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Any suggestions for expelling tenacioius mucus plugs?

Posted by coffcoff @coffcoff, Dec 26, 2024

Despite drinking lots of fluids (mostly water) and using 7% saline in my Aerobica twice a day, my CT scans consistently show mucus plugs deep in my lungs. Maybe it's because I live in such a dry climate (southern AZ) but I have a difficult time getting phlegm up. I'd appreciate any suggestions. Thanks!

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coffcoff | @coffcoff | 15 hours ago
In reply to @saburrows "@coffcoff I do have a nebulizer (DeVilbiss) and use it everyday with 0.9% saline. I have..." + (show)
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@coffcoff I do have a nebulizer (DeVilbiss) and use it everyday with 0.9% saline. I have also tried it with acetylcysteine which is supposed to thin the mucus and after doing it everyday for almost a month, nada. I did see an ID doctor who put me on the 3 antibiotics 3 times a week. After 20 months the CT scan showed it was still there. He referred me to a pulmonologist in the Non-Tuberculosis clinic is a larger city, 1.5 hours away. I can't change to another pulmonologist as this is the only clinic in the province and it's very busy with patients. A different pulmonologist that I had done a "breath easy" zoom class told me that I might be one of those people that just doesn't produce much mucus. That may be true because when I was sick last year with something I was coughing up mucus and manage to get one sample, but one only. I have watched YouTube for huff coughing, and again, didn't help. I do and always have drank lots of water. I would like to be able to produce a sputum sample instead of having to rely on CT scans. The ID doctor went nuts with them. I had 7 scans done in 18 months. That's like 7000 x-rays. Not good. Oh, and I also have bronchiectasis, though the pulmonologist said it was serious, like 5%, and she wants to keep it that low.

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@saburrows Interesting that your doctor is treating you based on CT scans. How will you know when the infection has cleared? (Not to mention the radiation you're getting from all those CTs.....) The CT will show bronchiectasis and whether or not you have an infection but it can't quantify it. Only sputum can do that.

In what way are you having a tough time with the 7% saline? Throat irritation?
I'm no doctor (I am a retired RN who used to work respiratory and critical care) but I really can't see how 0.9% saline, which is called "normal saline" because it's the concentration of saline in our blood, can help you get the mucus out of your lungs.

Sorry to sound so negative, but I was in your shoes and I remember feeling so desperate. Don't let it get to you. Just do the best you can.

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blm1007blm1007 | @blm1007blm1007 | 2 hours ago
In reply to @coffcoff "@saburrows Interesting that your doctor is treating you based on CT scans. How will you know..." + (show)
Profile picture for coffcoff @coffcoff

@saburrows Interesting that your doctor is treating you based on CT scans. How will you know when the infection has cleared? (Not to mention the radiation you're getting from all those CTs.....) The CT will show bronchiectasis and whether or not you have an infection but it can't quantify it. Only sputum can do that.

In what way are you having a tough time with the 7% saline? Throat irritation?
I'm no doctor (I am a retired RN who used to work respiratory and critical care) but I really can't see how 0.9% saline, which is called "normal saline" because it's the concentration of saline in our blood, can help you get the mucus out of your lungs.

Sorry to sound so negative, but I was in your shoes and I remember feeling so desperate. Don't let it get to you. Just do the best you can.

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@saburrows You appear to be doing the right things....drinking lots of water to stay hydrated to help with the mucus and health in general.
You are nebulizing, you know about the huff cough,. Have you looked up the various ways of doing airway clearance like percussion, Autogenic Drainage, Active Cycle Breathing...all under the umbrella of Air Way Clearance Techniques.
Also, have you been diagnosed with Acid Reflux of any type. One must take that into consideration if trying postural drainage under the umbrella of airway clearance. The professionals don't recommend it if you have a type of acid reflux.
Personally if you could I would see if you could go to NJH in Denver, I know that might be difficult for a multiple of reasons. National Jewish Hospital/Clinic in Denver test you for a week long to see if there are any other types of problems that are associated with Bronchiectasis that might help knowing in this journey. They have concentrated on respiratory illnesses since the late 1800's.
Hope all that you have read on this site is helping somehow.
Barbara

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lilianna | @lilianna | 1 hour ago

When I have sputum induction at NJH I ask to use 10% saline after a treatment of levalbuterol( learned that hard way when they used 10% without a bronchodilator first- I had a bronchospasm) but even with 10% I produce minimal amount and it mostly saliva. But the Resp technician says it’s fine because the lab sees the smallest mucus particles under the microscope and that there is always something there. At home I produce mostly nothing that I can send to local doctor/ lab and it’s rejected.

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coffcoff | @coffcoff | 50 minutes ago
In reply to @lilianna "When I have sputum induction at NJH I ask to use 10% saline after a treatment..." + (show)
Profile picture for lilianna @lilianna

When I have sputum induction at NJH I ask to use 10% saline after a treatment of levalbuterol( learned that hard way when they used 10% without a bronchodilator first- I had a bronchospasm) but even with 10% I produce minimal amount and it mostly saliva. But the Resp technician says it’s fine because the lab sees the smallest mucus particles under the microscope and that there is always something there. At home I produce mostly nothing that I can send to local doctor/ lab and it’s rejected.

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@lilianna I had the same experience as you. Local labs will reject anything that has saliva in it. My local ID doctor sends sputum to NJH, since they have the best lab in the country for detecting NTM. My NJH doctor says that even if I think my sample is nothing but spit, they can determine whether or not I have a NTM infection.

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