How to get your child(10) to expectorate mucus?

[Rebjane]

My 10 year old girl with CF does not like to cough up her mucus. She thinks it' gross and makes her want to throw up. She has on very few occasion coughed up stuff for me to see(came up just by force). She will just swallow it. I told her I would get her something special if she coughs something into a cup. Any ideas? She already does Hypersal, Vest, flutter valve(this helps her cough stuff up) but again she swallows it. When we go to clinic the CF doc does a throat cough swab, she prefers this. I thought if she coughed her mucus in a cup it would give a better sputum culture? She can't get throat swabbed forever?

Also, if she has stuff kind of stuck in her throat if we tickle her and she laughs she can cough it up but again swallow it.

 

[Aboveallislove]

I wonder if saying something like yeah it is kinda gross. But isn't the thought of eating that even grosser though then spitting it out? I know I hate when I have to swallow mucus because it is so gross to think about eating it, but you're not me.

 

[Rebjane]

She's stubborn. This productive mucus thing is fairly new as well. She had been having lots of issues with tightness and wheezing; then we finally increased her Pulmicort dose. Since that time she seems to be able to mobilize stuff and it is there to cough up(most of the time). She has not been complaining of wheezing or tightness since, now it is a battle(sometimes) to get her to cough it out. I would love to have her cough it up and into a cup; thought we could culture it? I guess there is always a worry she is culturing something new. Or perhaps it is just what had been sitting in there causing the original wheezing and tightness.

 

[Aboveallislove]

I guess I'd ask her those question s after doing the isn't it grosser to eat that? Maybe after saying your not me ask things like, is there a reason you don't want to culture it? I think if it were me I might worry about culturing something new. Does that worry you? Or does coughing it out remind you of your cf? In other words wondering if questions and getting her to think might help. Good luck

 

[Twistofchaos]

Either way, most important is to get it out of the lungs so as long as she's doing that.
Swallowing large amounts of mucus causes nausea and other digestive issues. But we swallow large amounts comming from the nose throughout the day without realising it so that's kind of double. However the nasal stuff is "fresh" and the stuff comming from our lungs is sticky and tough so we just want to get that out.

Not a parent but at 10 years old she's probably well capable of understanding these things so I'd try to explain these things honest as possible. (and other aspects of CF as they come along) She'll be thankful for that later.

You can ask her often about the colour of it and to know the colour..
Too bad she's not a boy. I loved distance competitions at elementary school because mine had more weight and consistency to them than those of my classmates.
Can ask her physician or physiotherapist to teach her new breathing and clearing methods like huffing and it will come up then too.

Lots of laughter and exercise to loosen it up.

 

[patpatstoo]

My 18y/o has NEVER spit out mucus. She always gets a throat swab. We tried everything and it just made things worse. We decided it wasn't a battle worth fighting.

 

[jshet]

My son has cf and autism he will not spit out his mucus.. He swallows it no matter what. His cf doc said most parents think it is bad if their child swallows their mucus. It will not hurt them. It may upset their stomach but it will not affect their lungs. It's only gross not worrysome.

 

[DebbieS]

I used to swallow my mucus too until I thought of the possible digestive consequences. Most kids with cf don't seem to understand how one thing affects another in cf- and most of those kids grow up to be adults who continue not to understand/ want to understand!

Maybe you can work with a basic point system but with coins. Have a clear glass container and have her deposit the coin she earns for each time she spits out sputum (this way she sees, feels, and hears the coin drop- satisying most sensory channels). Up the frequency of expectoration or amount expectorated and change it up (e.g. Mucus Mondays get 2 coins per tablespoon, 2nd tuesday of every month earns something huge for 2 ounces worth or 10 expectorations worth, last day of the month is break the coin bank day after whatever reasonable goal you set forth, etc).

The key always is to connect fun, positive stuff with things that are hard to endure. It makes everything infinitely more palatable! Whatever happens, please be very easygoing about it so that she doesn't have added stress to the grossness of it all. Good luck!

 

[sue3582]

I am 31 and swallow my mucus. The whole, isn't that grosser than spitting it out, thing doesn't work for me. I just don't spit it out. I will get a dime sized amount when needed at the doctor though. As long as it doesn't make her sick to her stomach then I would drop it. My doctor is fine with me swallowing it.

 

[TICMOMOFF1]

We have the same problem here. She is 10 also and refuses to spit it out too. It's all about control. That is the one thing she can control. At this age we dont give her an option of doing her meds/shaking or not. She is to do them because it doesent just affect her it affects the entire family when she is in the hospital. We try to give her the responibility of it and cleaning her nebs etc., but she feels that she has no control over her life and she needs some. It will not hurt her swallowing her mucus but it druves us nuts. I would explain that they will have to do other invasive procedures [ a bronch] sometimes if and when needed though and it can make you sicker by aggitating your lungs and cause a flare up or infection. I gave up, because if the doctor wants a better culture then he will do a bronch when necessary, just one thing off my plate to have to worry about. She wont like it and will probably start coughing it up to keep from having to do one. Good luck

 

[kosdancer]

I've never figured out how to bring up mucus (I'm 19). I sometimes am able to when I'm sick, or just randomly, but I really wouldn't worry about it too much. Throat swabs are adequate, it's clearly a pretty common problem, and swallowing it isn't going to hurt you. If she's capable of coughing it up, encourage it - it's of course a good way to see what's going on. But it's definitely not worth a huge battle.

 

[SoyaSauce]

I always spit my mucus out whenever I can when appropriate, even when I was little, I was encourage to.

I carry small disposable cups with me in my car, about the house, or when out, discretely and hygienically of course. Usually just when times I am more productive, Like an exacerbation or feeling more junky. Even first thing in the morning and during the night, I have a little cup at the ready.

If I am out in public or at dinner, movies, or with people, -obviously that not a good time to be spitting everywhere, so I end up just swallowing it, but I try to predict if I going to be clogged, so I try to clear myself out extra before an event, and usually that works.
When I doing neb/vest treatments, or exercising privately, I become the spew monster in all directions,(BLOW) cups and lots of tissues. I also wipe down plenty with antibacterial wipes after, close the room door so no one comes in.

Like the above posts say, make a game out of it, *IMHO, it is gross to swallow it, ESP. when it is green, dark and nasty. ALSO, some studies suggested that I read somewhere, CF'ers that swallow it have in increased risk of blockages, because your adding MORE stickiness to your gut and bowels. So....Spit away !!!

 

[LittleLab4CF]

Hocking up phlegm opposed to spitting out freshly coughed lung mucous is a difference of a mess of organisms or a useful culture. In my child mind I always believed mucous formed in the nose and head and drained down the throat, catching some mucous down into the lungs. Like most kids when a cold hit everything became a blur of symptoms.

The importance of her knowing that if she suffers tummy symptoms, it's likely the swallowed phlegm has been made and I agree. When I think of jade and emerald goobers that hung like stalactites from my sinuses and turbinates threatening to avalanche into my windpipe I can almost conjure a gag.

Gagging and the fear of choking rank right up there when it comes to primal fears. I doubt she's just being dainty but it is a great non verbal shout of disgust. Most CFers have mastered several contortions. Drawing out a massive head or throat mucous plugs without swallowing or choking takes some mastering. Having sputum that every kid recognizes as yours on the grass or sidewalk isn't exactly fame. Nailing your friend's toad with a hocker on the other hand, is. Try getting a disgusting pet and teach them a little game? Ask your doctor which source of mucous will be the most valid.

LL