I Like to MOVE IT, MOVE IT... Mucus Clearance Part 1

This week I am talking about a subject that may be a little uncomfortable to discuss, but is an integral part of lung health for many people with a lung condition. Whether you have COPD, chronic bronchitis, Bronchiectasis, MAC or interstitial lung disease you need to know how to manage and clear mucus from your lungs. If we let mucus collect in the airways it can cause patients to have more shortness of breath (because it is taking up space where air could go) and/or cause a severe infection. Mucus clearance comes in so many forms that after writing this blog, and looking at all the information, I’ve decided to break it up into 2 separate parts. It’s a lot of information and my goal is to inform and help each of you so overwhelming you with a TON of info is counterproductive to that. So we will just take it step by step and discuss mucus clearance one category at a time.

So let’s begin with coughs. It is hard to clear mucus from your lungs without a proper cough so I think it’s a great place to begin when it comes to mucus clearance. Did you know that there are several different ways to cough? That’s right… we respiratory therapists get trained on how to coach patients to cough. (I’m sure you feel like by now you have heard everything!) Here are a few of the ways we direct or teach patients to cough and effectively move mucus out of their lungs:

1. Deep Coughing – Sounds simple enough doesn’t it? The patient is instructed to take a very large breath in and hold their breath 2-3 seconds. Then with their stomach muscles aiding them, forcefully expel the air in their lungs. Why is this supposed to work? Well, the thought process is that if we take a very large breath in, that air will try and sneak around the mucus, get behind it and help to push the mucus out when forced out of the lungs.

2. Huff Coughing – You take a large breath in and using your stomach muscles perform a series of 3 rapid exhalations making a “hu, hu, hu” sound. (Some folks say you should make a “ha, ha, ha” sound but it really needs to be more guttural, squeezing your abs in.) Follow this with some deep breathing and perhaps a deep cough to help clear any mucus that you may have moved or “shaken loose".

3. Splinting – Splinting actually helps patients that are experiencing pain in their chest coughing to help them get a more effective cough. We use this method for people that have had recent thoracic surgery, have broken a rib, or may just generally feel their chest wall feels “unstable.” You can use a pillow or a large stuffed animal (definitely have a few of those lying around my children’s rooms) hold it up to your chest and squeeze it with your arms close to your chest as you cough.

Okay! Now that I have covered coughing… let’s get down to discussing some natural and/or homeopathic things that you can take to either reduce mucus production or thin mucus to make it easier to clear it out of your lungs.

1. Water – You all knew I was going there! During patient assessments in pulmonary rehab, I find 9 times out of 10 that my patients are not drinking enough water. Staying hydrated will help thin mucus and allow you mobilize it easier.

2. Hot beverages – if water isn’t working for you or you plain aren’t a fan… try drinking hot beverages like tea (preferably decaff), cider, or broths. These beverages may help with thinning mucus, relieve a sore throat, and quash a nagging cough.

3. Steam – Although many lung patients don’t tolerate high humidity well, the steam from a shower/bath or vaporizer may help to loosen thick mucus. You can also try a cool mist humidifier if you are worried about mold and mildew growth in a heated vaporizer. (I do admit that they are hard to keep clean.)

4. Essential oils – I would love to write a whole article on essential oils (and I just might) because when I am researching for the blog, I see SO much written about their health benefits. Some of the things that I found out are that there are essential oils that are said to loosen mucus and some that may help to stop infections from occurring. Here is a list of essential oils that are said to help with mucus clearance

· Eucalyptus

· Cinnamon bark

· Peppermint

· Basil

· Lemongrass

· Tea tree

· Oregano

· Thyme

· Rosemary

Do your research before trying essential oils. If using on your skin, test a very small amount to make sure you don’t have a reaction. Essential oils are also used in vaporizers, but be sure that you aren’t sensitive to their fragrances. Many people with lung conditions have very reactive airways that can react negatively to the fragrance of the essential oil. If you do decide to use them stick to their manufacturers recommendations for quantity and know where to use them so that you can get the most out of their efficacy. In talking to a few friends and several of my patients, they swear by them and use them daily for all sorts of purposes.

5. Saltwater – a simple salt water gargle can help to thin and remove mucus in the back of the throat. (Do not drink this solution. I figured this was a given but I felt as though it was worth mentioning.)

6. Spices – There are some spices that are said to help thin mucus and lessen a cough… Try garlic, lemon, and ginger. Turmeric has a compound in it called curcumin that helps you to mobilize mucus (you only need a pinch to gargle in warm water).

7. Supplements – Often supplements are not tested, however just like spices many people believe that if they add Echinacea, ginseng, zinc and licorice root to their diets that it may help to clear and prevent mucus.

8. Honey – is said to have antiviral and antibacterial properties helping you to fight infections associated with mucus congestion.

9. Raw Organic Unfiltered Apple Cider Vinegar – Yes, everything I have read says that it must be all of these. It should help thin mucus making it easier to mobilize and cough up. Add 2 tsp to one cup of warm water.

10. Black Elderberry – has anti-inflammatory and antioxidant qualities. It is used frequently to soothe and shrink swollen mucus membranes and fight off infections. It can come in liquid or capsule form.

11. Foods that have a high water content – Eat your fruits and vegetables. One of the key ways that I have mentioned is upping your water intake. One way you can do that is to increase your fluid intake via the food you eat as well. Eat lots of broth based soups. Vegetables like cucumber, celery, peppers, and tomatoes are loaded with vitamins, minerals and WATER. Fruits like watermelon, berries, apples, oranges have a ton of water and vitamins so feed your body what it will need to not only get rid of the mucus but to fight any infections that might occur.

Over the counter products that have worked for my patients

1. Mucinex – You can ask any of my patients, the first thing I say after hearing chest congestion is “You should start taking Mucinex.” I don’t know why but it’s my “go to” for chest congestion. There are a couple of things that you need to remember when taking Mucinex and one is you MUST drink a ton of water for it to work at its best. I also recommend the plain Mucinex for chest congestion alone. Mucinex DM has a cough suppressant in it and my goal in using this "stuff" is to get the congestion out. Taking a suppressant will in truth suppress your cough, making it difficult to get congestion that has already accumulated out of your lungs. So remember… Mucinex… not Mucinex DM for congestion that has already occurred. As always, call you doctor to make sure you have his endorsement to try this medication prior to taking it.

2. Robitussin – Again this a great expectorant to use (and the active ingredient guaifenesin is the same one as in Mucinex) but it has been hard for me to find it in the store with only guaifenesin and not the cough suppressant. This medication probably would have tied as my number one recommendation for expectorants but most of the stores I visit have Robitussin products that are “dual purpose.”

3. N-acetylcysteine – This clever little compound has so many uses in medicine that it probably deserves its own blog post, however, lung patients get mucus thinning relief when taking it orally. It is available over the counter in supplement form but doctors can also write a prescription for it as well. Make sure you check with your doctor before taking it to get their input on whether it might work for you and their recommended dosing.

That's all for now, but I'm super excited for Part 2! Next week I will be discussing different options for prescription medicines for mucus clearance as well as devices that you might be interested in that can help with mucus clearance. Stay tuned!

Thanks for reading!

Remember: We are in this TOGETHER!

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:) Christina

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