So....... how do you provide a sputum sample when you've nothing to cough up?

[SeasideSusie]

A bit of a story, and I've mentioned before that my GP surgery isn't the best but there's no alternative and I endeavour to see my own GP if I can who is about the best one there.

I received my diagnosis of COPD in March, had a few appointments with the nurse whilst trying to find the best inhaler, etc. In May I had the pneumonia jab. Nurse said she wanted to test for infection first but took my word that I was fine and gave it to me, but also wanted a sample sent off just to make sure everything was OK.

I've had a mucousy cough for years and when I had my diagnosis I just thought this cough was part and parcel of COPD.

I received a phone call to say I had an infection (can't remember the name but began with an H) and a prescription for antibiotics would be sent to the pharmacy and I could pick it up the next day, then take another sample in after I'd finished them.

I took Amoxycillin for 7 days, lo and behold my mucousy cough disappeared. There was nothing left but by some miracle I did manage another sample a couple of weeks later. I took it into the surgery and thought that if necessary they would contact me as before. I heard nothing.

I saw the nurse last week to see how I was going since a change of inhaler and she said "I see you've had two lots of antibiotics". "No", I said, just the one, "I did send a second sample in but haven't heard anything so assumed everything was OK".

Let's just say that apparently one of the doctors saw the second test, somehow it appears that the results either got overlooked or the doctor thought that because I'd had one course of antibiotics then that was going to clear up the little bit of infection that the test result showed was left.

So the nurse said she wanted the test repeated. I said I had nothing to cough up but if and when there was something I'd send it in.

One week later and the surgery rings me and tells me "The doctor has asked you to repeat your sputum test". I said this had been discussed with the nurse last week and that I have nothing to cough up but if I could do one I'd send it in.

So now I have a problem. Apparently there is still some infection, it's not causing me any problems, there is no mucous, I am not coughing, rattling, wheezing or anything. I can't have any more antibiotics until a new test has been done to confirm that it's still there (as the second test showed). And they want a sample.

So................. how do I give them a sputum sample?????????

Just in case it's not coming across, I am rather exasperated with my surgery!

[Hidden]

Seaside susie, I am sorry I cant advise you, but I have had this problem, too. Sometimes, you get sputum if you sneeze. But you cant make yourself sneeze. There is possibly is a way of breathing that might bring sputum up. Have to wait and see if anybody else can come up with something.

[Airhunter]

I have the same problem I have been asked to send in a sample but I don't produce any mucus nor do I have a cough....I was a bit wheezy around six weeks ago and had some stringy mucus in the back of my throat from my nose on one occasion but not enough to cause me to cough it just cleared up

[Toci]

I am another mucous free zone. I have a dry cough sometimes but only have any mucous when I have a cold (like 'normal' people). The problem I think is linked to the term used, COPD, which incorporates chronic bronchitis (lots of mucous) with emphysema (some can be mucous free) and so nurses just assume we can supply at will. In fact, I have been told I am "odd" because I don't produce huge amounts of mucous - well, it seems I am not the only oddity! x

[SeasideSusie in reply to Toci]

At my appointment with the nurse, she said she was thrilled that my mucousy cough had cleared up with the antibiotics, then got confused because it seems as though I should have had a second course following the second test. We sorted that by me telling her I hadn't been contacted following the second test and I hadn't had a second course so she said there was still some infection showing there with the second test. When she asked me to bring another sample in I explained that I'd got absolutely nothing to cough up yet she said nothing else and then I get this phone call saying the doctor had asked for a repeat so again I explained to the receptionist that I've got nothing to cough up and again nothing was said. I just told her I'd bring one in if ever I had anything to cough up.

Of course the answer is to give a second course of antibiotics which should finish off the remaining infection but they wont do that because the second test was done a couple of weeks ago. So I suppose it will sit in my lungs doing what infections do best until I get rattly and mucousy again sometime in the future. Not sure what goes through their minds but it's taught me to ring up and ask what the results are from any test I have to do in the future.............. could really do with a rolling eyes smiley :).

[Hidden in reply to Toci]

I have NEVER managed to supply any sputum for testing. No matter how bad my chest is - infection or no infection - I just can't cough anything up!!!

It is about 15 years since I was diagnosed with COPD (Emphysema in my case).

[Hidden in reply to Toci]

me too Toci, was diagnosed 5 years ago with Emphysema, I have no cough and no mucous. Hope I never have to give a sample................

[Hidden]

Hi SeasideSusie I have the same problem with providing a sputum sample but after contacting the BLF,( thanks to TOCI), I was told to request Mucodyne from my doctor as this thins the mucous and makes it easier to cough it up. It might be worth trying.

Good Luck

[SeasideSusie in reply to Hidden]

But there's no mucous at all, absolutely nothing, which is what I've told them. I have no dry cough, no chesty cough, no rattling or wheezing, nothing.

[Hidden in reply to SeasideSusie]

Sorry I got a bit confused Susie, I thought you said above you've had a mucus cough for years which you thought was part of COPD.

If you don't have that any longer my guess is you could just disregard what I have said below.

[SeasideSusie in reply to Hidden]

Yes I did say that in my original post, also that after the 7 day course of Amoxycillin it disappeared and there was nothing left.

[Hidden in reply to SeasideSusie]

Well I guess the answer to your question is you don't or you can't but I guess you knew that already

[SeasideSusie in reply to Hidden]

Yes, a bit of a rhetorical question really. I'd just got to the "banging my head against the wall" stage with my surgery. To say at best they're fairly useless is an understatement, a very common opinion where I live.

[Hidden in reply to Hidden]

Mucodyne will only work if there is any mucous to cough up though.

[Toci in reply to Hidden]

THAT is what I am trying to get through to my GP!

[Hidden in reply to Toci]

Sometimes we have to work extremely hard to get our thoughts and opinions through to our GP.

My GP is great, but if I am unable to see her, some of the others in the Practise are not so good as a listener.

[Hidden]

I am wondering if any one has shown you huffing? is the technique used to help you bring up mucus. Also you need to drink plenty of water to help keep the mucus fluid thus easier to cough up, your doctor may also be able to prescribe or recommend something to help keep the mucus fluid.

The respiratory nurse may be able to show your the huffing method if not your doctor should be able to refer you to the physiotherapist concerning this. there are other methods which I won't go into here but mostly all of these are part of a pulmonary rehabilitation course at least they were when I attended one way back. If you've not already attended a PR course ask your GP for a referral to that too.

Hope this information is of some help.

BC x

[SeasideSusie in reply to Hidden]

As mentioned above, there is no mucous, nothing, so nothing to bring up. I already do drink a fair amount of water every day. I mentioned a PR course to the nurse on my first appointment with her back in March but the hospital where it's done is 60 miles away so it's a no go.

[Hidden in reply to SeasideSusie]

sorry I replied to your reply to oldwheezer.

[knitter]

I agree with BC above. Huffing can be good, and a physiotherapist showed me some techniques to use try and shift any lingering mucus.

[SeasideSusie in reply to knitter]

But I don't have any mucous to shift as explained above.

[Toci in reply to SeasideSusie]

I get it. I am in the same place. But others will keep on trying to tell you how to bring up what does not exist.

[ptliverpool]

Just want to agree with SeasideSusie that we are all different. I have NEVER had any mucus

and only cough when I have a cold or chest infection like any one else but have still been diagnosed with COPD and Bronchiectasis. It's all to do with whats on the scan and breathlesness so they tell me. But I do sympathise as I can't tell if I have any infection either until I feel really ill and have temperature etc.I wonder what further damage an undiagnosed infection will cause to my lungs.I am sensing that that is worrying you too.

Keep smiling thats all we can do.

PT