Mucus

[nebrhahe53]

I've been having a terrible time with mucus and breathing.
I use BiPAP at night, by morning I can barely breathe my nose is so shut down. While using flonase helps somewhat, I can never seem to get rid of mucus. I have tried Mucinex, drinking more, the 2nd gen antihistimines, and my cough assist machine. No matter how much I use the cough assist, more mucus always comes up. i can see food stuck in it, and often this tickles my throat and I spend all day coughing. Its becoming exhausting.
Does anyone have any help to give?

Also a question about medical MJ. I was proscribed the pill with THC as the active ingredient-this is legal in all 50 states. My question is does it hurt or help sleep. I'm a bit afraid to take it before bedtime. How about breathing? Thanks.

 

[Graybeard]

Read wiki about phlegm. The more you cough, the more you make.

Weed has 483 compounds. THC or CBD alone don't seem to have the desired effect. Can't hurt, though.

 

[Vincent]

In answer to your second question, I tended to stay away from marijuana because it just made me sleepy. Not much fun at parties. My issue with mucous seemed related to reflux. Not sure that's your case but worth looking into.
Vincent

 

[gooseberry]

Neil is it allergy season there too? Its crazy here in FL. I use a nasal spray called dymista. It is flonase with an antihistamine. it really helps keep things under control for me. Steve has been on singulair for a year now and that has helped tremendously if its an allergy issue.

 

[Graybeard]

Have you tried adjusting the humidifier on your bipap?

 

[nebrhahe53]

yes ive adjusted humidity nothing seems to help. Also if coughing just causes more mucus, whats the point of the cough assist machine. they should just cause more problems right?

 

[Graybeard]

I use my machine only when I can't get a piece up.

 

[lgelb]

Re Marinol, Neil, esp. if you are an antidepressant, which I think you are, it is more likely to cause drowsiness than not. It is the effects on mood, etc. that have to be monitored most, as it is a psychoactive so can exacerbate depression, so I would take it when convenient, but I don't think its pharmacokinetics when used w/ a tube have been studied (not sure if you are still swallowing?), so I would be cautious on dosing...starting at the lowest possible, as I'm sure your doc suggested.

Re mucus, it is true that coughing begets coughing, so breaking the cycle is the goal. Getting too dry esp. with decongestants is always a risk since you don't want to coat the airway. I would think about liquid intake, humidity when not on the BiPAP (can't remember how much you use it), and avoiding food/liquid triggers like spices, whatever sets you off.

But you say the issue is waking with a stuffed nose. Does the stuffiness continue after you get up or break up at some point? What kind of mask are you using? A switch might help. You are using only distilled water in the machine?

 

[GregK]

Neil if you're seeing food in your sputum it means you're aspirating food, which ain't good. And may explain the excess mucus.
If you're already received a feeding tube perhaps use it more. If not, maybe it's time...?

I had a bad week or two with excess mucus. My house is being modified and is full of plaster dust and the nasty stuff from under the carpet. Now that work is winding down the problem has improved. Do you have any dust or allergen issues? Might a large HEPA air cleaner help?

The Marinol (synthetic THC) should help with sleep, but like Laurie said, start cautiously. No one of my docs expressed any concerns about my usage. The supposed benefits of thc can be found here.

A question for you: what was the Marinol Rx'd for?

 

[nebrhahe53]

greg Id like to respond now but I took one about 2 hrs ago so not sure I can trust my answer. Will let you know assuming I can even remember

 

[lgelb]

Oh, yeah, one more BiPAP thing in addition to water, mask, nasal steroid -- maybe time to change the filter? And for everyone, look at the machine filter more frequently in winter, because any central or radiator heat pushes more junk into the air the machine is drawing from -- and pushing back into your nose. That's why I push the heated mattress pad.

Once the mucus is there, a baby aspirator following some kind of spray (alternated steroid/Nasalcrom/saline for different isotonic properties) is the only thing that touched Larry's. No systemic med ever did.

 

[ECpara]

My husband is pretty much married to his suction machine. He gets up in the middle of the night coughing and gagging on phlegm, and all day long he is hacking it up the best he can, which is difficult considering he doesn't have a cough due to a failing diaphragm. Which leads me to an explanation. I read that as CO2 levels increase, the cilia lining the lungs becomes paralyzed (just like a smoker's cough). The lungs can no longer move the natural production of mucus that lines the lungs, and voila, we now have the phlegm problem.

 

[nebrhahe53]

isnt there a way to reduce the CO2 level in your blood like hyper ventilating?

 

[lgelb]

Ad hoc hyperventilation isn't going to be something you can sustain consistently enough to make a difference, and your trying it expends more energy.

But that is why as CO2 buildup begins, it is sometimes recommended to increase your RR (breaths per minute), so in effect you are hyperventilating for your level of function -- exhaling more often than you would without it. Your optimal RR could be anywhere from 8-20. If someone set it based on five minutes of observation six months ago, it may not work as well today.

You can try decreasing your Ti max so you don't air-trap, upping your backup rate if it's being triggered, and/or increasing the trigger/cycle sensitivity for quicker transition to the next breath (trigger) and/or quicker transition from breathing in to breathing out (cycle, if your machine has this setting). Those are the things that would be expected to accumulate less/expel more CO2. Of course, as with any setting tweaks, if any of this makes you lightheaded or feeling the train is going too fast, you tweak back down until things are comfortable.

Depending on individual circumstances, tweaking EPAP up or down may also help. If EPAP is too low, the airway could collapse when you breathe out, decreasing the outflow of CO2. If it's too high, you may be breathing out against too much resistance to exhale as well as you could otherwise.

 

[Graybeard]

Sure wish I had you here to adjust my machines, Laurie.