Airway clearance and how I feel throughout the day

Posted by @ling @wangling, May 4, 2023

Hi everyone,
I know it might be a diffuse question, but let me try.
My pulmonologist told me if I do the airway clearance correctly. I
should feel clear of mucus during the day. I spend almost 30 minutes
doing it (flutter + autogenic drainage in the morning and evening). But throughout the day, I have to constantly clear out mucus most days. I am wondering what your experience is, is it normal for you? Maybe I am too sensitive about it.
Your experience is greatly appreciated.
Many thanks!
Ling

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In reply to @amap2025 "C is ?" + (show)
Profile picture for amap2025 @amap2025

Contextually, the C means airway clearance.

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I have never had a symptom of Bronch. Only with a CT scan do I know that something is wrong. I do airway clearance twice a day and bring up enough mucus to actually see about once a week. Is this normal? Am I doing it wrong?

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Profile picture for amap2025 @amap2025

How do you know that you have cleared all mucus

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I’ve never know for sure. I usually stop when I’m either too exhausted to go on or when I do i feel like nothing more is making a gurgling or wheezing noise when I huff and I know there’s nothing else that will come up.

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Profile picture for amap2025 @amap2025

How do you know that you have cleared all mucus

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It's impossible to clear "all the mucus" since we need mucus in our lungs to live. With bronchiectasis we aim to expel the "extra" built up, accumulated mucus (called phlegm, when expelled it's called sputum). Removing the extra, trapped phlegm helps us to breathe more easily, rid bacteria and prevent infection. Phlegm gets trapped in dilated, floppy portions of our lung tubes wherever the bronchiectasis is. For me, the first several huffs of the day are thicker, have more color but after 20-30 minutes of airway clearance the sputum appears less in volume and a lighter color. Your mileage may vary! This is why bronchiectasis is considered a heterogeneous (diverse) disease.

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Profile picture for scoop @scoop

After a soapy soak, some people boil their equipment for 10 minutes every day or even after each use. Some boil once a week. Some sterilize using a baby bottle sterilizer. Even though we all aim to accomplish the same thing -- clean and sterilized equipment -- we each manage slightly differently. Really depends on one's disease state and risk tolerance. Since there is no home test for swabbing our equipment to find out if our method works, we look to experts like Dr. Falkinham, who published papers on NTM and its sources. His papers can be found in the ABC's on bronchiectasis thread. So you can decide what's right for you.

For me, it's a baby bottle sterilizer, Bololo, a few times a week for equipment sterilization. I have bronchiectasis without NTM (so far, working to keep it that way with 2x day clearance etc etc etc). Remember that sterilization of nebulizers etc is only one part of the equation for NTM, pseudomonas, etc avoidance.

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Thank you so much for the helpful tips and resources! I'll check out Dr Falkinham and Bololo.

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Profile picture for amap2025 @amap2025

I have never had a symptom of Bronch. Only with a CT scan do I know that something is wrong. I do airway clearance twice a day and bring up enough mucus to actually see about once a week. Is this normal? Am I doing it wrong?

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Everyone has a different "normal". Today mine was perhaps a half teaspoon of mucus - after my inhaler & 7% saline. Other days there may be none or a tablespoon. When I get a lung infection, it seems I cough and spit all day long.
Don't try too hard - you can actually irritate your lungs and airways, which is the last thing you want.

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Hi Ling. I too find clearing necessary most days throughout the day and carry a pocket small flexible container to hold my sputum. Wondering if this works for others. Hope this helps.

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Profile picture for cmb1 @cmb1

Hi Ling. I too find clearing necessary most days throughout the day and carry a pocket small flexible container to hold my sputum. Wondering if this works for others. Hope this helps.

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cmb1, thanks for your input. In the past two years after I posted this message, lots of changes happened with my mucus pattern.
I learned in the past two years that my own mucus produces changes from day to day. But normally I need to cough to get the mucus out after it culminates for a while. I do wonder since our body produces mucus all day long, it seems it would be normal that we need to constantly get it out, but it is always like that.

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Profile picture for @ling @wangling

cmb1, thanks for your input. In the past two years after I posted this message, lots of changes happened with my mucus pattern.
I learned in the past two years that my own mucus produces changes from day to day. But normally I need to cough to get the mucus out after it culminates for a while. I do wonder since our body produces mucus all day long, it seems it would be normal that we need to constantly get it out, but it is always like that.

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What I personally find is that the more thorough my nebulzing and airway clearance session is, the rest of the day remains less mucus productive. Then later in the day the second session produces more mucus that has built up. I do find my body is in the habit of a build up and clearing of it at certain times of the day.

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Profile picture for irenea8 @irenea8

Dear Ling, I do my best but it is not easy! It is rather hard to answer the question about infections in my case. I believe that I live with some level of chronic infection all the time. But it is a matter of degree. I have the mucoid form of Pseudomonas and normally that would be treated ongoing since it is not considered something you can get rid of. Treatments with antibiotics have only happened twice in 20 years believe it or not (LONG story). First time worked and second time did nothing. Currently struggle with bad GI issues and Kidney so getting by with my nebulizing and "remedies". Treatment with the right antibiotic would help but these other co morbidities are a barrier. Each time I use the Aerobika I do 15 breaths. And I do that approx 13 times. You would not need to do so much!! Probably no one does this much but me! But once I am done I have expelled almost 3 ounces each day.

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Would love to understand this better: you pick up the Aerobika 13 times during the entire day? And do ten breaths each time? How often do you switch your or sterilize your Aerobika(s)?

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