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Old 09-08-2008, 09:30 AM   #1
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Chronic asthma and green phlegm; help!

I had exercise induced asthma when I was a kid, and a couple of bad bouts of bronchitis. Also seemed to have issues with my sinuses once in a while, but nothing more than that. Then it seemed to go away. Now, I'm 37, and through all these years, up until I was 35 , I had no asthma issues that I knew of. Then i started sneezing all the time. Constant sneezing, which I began to see my Dr. about. Progressed to asthma, sinus infections, then for the last year, green phlegm from my nose and lungs, constant wheezing, etc. I've been on Advair for a year, and a rescue inhaler. Mostly, I just put up with the wheezing and use the Advair. Simply cannot exercise like I used to. Even when I'm "clear" if I try to run, I tighten up. My question: this green phlegm, very thick in the morning in my nose and in my lungs throughout the day, what could it be? I've been treated with several antibiotics, over and over again. It's been a year. What are the consequences of this? I have decided to see new doctors. What's your advice on how to start? THANKS so much for your help.

Last edited by marketp; 09-08-2008 at 09:31 AM.

 
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Old 09-08-2008, 02:47 PM   #2
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Re: Chronic asthma and green phlegm; help!

Have you been treated for acid reflux?

Acid reflux is a very common trigger of asthma that doesn't usually respond to medications like Advair and can cause wheezing and sinus symptoms. It's fairly common for people with acid-reflux to notice that their symptoms are worse in the morning (because the acid is worse when you're lying down). I'd recommend that you try PrilosecOTC for a couple of weeks to see if your symptoms improve - if they do, you should get on a regular treatment plan for acid reflux.

 
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Old 09-08-2008, 10:19 PM   #3
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Re: Chronic asthma and green phlegm; help!

Thanks for the reply. How does that account for my sinuses being full of green puss, and my lungs crackling and me spitting out stringy green mucos? I'm open to any advice, but it seems that possibly I may have something else wrong. Any advice?

 
Old 09-09-2008, 05:34 AM   #4
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Re: Chronic asthma and green phlegm; help!

Quote:
How does that account for my sinuses being full of green puss, and my lungs crackling and me spitting out stringy green mucos?
Over the last 5 years researchers have identified a connection between GERD (and a more serious form of acid reflux called Laryngopharyngeal Reflux) and both asthma and chronic sinusitis. The upper and lower respiratory systems (sinuses and lungs) are very closely linked and acid reflux can create irritation in the lungs and lower respiratory system that radiates up into the sinuses. Your body's natural response to the irritation is inflammation and the creation of additional mucus to try and protect those irritated tissues, but the inflammation can keep the mucus from draining correctly, causing it to become discolored, and leading to asthma flare ups, wheezing and sinus infections.

There are three keys to getting the kinds of symptoms you mention under control:

1. Figure out what's causing your initial reactions and get those things under control - for most people it's either allergies or acid reflux that causes the initial inflammation so you probably need to be taking a daily antihistamine and something to control acid reflux.

2. Reduce the inflammation that the triggers have caused so that the tissues in your lungs and sinuses can start to function normally again. Usually this requires antibiotics (which it sounds like you've tried) and possibly a short course of oral steroids.

3. Have an ongoing management plan to keep those tissues healthy and functioning correctly. Usually this includes ongoing anti-inflammatory sprays for the lungs and sinuses, saline nasal irrigation to keep mucus from building up in the sinuses, and ongoing treatment of the allergies and acid reflux.

Unfortunately there's no real silver bullet for this stuff, it requires a lot of trial and error and really good medical support because the causes are complicated and often take multiple adjustments to medication to get them under control.

 
Old 09-09-2008, 09:48 PM   #5
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Re: Chronic asthma and green phlegm; help!

Cgsmith's advice is really good. I have found that for me there has been a HUGE connection between sinus infections/ allergies/ asthma and reflux. Anytime one flares up, it throws at least one of the others off too. I usually end up needing to have extra treatment for more than one at a time. I also have a daily treatment regimine for all as well.

 
Old 09-09-2008, 10:18 PM   #6
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Re: Chronic asthma and green phlegm; help!

Ok, well thanks for the advice. I'm going to try to work with new doctors and get this handled.

Couple more questions:

One, what kind of a doctor should I start with? My primary care, or go straight to a pulmonologist?

Two, does anyone know how long it takes for the inflammation in the lungs to turn to something worse, like COPD? I'm concerned that I might be doing permanent damage to my lungs.

Thanks.

JW

 
Old 09-10-2008, 05:23 AM   #7
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Re: Chronic asthma and green phlegm; help!

Since you've been battling this for quite a while it's probably time to see a Pulmonologist and an Ear, Nose & Throat specialist (Otolaryngologist). You should probably start with the Pulmonologist (who may also want you to see an allergist).

As for your COPD question, if you're not a smoker and aren't exposed to other environmental/chemical irritants that cause permanent lung damage, the likelihood that you have COPD at your age is very low. One of the defining characteristics of asthma is that it is reversible (while COPD is not) and there are lots of asthma sufferers who live with it for decades without any type of permanent damage, so I wouldn't worry about that. Just see a pulmonologist and get this thing sorted out.

 
Old 09-11-2008, 10:09 AM   #8
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Re: Chronic asthma and green phlegm; help!

Thanks for the kind replies. Another question: in '05 i got pneumonia pretty bad, and when I went to the doctor, on xray, I was told I have "markings" in my lungs. He asked if I worked around dust at any time, which I kind of did, because my house was under construction for quite some time, where drywall dust was everywhere. Can that result in something bad, years later? I'm sure I was exposed to a LOT of dust, it was everywhere. Thanks.

 
Old 09-11-2008, 10:06 PM   #9
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Re: Chronic asthma and green phlegm; help!

Green phlegm is infection for sure. Any kind of drainage that is not clear is a sign of infection. As for your asthma it sounds like you are simply not on the best kind to control the symptoms. There are many asthma medications and sometimes they have to try something different. My dgt. was on a daily treatment and though she didn't get worse (that is to say she would still have bouts of bronchitis and the asthma symptoms)it wasn't working like it should have been and the doctor said she was immune to the inhaled med so we had to change to something else. When we first got sent to a specialist they did allergy testing and put her on medications for that and gave her a rescue inhaler as well as routine meds to use everyday. Before they ever sent us to a specialist (I couldn't believe how many episodes of bronchitis my dgt. had to go through before they ever decided she needed a specialist!)It always started off the same way: runny nose/congestion in her chest/coughing and then the shortness of breath. Finally the doctor we saw
routinely decided she needed a specialist and from there my dgt. made really
significant improvements and her asthma today is still well controlled.

 
Old 09-11-2008, 10:17 PM   #10
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Re: Chronic asthma and green phlegm; help!

I am working with my PCP, ENT (who is also connected with an allergy clinic to treat my allergies), a Pulmonologist and a Gastroenterologist to get my coughing under control.

I often end up with one thing flaring up another. For example, when I get a sinus infection, my asthma flares. When my reflux is bad, my asthma cough is bad. When the allergies get bad, I get sinus infections then have asthma problems. Infections typically flare up my asthma so I am often treated with an antibiotic and a round of steriods together or back-to-back. Treating all together helps me get things under control better.

I make sure my medical reports are shared with all of the doctors treating me so that my care is coordinated.

 
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