What am I doing wrong? How to get a good sputum specimen for a culture

Posted by pled @pled, Nov 28, 2023

Although I have tried several times, I have not been able to submit a sputum sample that meets the qualifications for testing. In the beginning it was because I was just dry coughing all the time and I basically gave up. But recently, by using postural drainage techniques I am able to cough up mucous in the evenings. My most recent sample came back "unacceptable for culture due to oropharyngeal contamination". I'm looking for tips on how to insure that my sample can be cultured in the future. Now that I'm actually coughing productively in the evenings, I am motivated to get this job done. How are you all accomplishing this?

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@pled What are you doing for lung clearance?

Basic fundamentals of airway clearance include: hydration with mucinex and/or NAC tablet, inhalation of bronchial dilator, such as an albuterol inhaler (2 puffs), or levalbuterol through nebulizer, followed by 7% saline via nebulizer. Then use autogenic drainage and/or active cycle of breathing to clear your lungs. Check out the AD app if you have not already. This routine likely will set you up for a successful sputum sample along with a good clearance regimen for your lungs. It seems like a lot but it is manageable once a routine is developed.

Your most productive time ought to be first thing each morning because mucus pools in lungs over night.

Prior to the routine described above, my sputum samples were rejected time and time again. Frustrating. Anyway, give the routine a try and please report back!

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@scoop

@pled What are you doing for lung clearance?

Basic fundamentals of airway clearance include: hydration with mucinex and/or NAC tablet, inhalation of bronchial dilator, such as an albuterol inhaler (2 puffs), or levalbuterol through nebulizer, followed by 7% saline via nebulizer. Then use autogenic drainage and/or active cycle of breathing to clear your lungs. Check out the AD app if you have not already. This routine likely will set you up for a successful sputum sample along with a good clearance regimen for your lungs. It seems like a lot but it is manageable once a routine is developed.

Your most productive time ought to be first thing each morning because mucus pools in lungs over night.

Prior to the routine described above, my sputum samples were rejected time and time again. Frustrating. Anyway, give the routine a try and please report back!

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Where is this AD app?

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I have yet to try albuterol or levalbuterol. I am certain the albuterol would raise my heart rate too much. But perhaps the Levalbuterol would be possible. Just wondering with so many people using one or the other if they notice any other side effects from using them regularly? And do they make a big difference in airway clearance?

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@irenea8

I have yet to try albuterol or levalbuterol. I am certain the albuterol would raise my heart rate too much. But perhaps the Levalbuterol would be possible. Just wondering with so many people using one or the other if they notice any other side effects from using them regularly? And do they make a big difference in airway clearance?

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I tried the abuterol and had a severe reaction. My pulse rate went up to 110 and it took it 3 hours to return to normal. I had the shakes and was dizzy. I switched to levabuterol and tolerate it very well. If you try it, you may want to start with half a dose to see how you respond.

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@cwal

Where is this AD app?

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App store for iPhone. Alternate app store for android but apparently not available if you are a sprint user. AD stands for Autogenic Drainage.

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I also had this problem. I just never really coughed a lot and when I did certainly it wasn't from my lungs. In the morning. It seems to be the best time for most people, but you know if you cough at night then that's going to be your best time. Or go for a brisk walk outside to kind of agitate anything in your lungs, when you cough try to huff it out as you cough with deep breaths for in your lungs and stand up and lean forward and really give it your all from deep in your lungs.. That's what I do. I've been able to get them samples and they never have complained. I do think that a lot of people have this issue. I wish you all the best of luck!

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@irenea8

I have yet to try albuterol or levalbuterol. I am certain the albuterol would raise my heart rate too much. But perhaps the Levalbuterol would be possible. Just wondering with so many people using one or the other if they notice any other side effects from using them regularly? And do they make a big difference in airway clearance?

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Hi Irene. My pulmonologist originally prescribed nebulized albuterol prior to 7% saline, but it made me tremble. He then switched me over to levalbuterol 0.31 mg/3 ml, and that has been fine. I don't know how if affects my airway clearance as I've never nebulized without it. Good luck!

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@irenea8

I have yet to try albuterol or levalbuterol. I am certain the albuterol would raise my heart rate too much. But perhaps the Levalbuterol would be possible. Just wondering with so many people using one or the other if they notice any other side effects from using them regularly? And do they make a big difference in airway clearance?

Jump to this post

My first pulmonologist prescribed albuterol and 7% saline from the first but the albuterol made me very jittery and raised my heart rate. She switched me to levalbuteral and it was a little better but I still didn’t like using it and wouldn’t use either in the evening. When I went to NJH, their comprehensive lung functioning test included testing how effective albuterol was. The results showed it wasn’t significant in increasing my flow in my airways (12%) and my NJH doctor left it to me to decide whether I wanted to continue or not. His suggestion was to maybe use it before I went to exercise.

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@kwi

My first pulmonologist prescribed albuterol and 7% saline from the first but the albuterol made me very jittery and raised my heart rate. She switched me to levalbuteral and it was a little better but I still didn’t like using it and wouldn’t use either in the evening. When I went to NJH, their comprehensive lung functioning test included testing how effective albuterol was. The results showed it wasn’t significant in increasing my flow in my airways (12%) and my NJH doctor left it to me to decide whether I wanted to continue or not. His suggestion was to maybe use it before I went to exercise.

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Thank you. I have declined the Albuterol as part of the Pulmonary Function Test because I am so certain of a reaction to it. Too bad they will not test using the Levalbuterol instead. So do you use it ever?

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No, I haven’t used it in a year.

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