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HEMOPTYSIS ....Nebulizing, air way clearance and huff coughing
I had two episodes of blood that came up today.
Not much, just a tiny amount and streaks, no clots.
Nothing feels irritated and swallowing OK. Feel O.K. also.
It came up after what I hope was a huff cough but I know I also find myself doing a hard huff cough. Not good.
Not sure if it is from the lungs or esophagus. However, I will assume it is from the lungs, for now.
I know about hemoptysis from reading posts here on Mayo.
I sent a message to my pulmonologists today.
Thank goodness I was able to read previously in threads, and today the posts about Hemoptysis and Exercise, so that I am not frightened...... just not happy.
I did not do therapy today however when I did clear what was clearly in my throat area today, in between the two incidents (Noon meal first episode and Five P.M. meal) I did not have blood.
What do the pulmonologists say about doing our therapy,....the nebulizing, air way clearance techniques and huff coughing if having or seeing blood ..... related to the lungs.?
Do we continue with therapy, and all, or give it a day or two to "heal?"
Barbara
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Added guidelines from NJH
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4 ReactionsMay 18 I had 3 episodes of hemoptysis within an hour and a half. Shortly before I had coughed up a small amount of “crud”. A smashed pea size of semi firm ??? Pretty sure it’s pseudomonas. I had it cultured a while ago. Colonized. It’s sensitive to multiple antibiotics, but so am I!
Went to the ER because I had coughed up a large blood clot and a significant amount of blood. They did a chest X-ray, negative. Kept me about two hours for nothing and discharged me with a hand out on hemoptysis.
Went to my local pulmonologist. He had me stop my Eliquis and nebulizing. Had a CT that didn’t really show anything new or alarming. Some mild atelectasis of lower lobes. Went to an ENT and got scoped. He did not see anything either. So, consensus is that I had a blood vessel burst when I coughed up the crud. I was told to resume nebulizing slowly when I felt comfortable with it and the Eliquis (for afib stroke prevention) is a risk vs benefit kind of situation. I have resumed nebulizing every other day and have not resumed the Eliquis. I’m sure my cardiologist will not be happy, but I feel so much better not taking it. This was totally different from the blood streaked sputum I coughed up when I first got sick. So, important to at least follow up with your doctor. Best wishes.
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2 Reactions@cwal Great information from NJH. Thanks.
Barbara
@bamaqueen Yes, for me also it was after I had to cough up, with somewhat of a strong cough a piece of food that felt lodged in the throat area. Couldn't tell in what part of the Pharynx it seemed to be caught in and wanted it out.
So far this morning no streaks of blood.
I am trying to be gentle with it all today. Not doing full morning therapy today.
Thanks for your response.
Hope you are doing well today.
Barbara
@cwal
When NJH says airway clearance can be resumed after 24 hours if no hemoptysis, does that include nebulizer? Thanks!
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1 Reaction@kamarla I thought about the salt as apparently you have?
This is what AI came up with so we still might have to get a better answer, and from ones own pulmonologist.
AI said:
"Salt can potentially irritate the throat, but it is unlikely to cause bleeding again from a strong cough.
Coughing and Bleeding: Strong coughing can rupture small blood vessels in the throat, leading to minor bleeding. This is often not serious and may appear as streaks of blood in mucus
.Salt and Irritation: Salt, especially in high concentrations, can irritate the throat lining. If the throat is already inflamed or damaged, salt may exacerbate discomfort but is not typically a direct cause of renewed bleeding.
.Recommendations
Hydration: Keeping the throat moist can help reduce irritation.
Avoid Irritants: It may be wise to avoid salty or spicy foods until the throat heals."
I also found this information from Univ. of Michigan. by José De Cárdenas MD. It is more for pulmonologists then a for a patients full understanding regarding a severe problem with bleeding.
"Basic management of airway" https://ipulm.com/wp-content/uploads/2021/11/Management-of-Hemoptysis-De-Cardenas.pdf
However, it is always good to confirm with ones own pulmonologist....our pulmonologists do prefer that we talk to them. But then it is also up to us knowing ourselves and erring on the side of caution for ourselves. We know ourselves best.
Barbara
P.S. Did you see and read what cwal posted above from National Jewish in Denver.?
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2 ReactionsThe consensus I've always heard is to wait 24-48 hours before resuming nebulizing treatments or even Aerobika. Something is obviously irritated so you have to give it time to heal. I always have to wait longer b/c I bleed so easily, but 24-48 hrs. is what I have always heard,
Hope it doesn't recur, Barbara!
All the best!
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2 ReactionsHello . I wonder if someone can help me with this question is have BE/MAC. My docto at the Infectious Disease clinic put me on 3% saline solution 2x day along with the Albutorol that i am already doing , do I do saline solution right after the albutorol? I got no further instructions , I was so overwhelmed I forgot to ask him . Please could I get some ideas . Thank you
@petry That is so common, "so overwhelmed. "
I don't use albutorol but it is my understanding that it is to help open the airways before you nebulize. With things like this, especially if needing information quickly from good websites like Mayo or Cleveland Clinic or the company that makes the albutorol could help with the information, I would think.
You will probably have a reply shortly from those who use it.
Barbara