I picked up a chest infection at my mothers a week ago, despite having a N95 on and opening the windows. I was subsequently prescribed antibiotics for a productive green cough. A few days later I start to cough up little threads of fresh blood in the sputum first thing in the morning. One week later this has developed into a little more fresh blood, if I had to quantify this, I would say no more than a pea. I only have about 6 light coughs first thing in the morning, after that my chest is just clear of mucus and blood for the rest of the day.
I have discussed with the Heam team at the hospital. A blood test performed is unremarkable (whites 6, platelets 130, CRP 43 which is to be expected).
I am on Ibrutinib and have contemplated discontinuing this for a few days (not discussed with my Heam team). I had a similar episode of this some 5 years ago and that was one of the actions.
So upon arising in the morning, I can hear a little rattle on my chest on the final part of an outward breath. I have only light coughing about 6 times with blood in the mucus. For the rest of the day I don’t cough.
Any thoughts?
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RobertCLL
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Since people who are getting surgery have to stop the BTK's because of potential bleeding issues, I wonder if your coughing is hard enough to cause a similar problem. Some of your lung tissue is infected/damaged, and I can see where the damaged tissue might bleed at the edges where damaged meets normal.
FWIW, my platelets run around 100 and when I last had a respiratory illness I could "taste blood". But my lungs were clear, I had no mucus so I wasn't coughing it up.
I would think your Haem team would possibly have you hold the medicine until the coughing resolves. Having an open wound area where blood is escaping, with active infection nearby, isn't ideal.
SofiaDeo. Yes I have held the Ibrutinib today and will access maters in the morning. It's funny that it's only in the morning that I cough and also bring up the blood. Friday is my next assessment with the Heam Team.
Sounds like you are on the "healthier" side of ill to me. Remember we lie down overnight, and our lung cilia have a different gravity pull to deal with compared to upright, which is where we are most of the time. It's possible there is a certain amount of mucus "pooling/getting stuck" instead of being cleared normally. You cough it up in the AM when you are upright and cilia are working normally. Perhaps increasing your hydration, if not contraindicated, will help with this, to thin out the mucus in your lungs. If it's not really detrimental to get awakened in the night to go to the bathroom, perhaps really pushing fluids for a few days will get you over this hurdle much quicker.
Hi Robert, I read your post with interest. I take Acalabrutinib and I am very well on it.
I too have what I call my morning cough and a little bit of clear mucus. I mentioned this to my friend, a retired oncology CNS. She said that it was most likely reflux which drained back onto my chest during the night. Like you, after my morning spluttering, I am fine all day.
However, if you have blood there, it does need investigation. Good luck, stay safe.
It will take a few days for the "antiplatelet" effect to stop. I think the preop recommendations are 3 days before procedure? And really, really push the liquids. The thinner the mucus, the more easily your lung cilia will drain it into your stomach, even lying down. The only other thing you might do, is make sure the humdity is at least 30% since the heating is on. Very high humidity can also affect breathing, some folk need to bring it down lower than 60%. My understanding is that ideal humidity is 30-50%.
get, use an "Acapella" device, about 30 dollars on amazon, breathing into it sets up a chest vibration which loosens mucus. not new knowledge, has been done by physiotherapists for years, but they do not have the time.
-get an IMST device, breathing against pressure, strengthens the chest muscles, opens tiny air sacs( bronchioles). also side benefit of reducing blood pressure. On Amaxon for 10 or so dollars.
-hydration, helps to keep mucus thin, otherwise it is thick, sets like glue.
-proper humidity in air, winter tends to be too low. sweet spot 40-60,%, humidity. too low damages airway epithelium. too humid encourages fungi and other pathogens in air.
-Breathe exclusively through nose, not mouth.
-Suggest reading Nestors book" breath".
-If you have a CPAP machine use it, keep it very clean.
I second some of the above recommendations, especially the comment about humidity: heaters reduce the humidity in a home. And on Amazon you can find a good variety of cool mist (or dual mist) humidifiers. You can also pour boiling water into a bowl and lean over it (with your head covered in a towel) and breathe the warm steamy air in.
However, you commented above, I think, about feeling rattling in your chest this morning. Rattling needs investigated. And the blood in your mucus is disconcerting. You might have a small wound from all the coughing. Do please consider discussing this issue with your GP, in addition to your Hematologist.
We are still at the end of autumn in the UK, so the air is still a little damp. house is at 52% RH so not to dry. The Heam team are still keeping an eye on my. Must try tomorrow morning not to cough too hard.
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How long should a course of antibiotics be?
I was diagnosed with CLL in 2009 - still on w & w. 
Chest xray
Another CLL ‘wobble’, seems like I’m ‘losing it’ slightly.
