Ventilator-Assisted Living©

Summer 2000, Vol. 14, No. 2

ISSN 1066-534X

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Read selected articles from this issue ...

No Barriers in the New Millennium
Bill Miller, Leesburg, Florida

MiCASSA Is Back!

IDEA: Individuals with Disabilities Education Act

The Awesome Privilege of Living
Mark Warren, Crookston, Minnesota

Ontario's Ventilator Equipment Pool
Regina Pizzuti, RRCP, Kingston, Ontario, Canada

Update: Daniel C. Vilaseca Dreischer

New Masks and Equipment

Potpourri: Pediatric Tracheostomy Home Care Guide by Cynthia Bissell, RN;
Respiratory care videos from The Muscular Dystrophy Association;
Medicaid waivers –

No Barriers in the New Millennium

Bill Miller, Leesburg, Florida (,

I am a 23-year-old ventilator user as a result of a spinal cord injury, which I incurred on August 23, 1997, just two days before I was to begin my senior year at the University of Florida. I tripped in my room and ended up a C-1/C-2 quadriplegic like Superman Christopher Reeve. Currently, I live at home in Leesburg, Florida, with my parents and older brother as my primary caregivers.

Despite the challenges my condition presents, I am proud to say that I have been out and about all over the state and beyond, proving that the ventilator, though it can make things more interesting, does not prevent or heavily hinder an active lifestyle.

Shortly after my accident, I developed pneumonia and it was touch and go for a while. When I stabilized, I was transferred to The Shepherd Center (a hospital specializing in spinal cord injuries – in Atlanta, Georgia, where I was introduced to the In-Exsufflator (J.H. Emerson Co., Cambridge, Massachusetts).

The In-Exsufflator is essential to vent-dependent health. As testimony I offer the fact that I have not had pneumonia – or any significant respiratory ailment whatsoever – since my initial hospitalization. My pulmonologist, Dr. Humberto Delgado, agrees that the In-Exsufflator has made a tremendous difference in my life.

Nondisabled individuals can easily cough up secretions, but ventilator users do not have the diaphragm control or ability to cough up respiratory ailments on their own. One solution is suctioning. Remove the air supply, then stick a plastic tube down through the airway and into the lungs and hope the tiny hole at the end of the catheter will find the problem and hold on to it as suction is applied to the other end.

It would be like eating mashed potatoes and gravy with a straw – while blindfolded. It would work fine with the gravy, but the potatoes? You must work quickly because you cannot breathe while doing this. With every miss you make, every stab you take trying to find the potatoes on the plate, you are causing trauma to your lungs and airway.

Suctioning is very uncomfortable. It gags you. It's invasive. It's traumatic. At best, it pulls out dribbles of “gravy,” and it's not very efficient.

There had to be a better way. Fortunately, the experts at Shepherd knew about and used the In-Exsufflator which simulates the body's natural way of clearing secretions. The In-Exsufflator fills the lungs with air – a big, comfortable breath in – then, with the flip of a switch and an assist cough, pulls out the air and secretions (potatoes, gravy, and all) easily, effectively, and efficiently. This noninvasive procedure is over in seconds and relief is immediate. An added bonus is that family and friends can easily learn how to do it.

Though the In-Exsufflator is key, there are several more aspects to a happy and healthy life of vent-dependent independence that I will detail in the fall issue of IVUN News. If you cannot wait until then or wish to comment, please contact me.

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