7% and excessive phlegm

Have you considered whether the daily sinus rinses are irritating your nasal passages and sinuses and CAUSING them to produce more mucus - which is your body's defense against foreign matter. What I mean is that you wash away the natural mucus, your body produces more mucus to recoat the tissues, then you wash it away again...creating a vicious and endless cycle. And some of the saline from the nasal rinses is flowing down as well.

I wonder if you might want to try to eliminate the nasal wash for several days to several weeks and let your body take over?

I was having this excessive mucus before my Dr. suggested I try sinus rinses but yes I agree with you I may have irritated my nasal passages so now I have not rinsed for 3 days but still using vest and 3 or 7% saline for my lungs. I never had these issues prior to starting airway clearance. Now upon waking and drinking water it starts back up and meals make it worse. Dinner creates the highest amount. I have no food allergies and 3 ENT’s say my sinus’s look normal.

I suggest eliminating potential irritants one at a time, and waiting for several days for things to calm.
Since the purpose of the saline is to enhance mucus production to improve clearance, maybe you don't need it at all. And maybe it is doing the same to your lungs as the rinses to your sinuses - irritating and causing more mucus?
The vest is not a requirement for airway clearance. If you are able to produce and expel mucus without it, maybe it too is irritating your body?
Finally, when you are doing your clearance, are you coughing (another irritant) or just active breathing cycles and "huff coughing"?

I looked at your statement "I never had these issues prior to starting airway clearance..." and started thinking maybe you need a complete "do over" after a rest, trying to reset yourself to baseline. Do you thinks that is something the doctor would be willing to let you try? Or something you are willing to try on your own?

By the way, have you been diagnosed with MAC, and are you taking antibiotics for it?

@deb2727 Your situation is puzzling. It caught my eye as I feel as though I produce a lot of phlegm with airway clearance but when I measure it in a metered cup, it's less than 10ml (10ml is almost 3 teaspoons).

How much are you coughing up? Have you measured it? What does it look like? On this board and others, mucus, phlegm and sputum are readily interchanged even though they are different. Do you know which one you are coughing up? Have you been tested for reflux/GERD? What medications do you take? Mucinex? NAC? etc.

Mucus is a clear slippery substance produced by respiratory tract. Everyone healthy or not have it. It's our lungs first line of defense, it moistens and protects. It's in the nasal passages, trachea, bronchi, and lungs.

Phlegm is mucus that is specifically produced in the lower respiratory tract, often during illness or inflammation or during chronic disease like bronchiectasis. It's thicker and harder to expel. It can be any color, if yellow means there are immune cells present. Green can indicate an infection.

Sputum is mucus from the lungs that is coughed up, often containing additional elements like cells or pathogens. It's what we send to the lab for testing.

I feel your frustration.
I have read other posts of other patients stating constant need to clear out sputum. Meaning whatever the fluid is that keeps coming up. For me the constant need to clear out what comes up looks like a mixture of moisture (bubbly and foamy) maybe some white mucus (gel like substance/clear) maybe some saliva with "legs" ..etc. etc. Then there are other times that I have mucus plugs come up with it and then at other times I have the light colored/pale yellow small mucus "pieces" come up and I can tell the difference of what it is because of how it feels coming up.

I understand that a hiatal hernia can cause mucus and I do have a hiatal hernia. So overall it is hard to know why some of us have this need to clear out the sputum most all day long.
Mornings are worse for me and yes after eating and drinking water also causes it to happen.

How I wish I knew for sure what is causing the constant sputum and my need to clear it.
For me I am learning how to live with it and keep saying to myself, 'most important is that I feel well overall, no fatigue and no pain.
Barbara

What you have described is exactly what I am getting out and exactly what mine looks like! The color, consistency (sometimes gel consistency) bubbly, foamy clear secretions and sometimes a mucus plug that came from lungs but this daily 1/3-1/2 cup of clear, bubbly sometimes watery, sometime gelatinous mucus seems to me to be coming from my sinus’s. I don’t have a hernia but I do have one CF gene mutation that causes thick sticky mucus. My CF pulmonologists however say what I am experiencing is not from CF but all the ENT, Allergy, Neuro, internists seem to just say, “ oh that is due to your partial CF.” Have you tested for CF with a genetics test and sweat test?

Sue-I was surprised about your comment that says "saline is to enhance mucus production to improve clearance." I was under the impression that the saline is used to moisten the lungs to get mucus up and out easier. If what you are saying is true that it actually creates more mucus that would make sense as to why I cough up 1/2 c. each session which is more than I use to have to clear out. My doctors told me to nebulize twice a day with 7% saline but it's been concerning how much mucus I am producing every day which seems like an excessive amount and pretty much keeps me house bound. The physical toll on my small petite frame and low weight is tremendous as I work very hard at getting it all out. Thank you.

Hi, I am going to answer your questions: I produce 1/3-1/2 cup daily. It is clear, foamy, sometimes white and always sticky and sometimes I get something up in that, most times not. I feel it is mucus. I have been extensively tested for reflux and gerd and that is not my issue. I take NAC in pill form and did use musinex for about 2 weeks but I decided to stop it. I have inhaled NAC in my nebulizer cup but not on a consistent basis and not doing that currently. I have such constant sinus drip that I never had before I started airway clearance that I suspect that is what I am getting up daily. Not knowing how to stop the flow of this new (2 years now) problem.

Hi Sue, Thank you so much for your thoughtful response to my post, I am new to this posting on Mayo site and having already heard from many of you who have similar problems gives me hope we can all learn from each other and figure out what is going on in our bodies with this phlegm issue. I was diagnosed with MAC in 2017 and went on the Big 3 at that time. I was not told by my local pulm anything about airway clearance, he had me get an aerobika with no help really on how to use it and no saline was being suggested. In 2021 I went to National Jewish and still had the MAC so went on the Big 3 again but higher dosages for 18 months and had my RML removed as it was destroyed with Bronchiectasis. Since then I have been in good shape with my lungs however with the directive to still use the vest and 7% saline with aerobika. Something changed for me as I started to have mucus all the time especially after a drink of water and eating food. It never leaves my throat. I am not coughing very much, some huff coughing but mostly just using my throat to get this mucous out. I know what I am doing is harming my vocal cords. I do try to stop using things and drop down to 3% sometimes. I like your suggestions however and I should try to reset to baseline. I am fine doing that on my own as my doctors think my lungs are in good shape now but they are never wanting to stop airway clearance is what I have learned. I will try, it is hard with all the phlegm/mucus that wants to come out, but will make some changes and see if helps. Thanks again!

Yes I have had the tests at National Jewish Health and the sweat test was fine. Main finding was the small hiatal hernia and MAI.
Medicine has advanced to what it is today and in reality it is wonderful what they can do and help us with....however as we know they don't have all the answers and we don't have them either. Would love to know the why but may never have the answer.
I believe I produce much more sputum than what you have mentioned. I haven't measured it and probably should.
Barbara