Coughing up blood

[Kathy813]

I need some advice. My difficult child has a bad sinus infection and is coughing a lot. She went to the doctor on Tuesday and was given an antibiotic and a prescription decongestant.

It doesn't seem to be getting better and she just called to say that she was leaving work early because she wasn't doing well. She also asked if she should be worried that she has been coughing up blood. She said that it has happened twice now.

Does anyone know what would be causing this and can it wait until Monday when she can go back to the doctor? Or should we make a trip to the ER?

I guess I should add that difficult child is a bit of a hypochondriac so it's always hard to judge just how bad this really is. I asked her the amount of blood and she said "chunks." Again, based on past experience that could mean microscopic traces of blood in the phlegm that she is coughing up.

Any advice or experience with this would be much appreciated. Oh, by the way, she is also a smoker if that factors into the equation.

~Kathy

 

[AllStressedOut]

If she coughs hard enough to burst a blood vessel, blood will come up. That is a pretty normal reaction if you've been coughing for awhile.

The thing I would watch for or listen for is her breathing. If she is wheezing or if she is having trouble breathing, she needs to go to the ER. It could have turned into pneumonia. (sp?)

 

[flutterbee]

I would go to the ER just to be on the safe side. Better to be safe than sorry. It could be bronchitis (especially if she's a smoker) or pneumonia or any number of other things.

 

[Lothlorien]

I think I could be a resident expert on sinus infections, unfortunately.

One, sinus infections, if she gets them frequently could need a much stronger antibiotic than the typical Erythromycin or that stuff.

two, she could have developed bronchitis. That typically happens to me when I get a sinus infection.

Three, if it is small amounts of blood, that is typical of a sinus infection. When a sinus infection occurs, the sinus cavities get swollen and typically, you will see blood when you blow your nose. Right now, it's probably draining down her throat and now she's coughing it up.

If it more serious than that, then certainly she needs to be seen in the ER. However, if it's not, then my suggestion is to get her into a good ENT first thing in the am, which might be hard, since it's going to be a Saturday.

I always go to an ENT when I get sinus infections now. He typically prescribes a very strong antibiotic. Generally, a simple antibiotic is just not enough. It may take some of the symptoms away, but the infection does not disappear and lays dormant for a while, only to come back. I know, from personal experience after dealing with a sinus impaction. After being on an antibiotic for 6 weeks, it didn't go away, so I ended up having surgery.

 

[witzend]

When I coughed up blood it was because a blood clot in my lung had burst. Does she have chest pain, like around the lung area? If she has burst a clot, it will be incredibly painful in that area.

She should go back to the doctor, for sure.

 

[Hound dog]

Kathy

Is she where you can get her on the phone?

Even if she's coughing so hard or so long to bring up blood she needs to get to the ER. She needs to be checked out. ASAP!

If it were my child, I wouldn't hesitate. Coughing up blood is NOT a good sign.

I realize difficult child is prone to exaggeration, but this time I'd error on the side of caution.

Let us know.

((hugs))

 

[Kathy813]

Loth ~ She is on Augmentin and does tend to get sinus infections frequently. For some reason, she and husband get them every fall like clockwork.

Thanks for the quick replies. I just tried to get her on her cell phone but she didn't answer. She did tell me that she was going to take her medication and go to bed so she may not be hearing the phone.

I'll check with her in the morning and if it's not any better I'll take her to the ER.

Edited after talking with difficult child:

She just called back and upon further questioning, it sounds like she has had some phlegm with a little blood. I think it sounds like irritation from all of the coughing. She doesn't have any real pain ~ she described it as her chest is sore from the coughing. I told her to call us if it happens again tonight and if not we would decide what to do in the morning.

Being my usual difficult child, she has decided that she has tuberculosis like Nicole Kidman's character in Moulin Rouge. I told her that it was HIGHLY unlikely that she had TB. She mentioned the guy in Atlanta that made the news flying across the world with TB. I asked her if she was on his flight and pointed out that since she wasn't I doubted she could have caught it from him.

Leave it to my difficult child!

~Kathy

 

[hearts and roses]

I am in favor of getting her to an ER - err on the side of caution. She should be checked out. There are just so many things it could be, pneumonia, bronchitis, sinus related, smoking related, but it should be checked out. I can't even believe that they prescribed Erythromycin - I'd laugh in my DR's face if he tried to pull that on me!

How is her breathing?

 

[witzend]

In my situation it was phlegm with specks of blood, until they gave me the blood thinners and it was much more obvious. At the very least make sure that she is taking in plenty of fluids.

 

[Kathy813]

<div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body">I can't even believe that they prescribed Erythromycin - I'd laugh in my DR's face if he tried to pull that on me!
</div></div>

Augmentin is the same as Erythromycin?

~Kathy

 

[Lothlorien]

My body laughs at Augmentin. That's the stuff they give my kids. She definitely needs a stronger antibiotic. I was thinking of that with my original post, but couldn't think of he name. It's a very light antibiotic, especially for a sinus infection.

Get her into an ENT as soon as you can. It sounds like it's irritating her lungs. If it's not taken care of properly, it can develop into bronchitis, if not already. I have actually gotten pneumonia twice from not taking care of myself with a sinus infections (young and stupid with horrible health ins.). The pneumonia took months to get rid of completely. Don't fool around, get a stronger antibiotic.

 

[SRL]

If she's had any change for the worse she may need prednisone added to the antibiotic.

Lothlorien, I am sorry to say I could probably give you a run for resident expert. :hammer: I've had surgery once and difficult child's needed TWO sinus surgeries before we figured what we needed to do to keep it at bay. Nowadays when he starts tripping over into infection I call into his ENT who prescribes the combo immediately and we see him after only if he's not improved.

 

[susiestar]

Push the fluids. I used to have a ton of sinus infections. I was looking at sinus surgery and my doctor, who had treated things in very bad areas of Guatemala before his wife wanted to come home, said it was worth giving major fluid pushing a chance. He had me dring a GALLON of water or more a day. I actually had a 1 gallon water bottle I would fill and empty during hte day. Even at school, adn we were NOT allowed water bottles or drinks at school. I drank and drank and drank. And it took a little while, but it helped a LOT. Somehow I managed to get all the really thick gunk to drain out. Now I go back to that when I am getting a sinus infection. It has been several years between these for me. Mucinex is also a great help. he had me take a double dose of robitussin every 4 hours, not the dextromethorphan kind, just the regular plain stuff. That is what is in mucinex.

I hope she feels better, and doesn't drive you crazy. TB IS on the rise in the US, and most of what is seen is the medication resistant stuff. If they think you have it they immed give you very strong antibiotics and I forget what else. When I was pg with Jessie we found out that an employee I trained with had TB. He always coughed horribly, and was a smoker. He died from it not much after that, but he also had other problems. We ALL had to be TB tested. Even while pg I had to be tested. They did let me check with my doctor first though.

Hugs,

Susie

 

[hearts and roses]

There are tiers of antibiotics and with all the superbugs going around the lightweight antibiotics (the ones mentioned above) don't stand a chance. There are some for whom those work, but for me and mine, we need stronger stuff to kill a sinus infection. Plus prednisone, plus saline nasal spray followed by a prescription nasal spray. To keep sinus infections at bay, I use a neti pot with a saline solution daily. It works. It's kind of gross, but it works. Lots of fluids are also a key factor.

 

[flutterbee]

I had bronchitis last month and it wasn't my chest that was sore from coughing, it was the muscles around my rib cage. FWIW, my doctor did tell me that water is the best expectorant. Stay hydrated. Might tell her to pick up a cool mist humidifier and run it in her bedroom.

I'd still say to take her to the doctor ASAP.

 

[Marguerite]

It sounds to me like she's coughing up small flecks of blood in her sputum - this is probably from her throat, which (if she's been coughing a lot) is probably the consistency of raw mince. Or at least feels like it. A teaspoon of honey taken occasionally can help soothe a throat.

You can also have blood vessels leak a bit when you blow your nose a lot. With inflammation, blood vessels swell, lymphatic tissue swells, everything feels clogged and to shift air (breathing, plus nose blowing or coughing) the air is forced through a narrower passage and moves faster - can do a bit more damage, hence a little bit of blood.

Prednisone - I would avoid it if there is active infection. It suppresses your immune system right at a time when it needs to be kicking bugs. It needs a doctor's OK, anyway.

The antibiotics - they could easily be doing the job, it depends entirely on how vulnerable the bug is to it. But if there's no improvement at all after about three days, you can assume that maybe a different antibiotic is needed. Not necessarily stronger, just different. Some bugs could be resistant to a strong antibiotic, but totally vulnerable to a very different but weaker one. Or not.

If this continues and she's still panicking about TB, she might be needing a sputum test anyway (to directly test the antibiotics for the sinusitis/bronchitis). Use her paranoia and hypochondria to get her checked out appropriately.

My dad had TB. In his case it was a fairly benign form he picked up during WWII and it was dormant for 50 years. He was taking prednisone for shingles when the TB nobody knew about flared up. He was a former smoker and had emphysema as well. He was actually relieved when they diagnosed TB - he thought he had a galloping lung cancer. A sputum test confirmed it and he was put on the TB-specific antibiotics which these days have a high success rate.

The resistant strains of TB are mostly found on the streets. People who are unwell for other reasons are often the most vulnerable. And it's still TB - it will still show up on the tests. Then the drug sensitivity tests will show how resistant it is (or not).

This does sound to me like a rather bad bronchitis. I think a doctor visit would be a good idea if she doesn't start to feel better soon. They can assess a possible antibiotic change and hopefully set her mind at rest by checking out other things. A professional listening to her chest is always useful to make sure it's not getting nasty.

Giving up smoking would be a good start - she might be able to skip the autumn bronchitis attacks in future! The trouble is, she may be scared, but is she THAT scared?

Hang in there, Kathy. I think you're doing the right thing.

Marg