1. < MAC & Bronchiectasis

Coughing up blood normal?

Posted by beatrixflower @beatrixflower, May 9, 2021

Hi everyone,
I was diagnosed with Bronchiectasis and MAC about 3 years ago but because I am "asympomatic" (am I?) the doctors have not yet treated me with antiobiotics or saline. I have two questions I am hoping you can answer.
1. I just coughed up blood. Is this normal for Bronchiectasis? I coughed and felt it was "productive" so I got up to spit it out and it was sort of dark red, about 1/2 teaspoon. It seems related to the following: Earlier today, I felt I had some mucus but I couldn't get it out so I tried the technique of elevating my legs that was posted earlier this week. When I did that, I could swear that I heard fluid moving in my lungs. I felt sort of weird after I did it but nothing came out. Then this evening I coughed up the blood. Are these things related? Do you think I heard liquid in my lungs? What is the blood from?
2. I should leave my post at that because it is a big enough question but a couple of years ago, after doing several techniques to clear my lungs, I was able to produce the mucus. But when it came up it felt so much that I felt I was going to choke on it or like I couldn't breathe. That feeling only lasted a moment or two until I was able to cough it out but I think it really scared me to continue trying to move the mucus. Is it possible to bring up so much that you could choke on it? What do you do in that situation where it feels like there is so much you can't catch your breath?
I apologize for yucky questions.
Thank you for any insight.

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hauoli | @halford | May 10, 2021

When I first went to see a pulmonologist, it was because I, like you coughed up a lot of dark blood. Scared me. The doctor said for me not to worry unless it was more like a cup full or
persisted. So he put me on a nebulizer using budesonide .5 and sodium chloride 3%. The blood stopped and got mucus/sputum release. Rarely now, Ill see bits of blood. He said it was the lining getting irritated. I do have Bronchiectasis/MAC and wish you the best.

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heathert | @heathert | May 10, 2021
In reply to @ginak "@beatrixflower I have also had hemoptysis a few times. Also Dx with bronchiectasis and MAC/MAI in..." + (show)
@ginak

@beatrixflower I have also had hemoptysis a few times. Also Dx with bronchiectasis and MAC/MAI in 2016. I was told the blood comes from having the bronchiectasis, caused by inflammation in the small bronchial tubes. It happens to me 1- 3 times a year. I’ve noticed mostly during the change of season. I was also told by my pulmonologist a couple of tablespoons is not really an issue. Unless it doesn’t stop. Like Heather, I also feel it “gurgling” up. Although I know what causes it, I still get very nervous and shaky when it happens, and I notify my Dr through email.
As for the “yucky” questions, we’ve all been there and pretty much experience the same things. And even though I’m doing this coughing, nebulizing and lung clearance for almost 5 years, there have been a couple of times when I’m coughing, spitting and gagging so much my husband comes in to check to see if I’m ok. LOL. This darn disease is never boring!

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@gina oh wow the change of seasons makes a lot of sense, thanks Heather

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heathert | @heathert | May 10, 2021
In reply to @poodledoc "@beatrixflower @heathert I concur with heathert. You should talk to your pulmonologist asap if you have..." + (show)
@poodledoc

@beatrixflower @heathert I concur with heathert. You should talk to your pulmonologist asap if you have one, or at least your PCP. My thoughts are the sound you are hearing is mucous/sputum coming up, no way to get "choked" on it since it is already in your lungs. The blood is coming from damage to the inside lining of your small airways (bronchiectasis). I would modify anything you are doing that brings up blood, making it less aggressive, perhaps keeping your head above your feet instead of below. Good luck, Bill

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all members @ginak @ @poodledoc @lorifilipek Thank you for the explanation of where the blood is coming from, interesting. I sometimes feel that I start bleeding if I have choked a piece of orange or whole grape, the juice seems to squirt down my windpipe and I choke then either immediately or an hour later I start to bleed, ma by the acid in it, other times when I have a cold and cough alot and others I have no idea Now I chop my fruit small. Does anybody else get this. Thanks Heather

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1 reply
baz10 | @baz10 | May 10, 2021

I have had blood come up in the past and have been diagnosed with bronchiectasis and also have some lung nodules that are stable for the past 5 years. When the blood comes up, I can hear the gurgling sound and it is scary. Haven't had it happen for about 3 years. I nebulize twice daily and use an inhaler afterwards and see the allergist/asthma doc every 6 months. Baz10

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lorifilipek | @lorifilipek | May 11, 2021
In reply to @heathert "all members @ginak @ @poodledoc @lorifilipek Thank you for the explanation of where the blood is..." + (show)
@heathert

all members @ginak @ @poodledoc @lorifilipek Thank you for the explanation of where the blood is coming from, interesting. I sometimes feel that I start bleeding if I have choked a piece of orange or whole grape, the juice seems to squirt down my windpipe and I choke then either immediately or an hour later I start to bleed, ma by the acid in it, other times when I have a cold and cough alot and others I have no idea Now I chop my fruit small. Does anybody else get this. Thanks Heather

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@heathert I didn't see any pattern in my two blood episodes except being horizontal. I was lap swimming in Michigan in August during the first one and had recently gone to bed in Tucson in winter when the second one happened.

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rmason | @rmason | May 11, 2021
In reply to @lorifilipek "@beatrixflower HI! Was this the only time you've coughed up blood in the 3 years? I've..." + (show)
@lorifilipek

@beatrixflower HI! Was this the only time you've coughed up blood in the 3 years?

I've coughed up about 2-3 TBS blood twice over the past 3 years. Both times it was a combination of red blood and clots, and I felt it come up. I don’t recall “hearing” it, but I’m also older and don’t hear as well as I used to.:-) The first time, I went to the ER and that, eventually, led (after about 1 ½ yrs) to the diagnosis of bronchiectasis and MAC. The second time was last year when I was in another state from my infectious disease doctor. She (my ID doctor) suggested I go to my PCP there and have her check my vitals, especially my oxygen levels. They turned out to be fine and I felt fine except for being scared because of the blood. I now have a pulse oximeter and check my own oxygen level periodically. I cough and bring up minor sputum in the mornings, but don’t really have any other symptoms. I don’t take any antibiotics. I exercise/walk 2-3 miles daily. Recently, I started nebulizing 7% saline once daily in order to, hopefully, keep my condition from getting worse. I agree with Bill (@poodledoc) that you aren't likely to choke from the mucous--it just feels icky until you get used to it.

I've been investigating whether coughing up blood may actually be a good thing in MAC. In my reading of MAC articles, I found one called "Retrospective study of the predictors of mortality and radiographic deterioration in 782 patients with nodular/brochiectatic MAC lung disease" by Gochi et al. ( https://www.ncbi.nlm.nih.gov/pubmed/26246077) From the article, the women with bloody sputum fared the best. I've been trying to find out why.

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My story is very similar. I have coughed up blood on about 4 occasions in the past almost 4 years. The first time led to my diagnosis of bronchiectasis and MAC. I have very few other symptoms except coughing up sputum after nebulizing saline in the morning. Antibiotics for a year did not eradicate the MAC.

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migizii | @migizii | May 11, 2021
In reply to @lorifilipek "@beatrixflower Hi Darla, I started with 7% because I hope to kill (or at least limit..." + (show)
@lorifilipek

@beatrixflower Hi Darla, I started with 7% because I hope to kill (or at least limit growth of) the MAC found in my lungs (See also tables 2 and 3 of the paper Sue referenced in the other thread). I've never had problems with 7%. The first time I used it, it caused me to sneeze and cough in the middle of the nebulizing, but that was the worst effect and only happened a few times. I talked my PCP when I was in Tucson into prescribing it for me after showing her the article at my annual physical. My ID doctor now prescribes it. (I'm in MIchigan now.)

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@migizii hi Darla; I was also started on 7% neb solution but I was not aware of. Mayo Connect at the time. I did not know I was receiving the “best” intervention and have had no problems adjusting other than a rare tender throat....I had several problems getting a diagnosis, but gratefully finally persisted long enough to find Mayo pulmonary!

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