Flute Relieves Suffering For Patients With Chronic Lung Disease
Jan 25, 2013 03:43 PM
BUFFALO, N.Y. (Ivanhoe Newswire) – It's the third most common cause of death in the United States. As COPD progresses, the damage to lungs can be irreversible, but now doctors have a new instrument to help people suffering from the chronic disease.
Bernard and Barbara Swanekamp have a lifetime worth of memories. They've been married 56 years.
"He's my best friend," said Barbara Swanekamp.
After a lifetime of smoking, Bernard has the chronic lung disease, COPD.
"It restricts my lungs. I don't like doing this, but if this is the way I have to live, then this is the way I have to live," said Bernard Swanekamp.
Life has been easier the past year thanks to the lung flute.
"Usually I wind up in the hospital one or two times a year in the wintertime. Last winter, there was nothing," Bernard said.
Some people with COPD have excess mucus in their lungs. When patients blow into the flute, sound waves are sent down the airways, mobilizing that mucus. Studies show using it twice a day improves lung congestion and other COPD symptoms.
"It helps with clearance of the mucus and essentially, then they feel better the rest of the day," said Dr. Sanjay Sethi, professor of medicine & Chief of Pulmonary at the University at Buffalo School of Medicine and Biomedical Sciences, and staff physician with the VA Western New York Healthcare System.
It may also help protect against potentially fatal respiratory illnesses like pneumonia.
"There were patients who would come to me all the time and they say, ‘Listen, once I clear the mucus, I feel better,'" Dr. Sethi said.
Bernard relies on the flute.
"It saves me a lot of trips to the hospital, I'll tell you that. This thing has made a world of difference in my life. It really has," Bernard explained.
"When he feels better, I feel better," Barbara said.
The lung flute is FDA approved. Insurance typically covers most of the cost, but if you'd rather pay out of pocket the lung flute and a six month supply of reeds only runs about 50 dollars. A doctor's prescription is needed to get one.
BACKGROUND: Chronic obstructive pulmonary disease, or COPD, is a cluster of lung diseases that block airflow when exhaling, making it very difficult to breathe. There are two main conditions that make up COPD: chronic asthmatic bronchitis and emphysema. Many people have both. Chronic asthmatic bronchitis causes narrowing of the airways that lead to the lungs and inflammation, making the patient wheeze and cough. Emphysema damages the tiny air sacs in the lungs. It gradually destroys the inner walls of the air sac clusters, reducing the amount of surface area available to exchange oxygen for carbon dioxide. Shortness of breath will occur because the chest wall muscles have to work harder to exhale. Most COPD is a result from long-term smoking. Damage to the lungs can't be reversed. So, treatment aims to control symptoms and minimize further damage. (Source: www.mayoclinic.com)
SYMPTOMS: Symptoms don't appear until there is a great deal of lung damage. Patients with COPD are also likely to experience exacerbations when symptoms worsen over time. Symptoms will vary because there are different lung conditions that form COPD. Most people will have at least one, but usually more than one, of these symptoms: shortness of breath, chronic cough, wheezing, and chest tightness. Complications can occur with COPD; respiratory infections, high blood pressure, heart problems, and depression. (Source:www.mayoclinic.com)
NEW TECHNOLOGY: Since there is no cure for COPD, there are various treatment options to reduce the risk of complications and exacerbations. The only way to keep COPD from getting worse is to quit smoking. Doctors will prescribe medications as well. Bronchodilators help relieve coughing and shortness of breath. There are inhaled steroids that can reduce airway inflammation to help patients breathe. However, prolonged use of inhaled steroids can weaken bones and increase risk of cataracts, high blood pressure, and diabetes. Oxygen therapy can be recommended for those who don't have enough oxygen in their blood. Then there are pulmonary rehabilitation programs that combine education, exercises, nutrition advice, and counseling. Surgery is always an option for people with severe emphysema who do not get the help they need from medications. Finally, there is a recent device that is different than all the other treatment options. It is the only product that uses sound vibration to stimulate the body's natural mucus-clearing system. It is called the Lung Flute. It's a reusable, plastic device that is non-invasive and drug free. Clinical tests have proven that the Lung Flute is capable of breaking up mucus in the lungs, making it effective for diagnostic use and therapy. This technology is based on low-frequency acoustic waves that are produced when it is blown into. Unlike other technology, this device reaches into the lower airways and lung parenchyma to clear secretions deep in the lungs. (Source: www.lungflute.com)
Sethi, MD, Professor of Medicine and Chief of Pulmonary, Critical Care and
Sleep Medicine at UB School of Medicine and Biomedical Sciences, and staff
physician with the VA Western NY Healthcare System, talks about a new therapy
for COPD patients.
Can you tell me what problems do people with COPD have? What are
the difficulties? Why is it so difficult to live with this?
Dr. Sethi: The
biggest symptom is dyspnea, shortness of breath. They also have problems with
cough and sputum on a daily basis. So those are the major symptoms. They also
tend to have fatigue; more advanced cases develop weight loss. They also become
more prone to respiratory infections and they get these episodes known as
So they are more prone to pneumonia?
Dr. Sethi: Yes,
but they also get more bronchitis attacks. They experience on daily basis;
shortness of breath, cough and sputum.
How does it impact them? Are they tired all the time?
Dr. Sethi: They
are very limited in their activities and the different symptoms impact them
differently. For example, when they have shortness of breath they become more
and more inactive and this inactivity makes them deconditioned which makes them
more inactive. So they kind of get into this vicious cycle of shortness of
breath, inactivity, and deconditioning. The cough and sputum is, of course,
very irritating for them. It is also sometimes a social issue and then the
sputum itself, bothers them because they feel it in the chest, in the airways,
and that essentially can contribute to the shortness of breath and chest
Is COPD an umbrella term for a lot of kind of different lung
Dr. Sethi: Pretty
much; mainly chronic bronchitis and emphysema. So those are the two terms we
used to use. Bronchitis refers to having a cough and Sputum Emphysema refer to
having destruction of the lung, but there was actually used to be a lot of
diagnostic confusion because some patients thought they had bronchitis; some
thought they had emphysema. So now we have moved back, moved to more of an
umbrella term of COPD and the other way to think about it is most of COPD in
the US now is smoking related or ex-smokers. I like to call it, smoking-related
lung disease, smoking-related chronic lung disease, or other exposures too.
What currently do they have to help them?
Dr. Sethi: In
terms of the medications, the most important thing is quitting smoking. That is
the cornerstone of treating COPD, but many a times the disease gets established
or they have difficulty quitting. Then we have medications. They mainly fall
into two categories; bronchodilators and anti-inflammatories. Bronchodilators
open up the airways, help them breath better. The anti-inflammatories also help
with the breathing, cough, and sputum. Also they help with reducing the exacerbation
episodes. All these medications reduce exacerbation episodes, but none of these
drugs directly attack the mucus in order to help directly in terms of clearing
What are the dangers of having that mucus kind of sit there in
Dr. Sethi: Well
I think the danger is the discomfort of having it. You have some blockage of
the airways. Obviously, it is going to contribute to the shortness of breath
and sensations of chest discomfort. Then the other danger is that the mucus is
basically a pool. A little amount of mucus is normal, but we don't cough
normally because we have these cilia in our airways which clear the mucus. We
don't normally cough on a daily basis and the amount of mucus is quite small.
It is a very thin layer. When people develop COPD, they have more mucus and it
also changes in its viscosity and its clear ability. That becomes much more
difficult to clear and it then can become a small amount of mucus actually
protects against infection, the normal mucus, but if you have excess mucus, you
are more likely to get infections too.
Dr. Sethi: Like
pneumonia or exacerbations.
Can you tell me, what is the lung flute?
Dr. Sethi: The
lung flute is essentially a device known as an oscillatory expiratory device.
Essentially, when patients blow into this device, there is a reed in this
device and the reed oscillates and this oscillation kind of sends a wave,
retrograde, down the airways and that is supposed to help with airway clearance
basically, secretion clearance.
Can you please explain what the sound wave technology is?
Dr. Sethi: It
is a sound wave so that the reed is tuned in a certain way, to a certain hertz.
I think it is in the 14 to 18 hertz range. That particular frequency helps with
the, mucus clearance aspect of it.
And how does it help?
Dr. Sethi: It
was invented by, or at least part of the people involved, were a Buffalo
company and when they came to me and said we have this device which was created
by an acoustic engineer. I said well we can, there are diseases I know which I
deal with every day where people are very inconvenienced by and they do not
have adequate ways to clear their secretions; so can we look at that to see if
we can make these people clear their secretions easier. The other thing that
came up while we were discussing this was the whole issue of needing to get the
mucus from these patients to do studies in. For example, if you are looking for
somebody with pneumonia, we want to look at what bacteria are down there. We
want to look at sputum of people with suspected cancer. There was this
diagnostic need of getting mucus from people reliably and easily also. So that
was one aspect. The other aspect was helping people with COPD. There are other
chronic lung diseases in which the results are a problem with excessive mucus,
like cystic fibrosis, bronchiectasis, and also some patients with asthma. We
focused on COPD.
How does sound wave technology clear mucus?
Dr. Sethi: We
have not done all the detailed studies because they are rather difficult and
expensive and can be quite complicated to look at exactly how fast the
clearance happens. The concept is that because of the wave, the mucus kind may
be getting liquefied a little bit or shaken around a little bit and because it
(the wave) does go into all the airways, so that then results in better clear
ability. So the way we use it in our patients is that they blow through it a
few times and then they kind of do a huff cough, the kind of cough with an open
airway, and because the mucus is now easy to clear, they should be able to
bring it up easier.
What have your studies shown so far?
Dr. Sethi: Our studies, we have done two. Initially we started with healthy
people; made sure the device is safe and then we went ahead and did the
studies. These are pretty much following FDA requirements because the company
was interested in getting the indication for the device. So, we said fine. Then
we helped them develop the protocol and basically did the studies. The initial
one was to look at diagnostic to see if used once, can you get an adequate
sputum sample. We compared that with a more traditional method of doing that
which is known as hypertonic saline, which is highly concentrated saline. The
flute seemed to work as well as that. So, on the basis of that, they went to
the FDA and they had a diagnostic indication. Then for the therapeutic
indication, we took patients with COPD, who had mucus, which means they had
chronic bronchitis and took those patients and either put them on the flute or
another device which is marketed for similar purposes known as the acapella and
we showed that with both the devices, the patients did feel better. The idea
was to show that it is not inferior to the acapella, but at the same time also
were able to show that in terms of symptoms and all, actually they did better
with the flute.
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