk out into a tissue though rather than swallowing it. That way you can see what it looks like. Usually pale yellow, white or clear but if you get an infection it will change colour & may be darker, greener or murkier! Good luck.

Jean

Thank you both about 'not swallowing'

In my ignorance I thought that was the simplest and perhaps even the most hygenic way to do things.

I will take your advice and get a 'spitoon' of some sort.

Thank you again.

Quintain,

Re method of disposal, depends how much you bring up as to how you dispose of the gunk. If its not much a tissue is fine. After 55 years of post drainage, I still find the process of disposal unpleasant.  In years to come they might devise some sort of tap at the base of the lungs to turn on when necessary to drain on the go so to speak.

Regards, Gill