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 Is There an END to the Mucus?
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skhill
Member

USA
230 Posts

Posted - Feb 09 2019 :  11:17:14 AM  Show Profile  Reply with Quote
I have so much mucus. I am coughing uncontrollably now. I am using more sodium chloride with my levelbuterol so I can tolerate the levelbuterol. If not it gives me real bad chest pains. Can the sodium chloride be producing too much mucus? I can cough it up sometimes but not often. I am constantly blowing my nose too and getting crap out. I have never seen so much mucus before. All of this coughing cannot be good. I have almost threw up from coughing so hard.I am nebulizing every 4 hours. I use less than 1/2 of a vial of levelbuterol with 1 1/2 vials of sodium chloride. I have never coughed this much in my whole life. I have almost lost my voice now too.

jmrommes
Contributing Member

2023 Posts

Posted - Feb 09 2019 :  11:28:37 AM  Show Profile  Reply with Quote
It's time to call your doc. You're having an exacerbation. Coughing this much is unusual for you as is increased mucous production, so it qualifies as an increase in your COPD symptoms, which should, according to your action plan with your doc, trigger a call to her from you. I'd call her office and speak to the doc who's on call. If you're lucky it will be your doc and you can decide what to do. Don't let this go on; that's an invitation to a hospital bed or a much worse experience than usual at home. You want to catch this as early as possible, and you're probably a couple of days late as it is.

Exercise not only lets me live, it enables me to have a life.
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jmrommes
Contributing Member

2023 Posts

Posted - Feb 09 2019 :  11:38:07 AM  Show Profile  Reply with Quote
I forgot you were just home from the hospital. I would still call your doc to see if there isn't something else she could prescribe or suggest other than the nebulizing every four hours. Coughing this stuff out is the whole point; you need to get rid of it, However, not at the expense of the rest of you! You might thing about a device like the aerobika or you could try postural drainage. The easiest way to do that is to hang the top of your body off the bed and if someone will gently pound your back to loosen the junk up, you should be able to get rid of a lot.

Exercise not only lets me live, it enables me to have a life.
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Sandy9s
Member

USA
493 Posts

Posted - Feb 09 2019 :  3:28:42 PM  Show Profile  Reply with Quote
I am still using a Smart Vest to shake the smithereens out of me 3 times a day for 10 minutes each time. This is probably almost 3 months now. It is helping to rid my body of so much mucus.........shakes the mucus off of the lungs so that I can cough it up and out.

I have also been taking 3 - 250 mg. azithromycin each week......about 4 weeks already. THIS seems to be helping even MORE than anything else!

Also -- the past 4 days, I have taken a Zyrtec in the morning (I think 10 mg. without checking). It's a decongestant --- and I wondered if it would mess with my blood pressure. I take 3 b.p. medicines. It doesn't seem to be raising it -- so far.

Hard to know exactly which of the above is making the mucus better. I'm inclined to think it's the azithromycin.

I see my Pulmonologist this coming week.......will tell him about the azithromycin I'm taking -- and if I should now increase to 500 mg. x 3 times a week -- forever. (I read about this on the internet -- as a help for too much mucus production.) I won't go to 500 mg. without the Pulm. OK 1st.

I still HAVE too much mucus production! But compared to this past almost 1 year, it is a whole lot less!!!!!

My FEV is 29%. I'm on 02 for 24/7.

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jmrommes
Contributing Member

2023 Posts

Posted - Feb 09 2019 :  6:06:52 PM  Show Profile  Reply with Quote
Sandy the azithromycin is designed to reduce the inflammation in your lungs, thus reducing mucous production and exacerbations. If 250 is working why would you want to increase it? I assume your doc prescribed it; if he didn't, you might be ready for a bit of blow-back, depending on your relationship with your doc. Are you seeing a PCP or a pulmo? The pulmo ought to know about the azithromycin, but a PCP might not. Give it several months and see what happens. I wouldn't be inclined to increase it; if anything docs prescribe a higher dosage to get things under control and then reduce it.

Exercise not only lets me live, it enables me to have a life.
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Sandy9s
Member

USA
493 Posts

Posted - Feb 09 2019 :  6:50:48 PM  Show Profile  Reply with Quote
I see a Pulmonologist......same one for about 18 years now. We have a good relationship and I can start both an antibiotic and prednisone whenever I feel I am beginning an exacerbation. He has mentioned Z-Tabs, levaquin and amoxicillin as the antibiotics. And he knows I am quite cautious in starting a prednisone regimen. If "my regimen" works, fine.........I don't have to see him except for a scheduled appt. in usually 6 months. If my regimen doesn't work, I will call for an appt. At the appt., he will usually start a much stronger prednisone regimen --usually (when bad) a 40-40-40, going down. I usually start at either a 20-20-20 or sometimes even a 10-10-10 -- all going down.

The azithromycin on the internet for COPD mucus production talks about 3x a week of 250 mg. for 1 month. Then going to 3x a week @ 500 mg. if your body can take the 250 mg. tabs. That's what I want to ask my Pulm. about. Should I go to the 500 mg.???? I am still creating more mucus than I should be -- this leads to a couple of heavy-duty coughing spells per day..........and I will never know when they might start! So the mucus is still here -- obviously still a lot of inflammation in my lungs!

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jmrommes
Contributing Member

2023 Posts

Posted - Feb 09 2019 :  9:00:57 PM  Show Profile  Reply with Quote
There are two clinically tested and widely used treatments that are usually prescribed for people with a major chronic bronchitis element to their COPD and who have had multiple exacerbations and/or hospitalizations over the past year. One is daliresp and the other is the azithromycin 3 times a week. Both are designed to reduce inflammation in the lungs, mucous production and exacerbations; both have been successful. I'm involved in the development of a head to head comparative study of the two, so I'm quite familiar with the protocol. I've never see a protocol that calls for 250 first, escalating to 500. Could you give me a link? Thanks!

Exercise not only lets me live, it enables me to have a life.
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Sandy9s
Member

USA
493 Posts

Posted - Feb 09 2019 :  9:51:46 PM  Show Profile  Reply with Quote
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3186743/

This particular link specifically talked about 500 mg. azithromycin therapy for copd. It is from 2011.

I can't find the one that said to start with 250 mg. for 1 month @ 3 times/week and then escalate to the 500 mg. x 3 times/week for one year.

I will be staying with the 250 mg. x 3/week until I see my Pulmonologist anyway during this week.
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rjh-spokane
Member

USA
51 Posts

Posted - Feb 10 2019 :  02:46:03 AM  Show Profile  Reply with Quote
My Pulmonologist has prescribed me 250 mg of azithromycin daily about 2 months ago and it has helped for sure. I have used the albuterol neb 2 tubes at a time and if more needed went to the saline and have found this to work very well. I understand the azithromycin is for now on. On3e of my biggest problems is dehydration as I drink too much coffee and not enough water. this can really effect my mucus flow.
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skhill
Member

USA
230 Posts

Posted - Feb 10 2019 :  10:42:46 AM  Show Profile  Reply with Quote
I am on Omnicef antibiotic now. I am allergic to Azithromycin. I am not coughing as much today but still have a lot of wheezing at times. Still constantly clearing my throat and my voice is still not me. I sound very congested. I have cut back on my nebulizing to every 6-8 hours instead of every 4. I wish I wasn't so sensitive to medications but I am. It has to slow the recovery process down since I cant tolerate a lot of the meds that most people can to help breathe easier. I am struggling just to find the right combo on the saline and the levelbuterol so I don't get the chest pains for hours. I really appreciate all the feedback from everyone. This is a lot slower healing process than I ever imagined. Still hard to believe where all this mucus comes from and what caused it. I know I caught a bug from my friend I live with but I had no idea how bad a bug can affect someone with compromised lungs. I didn't realize my lungs were that vulnerable. I do now. Last night I took my 02 off for about an hour and sats stayed around 90-92. A representative from Apria called me to check up on me and said she was surprised they didn't do a atrial blood gas only a vein one. I was so glad they didn't because the atrial ones really hurt. Anyway she said it showed I had too much carbon dioxide in my blood system. She thinks I need some machine I sleep with at night to let the carbon dioxide out. Is anyone familiar with this machine and does it really help? I am thinking I will wait till I see my pulmo on March 1st before I add another machine. She also warned me about using too much 02. How will I know if I have too much carbon dioxide in my lungs or my blood stream? I feel crappy already and with this being my first time, how will I know?

Edited by - skhill on Feb 10 2019 11:05:16 AM
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jmrommes
Contributing Member

2023 Posts

Posted - Feb 10 2019 :  8:57:34 PM  Show Profile  Reply with Quote
I think you'll know if you begin to retain too much CO2. Basically, you get really fuzzy, might have cold and clammy skin, headaches, flushing, dizziness, increased blood pressure. Mostly the fuzzy thinking will be obvious. The machines used to reduce CO2 retention are bipaps and trilogy machines. Both work very well. If you're concerned, call your pulmonologist and discuss your concerns with her. The nurse might be right, but she's also talking about getting too much O2, and that's a red flag that she's still under the impression that the 'hypoxic theory" still holds water, when in fact it's be thoroughly debunked. That suggests that she's definitely old school and not current at all. So definitely something to talk with an expert about!

Exercise not only lets me live, it enables me to have a life.
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skhill
Member

USA
230 Posts

Posted - Feb 11 2019 :  7:27:12 PM  Show Profile  Reply with Quote
I am in a catch 22 here. The nebulizing is giving me chest pains now all the time and I still have mucus to get up and out. I don't know what to do. The doctors have no answers for me either other than to not nebulize as often which I already have been doing that. I have to get his mucus out. When I talk you can tell I am still very congested. I tried a decongestant and it made my heart go crazy too. I am on a beta blocker already to try and keep my heart rate slow and steady. Is there a machine the helps with getting the mucus out that I could see if my doctor would prescribe for me to use?
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jmrommes
Contributing Member

2023 Posts

Posted - Feb 11 2019 :  8:05:10 PM  Show Profile  Reply with Quote
There are devices such as the aerobika that do help some folks. There are vests that people wear, and are described in Sandy9's post that work well for some people. Postural drainage is also a good technique.

Exercise not only lets me live, it enables me to have a life.
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Dave-OH
Administrator

USA
4266 Posts

Posted - Feb 11 2019 :  10:59:21 PM  Show Profile  Reply with Quote
on my site I have some info, but I have not updated it for a while. I have used most of the mucus clearing devices at one time or other.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
Your source for peer support and COPD Info


My Site: http://lungresources.com
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MDC
Member

443 Posts

Posted - Feb 12 2019 :  09:14:38 AM  Show Profile  Reply with Quote
My original Dr I liked so much had me on 250mg azithromycin on mon, weds,friday. She also had me on 5 mg prednisone daily.This worked good.

When she left, new Dr put me on 500 mg 3 times a week and no prednisone. I could not tell much difference they both worked.

When my old Dr finished her new certification and came back she threw a fit that he increased me to 500 mg since 250 was doing fine. She reduced me back to the 250 3 times a week.She wanted to leave some room for an increase in case of flareup. So far works fine so I plan on staying on 250 long as possible.

Mike

Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.
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Sandy9s
Member

USA
493 Posts

Posted - Feb 12 2019 :  4:29:24 PM  Show Profile  Reply with Quote
Saw my Pulmonologist this morning. Told him I was taking 250 mg. Azithromycin 3 x a week and it seems to be helping. He said "Good Idea -- stay with it" -- and he wrote a prescription for it. I had gotten the original 250 Z-Tabs in Mexico nearby.

I also use the Smart Vest. All of this helps to relieve the mucus problem -- in both my head and in my bronchials/lungs.

I also have been taking 1 Zytec in the morning -- about 5 days now.

I STILL have mucus which will have me choking a couple of times per day. But the mucus seems to be lessened -- I am "measuring" the mucus by my vocal cords which have been full of mucus and unable to sing at all -- now able to sing all of the lower notes. I know this sounds strange -- but it's important to me. My Quartet is singing on our Show on March 2nd -- and I'm the least-productive member at the moment! I hate it! But I feel that mucus situation is getting better.

I will be having a CT Scan of my lungs during March. Being required by the Smart Vest People......to have Medicare pay for it.

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skhill
Member

USA
230 Posts

Posted - Feb 23 2019 :  1:21:26 PM  Show Profile  Reply with Quote
UPDATE: I am doing so much better. Did not have to nebulize at all yesterday and so far today I have not either. I have more energy today than what I have had in about 4 weeks. Not on an antibiotic right now either. I have been taking myself off of 02 periodically to see how I do and can breathe pretty well for a couple of hours without it. My sats stay around 92 without it. When I start feeling a little SOB I use the 02 on 1.5 and my sats are around 96-97. I feel a lot better when they are those numbers of course. Again I thank all of you for all your input and advice and replies. This was my first real exacerbation and it really was scary. I had no idea my sats could get down in the low 70's. I just hope it is a long time if ever that I feel like that again. I do my best to stay away from sick people but when someone you live with gets sick well I dodged the sickness for years but not this time. I am so ready for spring although it brings allergy issues for me then too. Wondering what happened to my other thread about me coming home on 02 now?
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sslei
Member

163 Posts

Posted - Feb 23 2019 :  4:33:54 PM  Show Profile  Reply with Quote
SK Hill Your other info is at the bottom under forums It says coming Home. I am on a Trilogy machine
Sandy L.
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