1. < MAC & Bronchiectasis

Mucoid impactions-clearing?

Posted by pacathy @pacathy, Mar 15, 2024

I had my CT and MD appointment this week. Doc was pleased the CT was no worse. There were waxing/waning trees in bud and ground glass, but the 3 areas with mucoid impactions distal to my areas of (mild) bronchiectasis are still present after >1 year. Is it possible to clear those since they’re distal to bronchiectatic areas? The report wasn’t available before my appointment.

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cwal | @cwal | Mar 19, 2024
In reply to @scoop "@pacathy Mucoid impaction is the same as mucus plugging. It seems that we all have some..." + (show)
@scoop

@pacathy Mucoid impaction is the same as mucus plugging. It seems that we all have some degree of mucus plugging. My understanding of the disease process is that mucus plugging/mucoid impaction can lead to bronchiectasis. Airway clearance as you suggested cannot hurt and it can only help with the mucus plugging/mucoid impaction.

Regarding NAC, Mucinex, I've read research articles that show benefit, and research articles that show no benefit. My take: NAC, mucinex break apart the mucus in our lungs and seemingly make it easier to expel. In that breaking apart process does it leave behind some of the broken apart mucus (phlegm) leading to further mucus plugging? Without NAC Mucinex the phlegm globs remain in tact and in theory can be huffed out all in one piece. Still, I would like a pulmonologist with knowledge, training and experience to explain it all to me. Until then do what you feel works for you!

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I tend to shy away from unproven treatments for fear of adding to or making something worse without meaning to from unknown effects. Sometimes it takes a long period of time for a adverse affect to show itself.

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becleartoday | @becleartoday | Mar 20, 2024

Yes! Good airway clearance technique and exercise can help break up impacted areas. I’ve experienced this firsthand. Do you think you could improve on your current practices?

Best,
Linda Esposito

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scoop | @scoop | Mar 21, 2024

Following up my comment about NAC and Mucinex, which I erroneously lumped into the same category. It's unclear to me whether either will help clear mucus plugging. This is what ChatGPT had to say about their differences:

1. Acetylcysteine: It is a mucolytic agent that works by breaking down the structure of mucus, making it less viscous and easier to clear from the respiratory tract. It also has antioxidant properties and can help in protecting the lungs from damage caused by reactive oxygen species.

2. Mucinex (Guaifenesin): This is an expectorant that works by increasing the volume and reducing the viscosity of respiratory tract secretions. By doing so, it helps to loosen and thin out mucus, making it easier to cough up and clear from the airways.

So, while both medications aim to facilitate the removal of mucus from the respiratory system, acetylcysteine directly breaks down mucus, while Mucinex primarily works by reducing its viscosity and increasing its volume, thereby making it easier to expel.

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1 reply
melinda561 | @melinda561 | Mar 22, 2024
In reply to @scoop "Following up my comment about NAC and Mucinex, which I erroneously lumped into the same category...." + (show)
@scoop

Following up my comment about NAC and Mucinex, which I erroneously lumped into the same category. It's unclear to me whether either will help clear mucus plugging. This is what ChatGPT had to say about their differences:

1. Acetylcysteine: It is a mucolytic agent that works by breaking down the structure of mucus, making it less viscous and easier to clear from the respiratory tract. It also has antioxidant properties and can help in protecting the lungs from damage caused by reactive oxygen species.

2. Mucinex (Guaifenesin): This is an expectorant that works by increasing the volume and reducing the viscosity of respiratory tract secretions. By doing so, it helps to loosen and thin out mucus, making it easier to cough up and clear from the airways.

So, while both medications aim to facilitate the removal of mucus from the respiratory system, acetylcysteine directly breaks down mucus, while Mucinex primarily works by reducing its viscosity and increasing its volume, thereby making it easier to expel.

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Can you take both medications? Thanks.

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1 reply
scoop | @scoop | Mar 22, 2024
In reply to @melinda561 "Can you take both medications? Thanks." + (show)
@melinda561

Can you take both medications? Thanks.

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@melinda561 I took both NAC and long acting mucinex together for some time and had no side effects for awhile. Then I started coughing a lot at night and my chest felt congested and rattily even after evening clearance. I wondered if NAC and/or Mucinex might be the culprit. Once I stopped Mucinex and later NAC the nocturnal coughing subsided.

Also this slide from a well-known bronchiectasis doctor made me wonder about the efficacy of NAC. As mucus is complicated stuff I did not find an easy answer as to why it is not recommended in non-cystic fibrosis bronchiectasis patients. Many people here take both and swear by it. I've been doing ok since stopping it but I do find Mucinex keeps my sinuses draining. Lately, I've been taking Mucinex after the first clearance of the day for my sinuses.
https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2024/01/NAC-in-NCFB-2022.png

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