Cough advice please.

[mickmac]

Hi everyone

I'm back looking for peoples advice and experiences again. This afternoon I had problems with excessive coughing. It started with some gentle enough coughing but continued to get worse for a while. I noticed that the saliva was thicker than normal and I could not quite get it to clear. It was stringy and I couldn't get it completely up which is terribly frustrating. The coughing fits lasted about three hours but at the end I managed to get one good cough which was nearly like throwing up and suddenly I felt fine. My chest was free and felt clear.

This happens on and off. The last time it happened was last Wednesday and I can go a week or two with no real problems except a little bit of coughing that might last five minutes or there abouts.

What are other peoples experiences with it. Do any foods or drinks bring on excess coughing. I'm trying breath stacking at the moment and it helps me clear my throat. Also I have a nebuliser which some times helps. I've heard of cough assist machines and certain medications that reduce the amount of saliva you produce.

I'm not sure of any of these as the problem only occurs intermittently and I don't want to add more machines and tablets to the regime unless needed. But it could be heading that way. I'm up in the mnd clinic next week and I will be talking to the palliative care nurse later this week but I wanted peoples opinions first.

Mick.

[Ellie]

You don’t need to reduce your saliva production Mick, unless it causes you to drool. Reducing saliva production often makes for thicker secretions (mucus) which would make your problem even worse.

You need to try to keep your mucus as thin as possible, so it doesn’t accumulate in your throat and cause irritation / coughing fits.

Some ways to keep your mucus thin (not stringy) are; make sure you get a good lot of water, about 2000ml per day; take pineapple or papaya juice (through feeding tube is fine); keep using your nebuliser on a regular basis.

Some people find certain foods, especially dairy, does increase mucus production, but only you’d be able to know which, if any foods, affect you.

Do you use an LVR bag (modified Ambu-bag) to do your breath stacking? If the names don’t ring a bell, this is what I’m talking about:

AmbuBag.jpg


If all else fails, carbocisteine is probably most widely prescribed as a thinning agent for mucus. Chesty cough syrups containing guaifenesin are also good for occasional use.

It’s good you’re going to your clinic next week, as they can examine you in person and give you the best advice.

I know a Cough Assist is yet another piece of equipment in your house, but if it helps you, it must be worth considering? I imagine you were exhausted after a 3-hour coughing marathon…

Love Ellie.

[Terry]

Hi mick,

Good that you have enough strength to cough for so long. I get the same sort of thing when I have a virus and when in bed laying down it can be really bad. The only way I can then get rid of the stuff is by laying on my side with some tissues under my mouth.

Nothing else to add.

Love Terry

[mickmac]

Hi Guys

Thanks for getting back to me. I do use the modified bag for the breath stacking and I have a prescription for exputex. I have never figured out when to take the exputex. Take it every day or just when I'm having problems with the saliva. Will check with the team and see what they think. I'll also try and increase the amount of water I drink.

Mick.

[Ellie]

Mick, the Exputex contains carbocisteine, which thins out the mucus, making it easier to cough up. So you should at least take it as directed when you have that thick, sticky phlegm causing you problems.

You've no excuse now not to take lots of water - between your feeding tube and your catheter, you're sorted

Hope your clinic visit goes as well as possible.

Love Ellie.

[mickmac]

That's true Ellie. Will try and follow the instructions.