How much mucus are you clearing with each nebulising/airways clearance

Posted by narelled23 @narelled23, May 7 9:34am

I have been diagnosed with Bronchiestases and more recently with MAC.

After coming across the Lung Matters protocol on Facebook 18 months ago, I have now given up the PPI (Nexium) and Spiriva and been following the Lung Matters protocol of nebulising with Salbutamol and then 7% hypertonic saline. The volume of mucus I extract each time is at least a cup, probably having increased as a result of having the MAC infection. Also, unlike others who have trouble obtaining sufficient for sputum tests, mine is very loose and prolific.

I am curious to know the volumes others produce and what you feel is the reason for this quantity.

I look forward to hearing from you.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Thank you for posting this question. I was going to do the same but assumed there would be no one else with the volume of mucus that I have (approx 3 ounces with my late AM nebulizing). Mine is also loose and prolific. I have chronic Pseudo and have not found a treatment option I can tolerate (thus far). I also have had Bronchiectasis for a very long time. Are you sure you are producing a cup each time?? Is it a guess or do you actually have a way to compare it to liquid ounces? What does it look like? Does your Dr offer any explanation as to such volume? Mine does not seem to know why but I do know that Pseudo is known to produce more volume. I think there is one other person on this forum who says she produces this kind of volume but not sure how it is measured.

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I have just measured the cup I use and it is 7 oz. I produce this much at least twice a day. It is always light, foamy and white...with occasional heavier white aspects.

I don't recall being tested for Pseudo. It is only in the last 18 months since nebulising that I was in a position to measure it and have been producing that much for 6-9 months. Not sure how much beforehand. Never thought to mention it to anyone. I have only ever been asked once years ago and then I estimated a tabsp.

Thank you so much for answering my question. It seems so many don't produce much I am just learning.

Perhaps I should be tested for Pseudo too.

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I was diagnosed with BE 10 years ago and about 8 months ago tested positive for Pseudomonas. I only started nebulising with saline 7% six months ago when I became a patient at National Jewish Health. I produce a quarter to a third cup of mucus after nebulising.
After nebulising in the morning, along with SmartVest, I block up with mucus a few times a week in the afternoon. If I lay prone for 5 to 10 minutes, while doing yoga (stretching arms back and forth and side to side and raising and lowering legs, all the while on my back), I bring up quite a bit of green mucus with huff coughing, which I assume is the Pseudo that is colonized in my lungs.
What I gather from the doctor is that Pseudo treatment is hard on the body, and Pseudo, even if cleared by treatment, often comes back.

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@happy2023

I was diagnosed with BE 10 years ago and about 8 months ago tested positive for Pseudomonas. I only started nebulising with saline 7% six months ago when I became a patient at National Jewish Health. I produce a quarter to a third cup of mucus after nebulising.
After nebulising in the morning, along with SmartVest, I block up with mucus a few times a week in the afternoon. If I lay prone for 5 to 10 minutes, while doing yoga (stretching arms back and forth and side to side and raising and lowering legs, all the while on my back), I bring up quite a bit of green mucus with huff coughing, which I assume is the Pseudo that is colonized in my lungs.
What I gather from the doctor is that Pseudo treatment is hard on the body, and Pseudo, even if cleared by treatment, often comes back.

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Oh I am so sorry to hear that. That must be discouraging for you.

I am wondering if Pseudomonas phlegm is always green...if so I thankfully don't have it. I am however trying to find an answer for the volume of phlegm I produce. There must be a lot of inflammation/infection going on. Perhaps having MAC is the answer, however others don't seem to be that productive.

Wishing you all the best and I do hope you can shake the Pseudo off. There are a number of new drugs being trialled at the moment. Fingers crossed for some additional options there.

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@happy2023

I was diagnosed with BE 10 years ago and about 8 months ago tested positive for Pseudomonas. I only started nebulising with saline 7% six months ago when I became a patient at National Jewish Health. I produce a quarter to a third cup of mucus after nebulising.
After nebulising in the morning, along with SmartVest, I block up with mucus a few times a week in the afternoon. If I lay prone for 5 to 10 minutes, while doing yoga (stretching arms back and forth and side to side and raising and lowering legs, all the while on my back), I bring up quite a bit of green mucus with huff coughing, which I assume is the Pseudo that is colonized in my lungs.
What I gather from the doctor is that Pseudo treatment is hard on the body, and Pseudo, even if cleared by treatment, often comes back.

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Are you aware of the Lung Matters Facebook group? There is some wonderful support there.

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White foamy mucus makes me think of reflux/GERD. How are you doing off of the PPI? Many lung disease suffers have reflux/GERD. I understand the rationale of getting off these meds but often people with lung disease require them to keep irritating acid from getting into the lungs. Also, nebulizing albuterol tends to relax the lower esophageal sphincter. Using an albuterol inhaler 15 mins prior to saline has less impact on the sphincter.

Lung Matters Protocol are guidelines to follow with caution and consultation from your doctor. It's grown from the documentation of one woman's journey. Yet, one size does not fit all. Several of the links used as supported evidence are not relevant, some are dated. It seems there's no room for any debate. One very positive piece of advice there, however, is the importance of airway clearance. In this way, the site has done a huge service to bronchiectasis sufferers as airway clearance is the cornerstone of treatment.

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I used to clear up to half a cup.
Now that I am on Guaifenisin, I seem to bring up phlegm throughout the day. Some increase after nebulizing, but only one tablespoon. As others describe, it is clear, white, with thicker white parts. Slowly goes from white to cream , yellow to green when infection has hit.

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I have read that if you also have asthma and/or COPD then you have more mucus. In my case I have asthma and allergies and some days I have a huge (couldn't face using a cup or measuring) amount of thinish varied color from light yellow to green and greenish brown plus lots of nose blowing all day long with or without the saline neb. The amount and color seem to have no effect on my sense of wellness and the pulm doctor said not to worry about it. Other days I don't have much. I am worse when a storm is coming for some reason. Lately I think I am getting bronchospasms (despite albuterol use) from the saline inhalation. I am taking a few days off to see what happens since it seems I am not have trouble getting rid of mucus (though deep down who knows). What causes the excess mucus production in my case is never clear though I think the asthma and allergies cause greater production.

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@liz440

I have read that if you also have asthma and/or COPD then you have more mucus. In my case I have asthma and allergies and some days I have a huge (couldn't face using a cup or measuring) amount of thinish varied color from light yellow to green and greenish brown plus lots of nose blowing all day long with or without the saline neb. The amount and color seem to have no effect on my sense of wellness and the pulm doctor said not to worry about it. Other days I don't have much. I am worse when a storm is coming for some reason. Lately I think I am getting bronchospasms (despite albuterol use) from the saline inhalation. I am taking a few days off to see what happens since it seems I am not have trouble getting rid of mucus (though deep down who knows). What causes the excess mucus production in my case is never clear though I think the asthma and allergies cause greater production.

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Such a good point about other airway diseases contributing to symptoms! It's a mystery to me how much asthma contributes to the mucus. I know COPD contributes from what I've read.

I'm taking allergy shots, 1st out of 5 years on maintenance. I also did shots in my 20s. Honestly, so far I don't notice a huge difference but was in my son's apartment with a cat and did not sneeze. Lately I've noticed wheezing after levalbuterol, which is weird. So I started using albuterol inhaler and not as much wheezing. I might be among few who cannot tolerate levalbuterol.

Changes in barometric pressure are a trigger for me too!

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@scoop

Such a good point about other airway diseases contributing to symptoms! It's a mystery to me how much asthma contributes to the mucus. I know COPD contributes from what I've read.

I'm taking allergy shots, 1st out of 5 years on maintenance. I also did shots in my 20s. Honestly, so far I don't notice a huge difference but was in my son's apartment with a cat and did not sneeze. Lately I've noticed wheezing after levalbuterol, which is weird. So I started using albuterol inhaler and not as much wheezing. I might be among few who cannot tolerate levalbuterol.

Changes in barometric pressure are a trigger for me too!

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I just finished 5 yrs of allergy shots and no obvious improvement! Will get retested probably in a few months. There was blood work improvement - lower IGE scores etc. We had a horrible oak pollen season here this year because we never had a frost and my asthma was off the charts and I am not fully recovered yet. I can truly say at this point there is no guaranteed rhyme or reason to the mucus production. Some times I have what I call a "storm" which causes massive coughing mucus and nose blowing then it stops after about an hour. Other times it's all day long. Night thank God is quiet.

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