The evolution of chest physical therapy has made life with CF easier

Reflecting on 3 decades of advancements in airway clearance vests

William Ryan avatar

by William Ryan |

Share this article:

Share article via email
banner graphic for

In my nearly 31 years of life, I’ve watched technology evolve at a rapid pace. Millennials like me have watched cellphones, video games, and computers transform from their rudimentary beginnings into the efficient tools we rely on today.

As an adult with cystic fibrosis (CF), I’ve also seen dramatic changes in the technology behind high-frequency chest wall oscillation, a type of physical therapy (PT) that puts pressure on the chest to help remove mucus from the lungs. I hope we continue to see the kinds of rapid advancements that have taken place in my lifetime so that future generations can embrace the vest as I have.

After all, if it wasn’t for the vest, I wouldn’t be here today.

The early years of chest PT

During one of my early doctor appointments, my parents were both taught the clapping method of chest physical therapy, in which they’d cup their hands and clap them against my ribs to shake mucus loose. My dad was terrified of doing chest compressions. I was only a few months old, and he didn’t want to hurt me. My doctor, however, assured my parents that they were doing the right thing. At the time, clapping was the ideal way to release the mucus that was stuck to my lungs like gum under a desk.

My doctor knew this firsthand because he received similar treatments from a physical therapist every day at the hospital where he worked. He had CF, too — a scenario that wouldn’t happen today because people with CF are advised to stay 6 feet apart to avoid cross-infection.

My parents weren’t physical therapists by any means, but they did a great job.

Recommended Reading
banner graphic for

In the spirit of Kendall Roy, I wonder what life without CF would be like

When I was 7 years old, a Hillrom-created machine called the Vest Airway Clearance System arrived at my front door. It looked like the world’s heaviest cooler. From my childhood perspective, it seemed to weigh as much as 20 bowling balls.

In terms of functionality, the old vest machines of the late 1990s and early 2000s weren’t so different from the ones that came along later. The machine’s chunky tubes connected to the black inflatable vest and generated air compressions at a much more efficient rate than human hands could. Plus, it could function for any length of time and at whatever pressure I needed to rid the mucus from my lungs. It was a pain to travel with on family vacations, though, as it took up a lot of space in our car.

An updated version was eventually released in 2007, and I got it in 2010, when I was in high school. It was much smaller and had a carrying case that looked like a duffel bag on wheels. I could much more easily carry it into the living room if I wanted to watch football with my dad, then back to my bedroom, where I could work on an essay while doing a treatment. I still keep this vest as a backup.

The present and hopeful future of PT

During my senior year of college, I learned about Hillrom’s Monarch airway clearance system, and in 2018, I finally received it. I still use the Monarch today. With past vests, I may have been able to carry them from room to room, but I had to be stationary while I did treatments. With the Monarch, which is essentially a vibrating, weighted vest, I can complete a treatment while doing the dishes or walking the dog. It makes life with CF so much easier.

While the Monarch vest helps with daily living, however, it’s difficult to travel with. Because of the vest, I’ve been stopped by Transportation Security Administration agents more than a few times at airports, resulting in some dirty looks from other passengers.

Chest clapping and early vest designs may not render good memories for some people with CF, but I look back at them fondly, as they were necessary to my survival. Still, there’s always room for improvement. I hope current and future children with CF have even lighter vests to walk around in that perhaps feature a place to hook up a nebulizer. I’m not in the business of design, but hopefully someone smarter than me can make it happen.

The CF community has seen many advancements in medicine and technology — to the point that CF is no longer considered a childhood disease because patients are living longer lives. In fact, there are now more adults living with CF than children.

Hopefully, the next 31 years will bring a cure, but if not, I’m confident that the constantly improving technology will treat future generations even better than it’s treated me.

Note: Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cystic Fibrosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to cystic fibrosis.


Anthony M Palmiero avatar

Anthony M Palmiero

Wow technology Will. Love Ya

Helen Palmiero avatar

Helen Palmiero

Hi Will! Thanks for another informative column which taught me even more (as I knew it would). The fact that you look back at your older vests "fondly" shows so much of your true, kind personality. My meds have continually and remarkably improved also in these past 12 years I've been involved with them. The future DOES hold promise and I'm sure changes for the better in your treatment will continue to come about, just like the improvements in the computers and cell phones you wrote of. Keep the faith! Much love, Helen


Leave a comment

Fill in the required fields to post. Your email address will not be published.