Blood coming from lungs, again.

I am a 40 year old male non smoker who two months ago had an episode where blood gurguled from my lungs followed by quite a bleeding episode that lasted about 5 minutes. For the next 12 days I coughed up blood clots mornings and evenings. I had a CT scan 4 days later that showed interstitial infiltrate in the left lingula. I finally saw a Pulmonoligist who put me in the hospital (after coughing up blood in his office) for a few days and did a bronchoscopy, that turned out negative, and all blood test were normal. With the bleeding now stopped, I was sent home and recooperated. Well after this harrowing expierence behind me and feeling quite well, today it happened all over again. I was just sitting around talking with some friends when I felt a gurgling in my lungs then up came the blood, again lasting for about 5 minutes, now followed by blood clots. I have not had a cold, any coughing, or chest congestion, suggesting any type of infection. But now my chest aches and I feel terrible. I am calling the Doctors office in the morning. Any suggestions or comments would be much appreciated. The last time this happened there was never really any diagnosis, other that I may have brake a blood vessel, while coughing.

[National Jewish]

This is serious.  The cause needs to be determined without undue delay.  The causes of coughing up blood, also called hemoptysis, are numerous.  These include infections, such as TB or a lung abscess; clots to the lung, also called pulmonary emboli; tumors; and vascular problems.  The infiltrate in your left lingula strongly suggests this as the site.  The cause should be determined and treated quickly, as massive bleeding is always a possibility.  Testing should include a repeat CT scan and an angiogram.

[rbr]

I had two more episodes last night with quite alot of blood. I sure hope to get into the Doctors office today otherwise it may be a trip to the emergency room.

[lisaS]

Hi,
2 years ago as a completey healthy 44 year old i woke up one morning coughing up blood. 2 bronchoscopies later and a very long story i ended up being diagnosed with Mycobacterium Avium Complex.
Looks like TB but is not contagious and is in the enviroment everywhere. Most people that get in are immunocompromised
Not in my case. I have had zillions of test and was declared completely healthy other than this rare bacteria.
I took antibiotics for 18 months, many of them, and i am fine now.  I do have middle lobe damage in my right middle lobe so i can cough up blood(so scary)again but haven't since Feb.
Gurgling is how i have described it too.
good luck, keep us posted
lisa

[AndyRRT]

These are very concerning episodes to say the least. You need to contact your physician again and update him with this information.

A Bronchoscopy is a fairly routine procedure with such symptoms, however it is has limited effectiveness with a diagnosis. The bronchoscope can only reach so far in the airways. Your bleeding may be coming from deeper down in the lungs where a bronchoscope can't reach. Your doctor may suggest more blood tests, a PFT, and possibly even a lung biopsy to rule out any malignancies and get a much more definative culture.

Has your doctor obtained a sputum sample from you? This infultrate may harbor a necrotizing (tissue eating) infection which could very well be the cause of your bleeding. However, I would suspect the bleeding would be more consistant where your symptoms are more sporatic and dramatic for that matter.

Try and take note of the volume of blood your coughing up and trend your info. Be sure to report this to your doctor so he/she can determine the progression of this mysterious process.

Andy, RRT, CPFT

[rbr]

I want to thank you all for your comments. I just spent 5 days in the hospital, shortly after my second post the bleeding was massive. After 16 hours of bleeding in the ER I was finally sent to a room. A broncoscopy was performed on Wednesday, which found a bronchial severly inflamed and bleeding. The Doc said a Bronc ususally last 20 to 30 minutes, they spent an hour trying to clear out the broncial to get a better look, however the broncial tube was so closed that they were unable to pass the scope through to get a better look. They took a ton of biopsies all which were negative for cancer, TB and any other sort of infection. The Doctors and everyone else on the case are completely baffled. I have to be very careful what I do now, its just a question of when the bleeding will start again. They are going to try another bronc the 1st of the year, to see how things look, and see if they can get past the area of inflammation to see whats causing all the bleeding. Just keeping my fingers crosssed.

[AndyRRT]

So they have at least found the route of your problem. THATS FABULOUS! And if they can reach the area with the bronch later on, it could be a complete fix. Sometimes a simple ligation or cauterizing of the bleeding area will do. Now, at this time, you'll want to stay away from blood thining medications like asperin. And to help with your blood clotting factors....EAT YOUR GREENS! Leafy greens have lots of vitamin K. Vitamin K is essential in our clotting factors.

Good luck, and be sure to update us!

-Andy, RRT, CPFT

[rbr]

Thank you Andy and everyone else. This event was hard on everyone, family, Doctors, and all those involved. Thanks for all the ideas and help. I'll let you know in a month what happens.

[lisaS]

rbr,
glad you are home and i understand what a harrowing experience it was. I have spent atleast 4 different times in the hospital with hemoptysis. Other than the MAC (which is gone now, but did take 4 weeks or so to grow after bronc) when i cough up blood now they don't really know why either. Except for a small amount of lung damage left from the MAC my lungs appear fine.
The good thing is for 2 years i coughed up blood every few months, this year i have gone since february and counting with no episodes.  Hopefully it will stay that way. It is so fustrating with a mystery like ours since it is so scary.
Hopefully you will be fine now.
lisa

[peterpan73]

Hello,

I'm 30 years old from India. After reading rbr's and lisa's postings I could help but share my experiences that were similar about 5 years ago. it was similar to rbr's case and I have strong reason to believe that it has something to do with mycobacterium passing on from birds (aka poultry). After the first bleeding, this decrepitation thing in the lungs got worse I gurgled a voluminous amount of blood. A first hasty medical opinion said I had pulmonary TB. I was sceptical as I did not have all the symptoms of TB and cos my sputum test did not show me as TB positive. A visit to the government run TB hospital later and the diagnosis was 'bronchopheumonia'. In India proper diagnostic equipment is either non-existent or their services exorbitant so I was not really diagnosed with really what I was infected with. A bronchoscope was not available in town and I was on a two month course of Ciprofloxacin & Tinydazole. The problems gone now and has never recurred and I guess i may have acquired immunity to it now. However, I find myself very susceptible to a temperature of less than 15 degrees celcius.Nowadays if the weather is cold and clammy I get a dry cough and would rush to the doc just in case it gets severe for days and haemoptysis recurs. Since lisa mentioned being diagnosed with the 'Avium' kind of mycobacterium, it did jog my memory as I worked with poultry then.

Could this have emanated from Poultry, Pets fur too as I breed Dobes.

Just a guess since there are many cases of respiratory diseases having passed from animal to man.

Please Keep me posted.

[lisaS]

I was told that the MAC i had was in the enviroment everywhere,
most likely my source was the hot tub in my house.
People who have had MAc are told to bathe, not shower.
I still take showers, takes to long to take a bath everyday.
Hot Tub Lung is also what MAC is referred too.
I don't know if you are more at risk with what you do.
lisa

[rbr]

Last Friday apox. 9 days after the last major bleeding episode, I started coughing up large black mucousy clots. I am assuming these  are clots left over from the bleeding episodes. But I am concerned because they continue even today, 5 days later. I also have a strange taste or odor in my mouth unlike the metallic taste I had with the fresh blood. Did any of you have the same aftermath of your hemoptysis? Just worried because it appears I am still bleeding just perhaps an ozing of blood in the lung, that  clots then has to be coughed up. It sure is making my quality of life difficult going around hacking up hairballs all day long. It makes it almost impossible to go out in public. I have an appointment next week with the Pulmonoligist to set up the next bronchoscopy. I sure will let him know whats going on. Just some advice for those of you out there who have had this problem, do your best to save your blood, or clots that you cough up. It gives the Doctors a great idea of the amount and an idea of what type of bleeding your having, I saved 4 baggies of blood that I took to the hospital with me. The Doctors and nurses sure appreciatted that, to get an idea of how much blood you are losing.

[lisaS]

Hi rbr,
First of all Happy Holidays, hopefully yours will get better.
I had black clots of blood sometimes a day or two after my episodes of coughing up blood.
I never saved my blood, but last Nov 23 i spent the night in the hospital in Boston, coughing up tons of blood and no-one wanted to save it, they just glanced at how much i was coughing up.  To me it seemed like so much since it was all night but they said it was still probably 1/2 cup, which if you're the one coughing it, it's alot.  As long as the clots are black it would mean old blood, if they become red again then it is probably new blood again.
Hang in there, i KNOW how scary and depressing it is..
lisa

[Rosetta]

Hello everyone, my father had a bought of coughing 2 weeks ago with blood.  He went to hospital and cut a long story short was diagnosed with lung cancer. This has been a nightmare ever since.  He has had 2 weeks without blood and yesterday coughed up more.  We saw one specialist and he was confident that his cancer can be maintained.  He was a very healthy 70 year old.  Yesterday at the hospital they told us that he may only have 1 year to live.  Apparantly the tumour is pressing on a vein in the broncial tubes which "may" be causing the bleeding. He painted a pretty bad picture..In a few days we will go and see the oncologist and see what he has to say...hopefully it will be better news.  Apparantly the cancer has spread to one of his nodes so they cant operate..Im looking for some hope, somewhere...

[Rosetta]

Hello everyone, my father had a bought of coughing 2 weeks ago with blood.  He went to hospital and cut a long story short was diagnosed with lung cancer. This has been a nightmare ever since.  He has had 2 weeks without blood and yesterday coughed up more.  We saw one specialist and he was confident that his cancer can be maintained.  He was a very healthy 70 year old.  Yesterday at the hospital they told us that he may only have 1 year to live.  Apparantly the tumour is pressing on a vein in the broncial tubes which "may" be causing the bleeding. He painted a pretty bad picture..In a few days we will go and see the oncologist and see what he has to say...hopefully it will be better news.  Apparantly the cancer has spread to one of his nodes so they cant operate..Im looking for some hope, somewhere...

[Rosetta]

Hello everyone, my father had a bought of coughing 2 weeks ago with blood.  He went to hospital and cut a long story short was diagnosed with lung cancer. This has been a nightmare ever since.  He has had 2 weeks without blood and yesterday coughed up more.  We saw one specialist and he was confident that his cancer can be maintained.  He was a very healthy 70 year old.  Yesterday at the hospital they told us that he may only have 1 year to live.  Apparantly the tumour is pressing on a vein in the broncial tubes which "may" be causing the bleeding. He painted a pretty bad picture..In a few days we will go and see the oncologist and see what he has to say...hopefully it will be better news.  Apparantly the cancer has spread to one of his nodes so they cant operate..Im looking for some hope, somewhere...

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