Coughing in the morning!

[Kathy57]

Hello all!

Well I feel the need to complain and commiserate with people who understand.  Every morning that I wake up I hesitate to get out of bed because I know that sooner or later (after arising) I will start to really cough. 

I'm bringing up thick yellow globs of phlegm.  (Yuck!! I said it). Pretty disgusting and tiresome.  I do not feel that I have any kind of infection.  I think this is part of my "new normal".  I sleep with a really good humidifier right next to my bed.  I sleep with my head elevated because if GERD.

I "think" that my "normal secretions" are no longer normal.  Everything is thick and sticky due to my chronic lack of moisture.  This even though I take the maximum dose of Evoxac three times daily.

Sometimes I use an albuterol treatment to help cough stuff up.  Once I get it all up, I'm good to go.  What is irksome is I know I'm going to have to go through this every morning.  During the summer months I had my windows open, and my neighbor admitted to me that she "heard me coughing up a lung" in the morning! 

I was embarrassed but what could I say.  I told her not to worry, as I was not contagious and not "sick".  I told her I have asthma and I have been diagnosed with asthma but I feel it is all related to Sjogrens and dryness.  I cough when I am dry.  Mornings are the worst.  It can last anywhere from 20 min to an hour to "clear things out".

Does anyone else have this issue?  I drink plenty of fluids.  Will this happen every single day from here on out?  Will it get better when the weather clears?

Will it get worse?  Ur really is debilitating.  I use a sinus saline rinse as soon as I get up to help humidify, but the coughing continues whether I do this or not.

Also if I become "dry" or if too much air is blowing in me I will have a dry irritating cough.  That's why I do everything I can think of to maintain moisture.  I even run my humidifier 24/7 now and I think it helps some.

In the past they have done several chest X-Rays and they are all "normal".  If u didn't know this you would think I have pneumonia! 

Most of the time I am alone in the morning so I don't bother anyone.  When I have guests it is hard to be "quiet".  My family understands.

Any thoughts or suggestions?  I wonder if my lungs/ sinuses are being permanently damaged,

thanks for letting me vent!

Kathy

[litliwlowa]

I ended up having to take 1 generic Mucinex every night (no decongestant, just the guaf - whatever that word is) to help thin out the mucus.

I wake up some mornings with a dry cough, not like what you describe.

I also mix in the morning 2 tbsp raw organic honey, 1 tbsp unfiltered organic apple cider vinegar and a glass of water. Gastro said once a day is okay. Also helps to thin out the mucus to keep it flowing.

SJS bites.

[cmclien]

I also get a dry cough.  Sometimes in the middle of the night I'll wake up coughing and choking almost, maybe from the dryness.

My son gets what you describe but he has asthma too so maybe its more of that than the sjs?  Not sure.  On the other hand, my nose is very dry, sometimes sore in the morning and I take mucinex-d twice a day at a half dose, I also use nasonex.  The sudafed part is of course drying but the stuffiness is horrible and I think after awhile the dryness from the sudafed part lessons. When I saw a EN&T doc he said my nose was very inflamed (and I don't have allergies) so the nasonex does help that.

[cccourt1942]

Hi Kathy,
      Gosh...what a long time to have this reaction.  I had it too..for less than a week.  It started immediately after diagnosis and beginning to take pilocarpine.  I was like you--what the???  I mean, I couldn't figure out where it was coming from.  My head (sinuses) felt clear....it felt like drainage, and it was thick...but not anymore so than if I'd had drainage from sinus infection.  The other thing was glop in my Eustachian tube.  I know this from the purous  otitis media in my left ear primarily consistently..in fact..today.
       But..back to the onset of mine, I visited my GP who laughed and told me it was my body becoming accustomed to mucous once again.  She told me to take Mucinex (as Litli said she does).  I had to take the Mucinex for less than a week.  Cough gone. 
      What is your Evoxac dosage?  I mean, are you fully (or possibly over) medicated for your oral dryness?  I can't figure out where that much phlegm could come from continuously!  For what??  over 6 months??  Is your Evoxac at 5 mg X 3 per day or 7.5 mg X 3 per day?  Personally I couldn't live with one mg less of pilocarpine per day.  It's just the only thing which could be causing you to produce phlegm.   I mean..the only thing since your dr. has ruled out pneumonia (lung) and I am presuming bronchitis too.  It's a puzzling ongoing mystery to me at least. 
       I think Litli's cocktail sounds promising.  If you try the mucinex, good luck.  If you don't, good luck at figuring out what the cause is.
   ccc

[Kathy57]

Thanks for all your suggestions!

To CCC: I take 30mg of Cevimeline (Evaxac) three times per day.  I wouldn't want to decrease this at all cause my life is bearable with it and I still feel too dry even with taking it regularly. Without it I am so uncomfortable and I can't chew my food.

I went out and bought some mucinex, raw honey, and raw Apple cider vinegar and will try this.  It's funny cause I thought the phlegm was too thick and dry but it never occurred to me to be connected to too much!  Maybe it is.  Thanks for your suggestions.  I'll let u know how this works out.  It also could be straight up asthma.

Kathy

[cccourt1942]

Remember..this is what I refer to as "artificial" saliva.  Our "natural" saliva is compromised and limited.  For instance, my sub linguals are hardened, my left parotid is non producing...so I have my right parotid.  The ENT isn't sure about my sub mandibulars without further testing.   You know we have 100s of them behind our lower lip...and none of them can ever say how many of those produce.  Anyway..back to me, I have that right parotid producing..but it's the compromised saliva resulting from the disease itself.  So all our medicinally produced saliva is not the same consistency.  Takes some adjusting to. 

    Hope the honey/vinegar helps too..let us know.  I don't take as much as you...I'm at 20.  I could take 25 easily..but it causes me stomach distress. 

Let us know how you are doing.  I say that because very few of us have ever asked about this strange reaction. 

Good luck.

[irish]

Sometimes a person can have a mild infection that doesn't give any big symptoms and the doctor can culture this and find out if you need an antibiotic. You may be surprised to find that you do have an infection. Our darn mucus is so weird and it doesn't grow the normal bacteria so this sets us up for more oral infections than most people have.

Also irrigating your nasal passages also help to stimulate the salivary glands somewhat. It helps too loosen the mucus so that it is easier to cough up. I cough like you and it starts in the morning, but continues some off and on all day and starts getting worse around suppertime and then becomes worse and keeps me up til 2-3 AM.

I have been dealing with this in some shape or form since the year 2000. I have had my right submandibular gland removed and my other glands don't produce much. My ENT doesn't want to remove any more glands unless he is forced to. My mucus is so thick that it doesn't flow well and gets hung up in my throat and upper trachea and sometimes in my larynx. I cough and cough until I get the "plugs" out and it can be miserable.

It does help to drink warm things like decaf teas and coffee, etc. Also, I have found that eating Cheetos willhelp as they are rough and sort of catch the mucus. Chocolate also helps me out also. I also have the myasthenia that slows down my swallowing so that adds fuel to the fire. Wish I had an answer for you. I figure it hasn't killed me yet and just have to live with it. Good luck. Irish

[Kathy57]

Thanks Irish and everyone else.

I tried the mucinex last night and I still coughed this morning but not nearly like I usually do. I also had a nice hot cup of water with the raw honey and organic Apple cider vinegar.  Not bad!  I figure I could even add this to a cup of tea.  Can u do it more than once per day?  I didn't think it was half bad.

I've come to the conclusion that this mucous is probably coming from my sinuses and makes me cough when it gets to my trachea.  I think at night time everything gets drier.  Occasionally I have woke up during the night and coughed but usually it's after I get out of bed and start "my blood flowing."  It's just such an irritation.  I've had such terrible sinus issues anyway.  The heat is so drying.  Just existing is drying!

Irish, I feel for you.  It's seems like you have this much worse than I do. I would give anything to have a house right on a warm beach with salt water in the air from the ocean!!  Wouldn't that be nice?!

Hang in there all!

Kathy

[warmwaters]

I have this sometimes in the morning. Some of the triggers for me are: Moisture first thing (such as taking a shower), bending over (I now keep all my clothes at the top of the dresser), cold air.

My morning ritual now is to make a cup of coffee or tea first thing, and slowly drink it. This seems to sooth the throat.  I can't eat right away, as that can be a trigger too! Then I eat, and after about 2 hours I can take my shower.  Big change from when I use to roll out of bed, shower and dash out the door!

By the way, my family refers to the coughing as "hairballs", like when a cat coughs up hairballs.

[litliwlowa]

I tried the mucinex last night and I still coughed this morning but not nearly like I usually do. I also had a nice hot cup of water with the raw honey and organic Apple cider vinegar.  Not bad!  I figure I could even add this to a cup of tea.  Can u do it more than once per day?

Personally, I don't know why my gastro said only once a day. But I occasionally do that twice a day.

Kathy - you mention sinus issues also. I use the netipot every day (in the evening)and it really makes a difference for me. My ENT said I can do that as often as twice a day when allergies kick up (good way to get the foofoo smell out of my sinuses when exposed to fragrances).

Do you use a humidifier? I do and that is also helpful. I can't run high humidity at home due to mold growth issues, but even maintaining humidity at 45% helps ( I also am on humidified BiPap so my nose is getting direct humidity throughout sleep).

By the way, my family refers to the coughing as "hairballs", like when a cat coughs up hairballs

warmwaters - what a visual that brings to mind!! My brother would like that comparison

[Dolly Dimples]

 Kathy , just another tip that helps me in mornings. When you make your coffee ,add some of the hot water to a small deep dish and deeply breathe in the hot vapour  ,  this helps me get the thick sticky goo cleared, sip your coffee in between the breaths.  Good luck, Dolly x

[SjoDry]

Kathy,

I was also going to suggest a humidifier like Amanda mentioned. I was having alot of these same issues. I bought a very good humidifier that streams both cool and warm moisture. I use mostly the warm. Also, I will throw a towel over my hair & around my face & just stand over the steam. It really helps my sinuses, cough,etc.

Hope things get better with all of these suggestions!
SjoDry