Aerobika

Nov 5, 2014

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

I was walking near G &G in Winnipegosis. A sporty little car with tinted windows pulled up beside me. The window rolled down. A very pretty young lady inside flashed me a smile and said, Hi Trevor! How's it going! No, unfortunately this wasn't a flirt. Apparently I'm well past the age where young women flirt with me out of their cars. This young woman had been a high school student working at the pharmacy. She is now a Mental Health Nurse whose territory covers Winnipegosis and Camperville. I've watched high school students grow into many different careers while working at DCP. We've had students become doctors, nurses, pharmacists, accountants, bankers, real estate agents and many, many others. It has been cool to watch, but I'm starting to feel like an old dog around here.

Can you teach an old dog new tricks? How about a pharmacist promoting a treatment that doesn't involve any medication? There is new device available in the pharmacy that loosens lung mucus efficiently. It's called Aerobika. You breathe into it and it loosens mucus in your lungs with vibrations.

Certain medical conditions like COPD and Cystic Fibrosis cause the lung to produce too much mucus. Normally, mucus traps the small amounts of dirt, dust, bacteria and other things that get sucked into the lungs every day. When in balance, your lungs have little hairs called cilia that move the mucus and all its trapped particles up and out of the lungs. Sometimes things get out of balance and the lungs produce too much mucus. This mucus builds up and narrows the airways which makes it harder to breathe. The mucus just sits there. This stagnant mucus is a great place to grow bacteria. This excess mucus leaves the lungs prone to infection.

How do you remove thick and stagnant mucus from the lungs? It isn't easy. People with CF will actually have people or machines thump on their chest to loosen up the mucus so they can cough it out. It has been shown that this kind of physical therapy can help people with COPD as well. However, in practice, it isn't done for COPD patients very often.

Trudell Medical, out of London, ON, has a cool new device that could help. It is called Aerobika. It is an oscillating positive expiratory pressure device. Let's break that down. Positive pressure means as you breathe into the device you encounter some resistance. This resistance creates some pressure inside your lungs which holds the airways open. When you blow up a balloon, it is the positive pressure that holds the balloon open. Inside your lungs this positive pressure opens up the small airways that may be blocked by mucus.

The other part of the oscillating positive expiratory pressure device is the oscillating part. It is really neat when you blow into the Aerobika. There is a valve inside that switches quickly between higher and lower resistance. The Aerobika makes a very rapid thump, thump, thump, thump noise as you blow in. This causes waves of low and high pressure inside the airways. In fact, if I breathe into the device and you put your hand between my shoulder blades, you can feel my chest vibrating. This vibration inside the lungs loosens and seems to decrease the viscosity of the mucus. So between the positive pressure opening the small airways and the oscillations loosening the mucus, the lungs are now able to get some of that excess mucus out. Getting out excess mucus improves breathing and reduces the chance of infection.

You would use the Aerobika twice a day. You could do it while watching TV. You would breathe into it 10-20 times and then perform 2-3 huff coughs. A huff cough helps get mucus out of your lungs. It is like when you want to breathe on a mirror to fog it up. You take a short, shallow breath and exhale forcefully with your mouth in an O shape. You would repeat this cycle for 10-20 minutes. The goal is to be coughing up little to no mucus. If you are coughing up a lot of mucus, your health care professional may tell you to use the Aerobika more than twice per day. It is also easy to clean. Aerobika is dish washer safe.

Is there any evidence that Aerobika works? Yeah, but There are studies. Even some really cool looking ones done at the University of Western Ontario. These ones had patients inhale a special kind of helium that can be seen on an MRI. This allowed the researchers to show air got into parts of the lungs after 3-4 weeks of Aerobika therapy that didnt get air pre-treatment. The problem with all the studies is they are really small. The ones I saw only had 10-20 patients in them. In drug trials we are always looking for hundreds or thousands of patients in a trial to show the results were not just a fluke. So the evidence for Aerobika is very interesting, but not overwhelming.

The Aerobika also costs some cash. It runs ~$85. Although the evidence for Aerobika isnt overwhelming yet (I hope more studies are being done) and it costs a little under $100, it is a drug free treatment. There is very little chance of adverse effects. You do have to be careful that with all the exhalations you dont get dizzy and fall, but other than that, there is very little down side to giving one a try. Aerobika can be bought without a prescription, but you should talk to your doctor first. The two of you should discuss if this is an appropriate device for you. Then you will want your doctor, pharmacist, respiratory therapist or other health care professional to go over its use and cleaning with you.

If you have COPD and you want to try something new, consider Aerobika. Using Aerobika is a trick anyone can learn. As for me, I think this old dog is going to learn how to ride a bull in a rodeo. Or not. Young or old, maybe every new trick isn't worth learning.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca

Aerobika and the UWO - http://communications.uwo.ca/media/copd/

Aerobika Studies - http://www.trudellmed.com/sites/trudellmed.com/files/pdf/consumer/opep_wtpaper_en.pdf

Aerobika Overview - http://www.trudellmed.com/consumer-health/aerobika-oscillating-pep

 


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