Coughing up blood normal?

Posted by beatrixflower @beatrixflower, May 9 10:59pm

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.

@beatrixflower I also get the bleeds occasionally, hemoptopsis,(I have MAI and Bronchiectasis) it is scary. Just try to stay calm if you can, I have never had a really bad one, the most is a few tblsp. I have heard it in my chest before it comes up and I sometimes hear it gurgling up in my throat, an awful feeling but think I have become used to it. If you lose amore than 2 tblsp call the ambulance. My Dr gave me some pills to stop the bleeding so maby ask for some of them. Take care Heather

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@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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@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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@beatrixflower I want to clarify the statement I made about "no way to get choked" in my previous post. It is unlikely to get choked but it is possible. Please get medical advice from your doctors about this.

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@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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@heathert

@beatrixflower I also get the bleeds occasionally, hemoptopsis,(I have MAI and Bronchiectasis) it is scary. Just try to stay calm if you can, I have never had a really bad one, the most is a few tblsp. I have heard it in my chest before it comes up and I sometimes hear it gurgling up in my throat, an awful feeling but think I have become used to it. If you lose amore than 2 tblsp call the ambulance. My Dr gave me some pills to stop the bleeding so maby ask for some of them. Take care Heather

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Hi Heather,
Thank you for your response! This is reassuring. I will definitely ask my doctor about those pills.
Warmly,
Darla

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@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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Hi Bill,
Thank you for your response. This makes sense. Yes, I think I will not try the elevated feet technique for a while to make sure that is what caused it. That was the only thing I did differently. I read your updated comment below as well about the choking on the mucus and will add this to my list of things to ask the doctor about. I think drinking a lot of water and tea to keep it thin is important but I just wonder if there is a maneuver I can do if it came up that thickly again and I couldn't breathe. Thank you again.
Warmly,
Darla

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@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!

Jump to this post

Hi Gina,
Thank you for your response. That is interesting about the change in seasons and is also what your pulmonologist said. That puts my mind at ease as this was about 1/2 teaspoon, maybe a bit more. Thanks for your reassurance about the yuck factor. Warmly, Darla

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@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.

Jump to this post

Hi Lori,
Thank you for your response. Yes, this is the first time I have ever coughed up something this red. Years ago before I was diagnosed, I coughed up a ton of mucus with a small bit of blood in it. Last night it was all dark red, the entire thing. That was why I got nervous! That is really interesting about the article you found. I will read it today. I posted another post last night about the nebulizing. I have a new doctor as of this past year and I asked her for the 7% saline but the prescription (I haven't tried it yet) is for 0.9%. I wondered if that is how everyone starts out to see how well you tolerate it or if she misunderstood me and I just need to ask again. Did you begin on 7% or work your way up?
Thank you again for your response,
Warmly,
Darla

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@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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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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@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!

Jump to this post

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

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