Unusual Coughing?

[1wombat]

My wife has bronchiectasis and has been coughing a lot. I have been wondering if her coughing is solely due to her bronchiectasis or whether something else is involved. She sets aside periods during the day when she coughs up excess phlegm and I am very familiar with this, but there are other times when she coughs up unexpectedly and very strongly and I am puzzled about this and how it can be softened. For example, I may begin a conversation with her and she will seem quiet and relaxed, respond with a couple of sentences, but then suddenly put her hand to the base of her throat and cough intensely for a while but with not that much phlegm. I ask her what is happening and she says she felt an intense itch in the area between the base of her throat to the top of her chest about midpoint on her body and this caused her to cough. I've also seen her nostril twitch as this happens. Has anyone else experienced this and know how to soften or control it?

Thanks very much

[peege]

Hi, more members with bronchiectasis will, reply soon I'm sure. I can only suggest that:

*If the mucus is yellow to green she may have an infection & needs to see GP

*Perhaps twice a day is inadequate for the expelling her mucus regime

*That she needs a lung mucylotic to soften mucus (if she's not already prescribed one). Many of us in UK take prescribed Carbocysteine. Recently more people are being prescribed N-Acetyline Cystiene (because its cheaper? or patient cant tolerate Carbocysteine? ) in England we can buy NAC over the counter however, of course she would need to see a GP foradvice.

*perhaps drinking more fluid would help to soften

*if she uses inhalers perhaps they are no longer adequate so need tweaking, again, GP or respiratory nurse advice

Edit: I removed my suggestion of NAC. Littlepom is our go to ☆ for bronchiectasis

[1wombat in reply to peege]

Thank you. There is no infection and she takes NAC and uses the flutter - I should have mentioned this. After submitting the question I did a long google search and came across the concept of "treatable traits of bronchiectasis" and "Bronchiectasis and cough: An old relationship in need of renewed attention" (ncbi.nlm.nih.gov/pmc/articl... which I will be digging deeper into. Thanks again pegge.

[Hidden]

Hi 1wombat. I have had bronch all of my life and am now 71. It is crucial that your wife gets rid of all mucus fastidiously every day. Not just excess mucus. Any left behind can do one of two things.Sit in little warm pools allowing bacteria to grow which creates more mucus which will need to come out and cause a cough until it is expelled. This is an exacerbation and can make her very poorly.

Mucus left in the lungs works its way up and if something irtitates your wife's coughing mechanism and she coughs it will urgently need to come out.

NAC is not a treatment for bronchiectasis. Some people use carbocysteine to thin the mucus. I nebulise isotonic saline.

It is impossible for you to judge whether there is any infection there when there is more mucus than there should be after she has worked on getting rid of it.

The mucus needs to be tested to find out which bacteria is there and the appropriate antibiotic given in the right dose for at least 14 days if an exacerbation is causing it.

If it turns out not to be an exacerbation she needs to work on expelling the mucus more efficiently and maybe more times during the day.

I do hope that she had a bronchiectasis specialist. GPs and general respiratory consultants have very little knowledge of this complex condition. Unfortunately , my contacts with people in Australia who have bronch have indicated that these specialists are difficult to find there.

It is very good that you are supporting your wife in living with her bronch.

[1wombat in reply to Hidden]

Thank you, All you say is true and is not new to me. I am following up a small pattern I noticed in the hope it might lessen the harshness of her coughing. Her bronchiectasis was a result of a little known and not immediately recognised reaction to her monoclonal treatment for leukaemia (CLL). Oddly enough when this treatment was stopped her CLL didn't return and this has been the case for two years now.

[Hidden in reply to 1wombat]

Some drugs can cause hard coughing. I have had a harsh cough since I started beta blockers for my heart. Your poor wife has so much going on. It's very good that the CLL didn't come back. If her bronch in itself is stable maybe look at any drugs she takes in case they are making her cough.

[Lfcpremier]

Hi.. I've had Bronchiectasis 11yrs now & despite rigorous endeavour to expel it(carbocisteine & 7%saline) still cough up lots of phlegm.Awake all night cos of some virus or infection, half way through doxycycline but worse than ever.

Hard to stay positive at times. 😊👍

[asafoetida2020]

Hi wombat,Like everyone else replying to you I think the expelling of excess mucus is a must as is seeing your physician to talk things over.

In my case I inhale asafoetida oil vapour in the evening and as well as loosening mucus enables me to sleep well.

Does your wife do activities like gardening or bread making which can encourage the inhalation of a lot of dust or other irritants? If she does then wearing a mask could be helpful as would watering plants to be cut. Is she allergic to any plants or anything else which could bring on the coughing?

Hope she (and you) get her problem lessened.

[1wombat in reply to asafoetida2020]

My wife sees reputable cancer and respiratory specialists as well as her GP regularly and this is free under our national healthcare plan. She also has hospital insurance so hospital costs have been contained. I originally raised my question as I know medical discoveries happen all the time and the different disciplines we get advice from don't necessarily overlap or communicate or update. I was just trying to find more information. The information on internet is like a thick jungle and it is necessary to continually google questions from different perspectives to get new information. One example of this is the acupressure point STOM 40 that is used in TCM to control "tan" in the body, which includes mucous.