When you have been a physician as long as I have you have heard most if not all the usual complaints and symptoms patients may have. However, as time goes on and new information or studies become available there is often new meaning found in a patient’s story.
The particular complaint that brought this to my attention may not be so pleasant to envision but for many patients it is very real and concerning. Many patients with COPD and asthma will complain of cough but some patients will describe in sometimes graphic detail the fact that their cough is productive of thick mucous which will contain “chunks”. I have heard this complaint for years and would tell patients that this was expected with their disease and would advise better hydration and occasionally chest physical therapy to help the problem. I was unaware of any other significance to this complaint.
In a recent study of over 4,400 patients researchers have found that patients that have so-called mucous plugging which can be seen on cat scanning of the chest have an increase in all-cause mortality when compared to patients without these findings on scanning. What this does is make me want to be more aggressive with a therapy for these patients, but the study does not give any advice about how to help.
Until better treatment is suggested for these specific patients, the usual advice will continue to be better hydration and chest physical therapy just more insistence on follow thru.
