Can an asthmatic choke to death on mucus?

[scheeler]

For years now, most winters I've had a cold that was then followed by a bacterial chest infection which in turn triggered inflammation of the airways, causing mucus production, that my doctor says is caused by my asthma.

Normally my asthma is well controlled, and I don't get this inflammation and mucus, just the ordinary constricting of the airways - it's only the bacterial infection that seems to trigger this other condition.

Sometimes it goes by itself, after many weeks, but usually I need a course of steroids.

This year, for the first time, I've got it in summer, and it's far worse than it's ever been - after a week or more on steroids, I'm no better. But why I'm writing this, at 5am, is because at 2.30am I awoke with mucus clogging my windpipe, and I was really frightened I was going to die. It needed as much breath in my lungs as possible to generate a cough strong enough to force the mucus out, but of course, I couldn't breathe enough to get the air into my lungs in the first place. I was thrashing about my bedroom, desperately trying to force the stuff out and get some air in. Finally it came, but only little by little.

The exact same thing happened to me through the night four days ago.

When the mucus does come, there's not much of it, only about a teaspoonful. It's the stickiness of the mucus that makes it so hard to cough up, not the amount. I've asked the doctor for a drug to make the mucus less sticky, but she said the only drugs that do this take a long time to act.

I saw my doctor yesterday about this, and I'm being sent for a chest X-ray, but I'm really worried about this happening again. So my question is, can you choke to death on mucus like this, or is this only an illusion caused by panic? What I mean is, if I really needed air, would my lungs suck in air strongly enough to push the mucus aside just enough to let the air past, even if it didn't shift the mucus away entirely? On both occasions, I was desperately using all the strength I could to get that mucus out, so I don't know what would have happened if I had just calmed down and trusted my lungs to get the air past the mucus.

So am I right to fear choking to death one night? I'd really appreciate people's opinions on this.

[PGH1943]

I have been extremely susceptible to  laryngospasm virtually all my life. Born in 1943 I was subjected to some primitive medical treatments and the one that started me on this was when I had to be given a teaspoonful of liquid - I cannot say what it was as I was a baby - and apparently I wouldn't willingly swallow it. Mymother went back to the doctor, told him the issue and believe it or not he told her to go home, wrap me in a blanket so that I could not struggle, nip my nose and pour the liquid into my mouth which she did because back then doctors acted like gods and had to be obeyed without question.  The result was that the liquid went directly into my lungs, and to cut a long story short I turned blue after a short time but fortunately my dad was at home and he held me upside down by my ankles and beat me on the back until I was responsive again.
Ever since that time all it took for my larynx/pharynx to close entirely (NO AIR IN OR OUT) was a bit of spit, or a crumb, or it would sometimes just come on without warning. I have never ever known what it is like to drink anything like normal people do - I have to hold liquid in my mouth and concentrate like blazes before I can swallow a mouth full. Solids (food) are much easier to swallow.
Now the important bit. I can tell you that it is 99.99999% unlikely that anyone can die from a closed pharynx/larynx because of this kind of reaction. You will stay concious during almost all attacks and even if you lose conciousness your "throat" muscles will relax of their own accord very soon afterwards. Keep that uper lip stiff and say sod it. I now have at age 80 emphysema stage 4 (COPD) and my lungs fill up with phlegm that makes liquid rubber look like it is watery and thin. It is hell to cough up, very difficult with little air in my lungs and I frequently have to reach into my throat after coughing it up far enough to get a hold of the phlegm and pull it out of my throat like a piece of rubber bungee cord. Horrible when it happens but I'm still here. One thing you might ask from your doctor (they are all idiots) is a nebuliser and cheaply replaced bronchodilator liquid such as DUONEB. Read up on these as they cause the heart rate to rise markedly, especially if you take more than 4 vials a day. Mucous thinners are, in my experience, about as much use as a chocolate fire guard. Your doctor won';t prescribe you Valium (Roche) or Diazepam tabs as a muscle relaxant since it is used by junies who have ruined the pharma market for really needy patient medications. However he/she will give you anti-anxiety tabs which you may want to read up about. ALL MEDICATIONS CAN iNTERACT WITH BAD RESULTS so don't take anything for granted.
I hope this info helps someone who lands on tis page even though it is years since anyone has. Healthcare in the US is a crap shoot and as I've said most doctors cant agree with themselves let alone their colleagues. Costs are ridiculous so I am NOT going to say SEE YOUR HEALTHCARE PROVIDER before doing anything - he/she and the insurance copanies are in the business of making money - not saving lives.
Best wishes to all and peace from a limey corpsman (British Royal Marines, early 1960's)

[Tammy2009]

holy cow I would have punched that doctor!!  (although if I felt like you do, probably wouldn't have the strength).

A useful supplement you could try is N-acetyl cysteine or NAC.  You can find it in natural health food stores or supplement stores and works to thin the mucus.  My pulmonologist suggested I try this back when I was really really bad and it helped a lot with the mucus.  I tend to use it sporadically now when my allergies flare up and the mucus comes in truck fulls.  

1500mg daily was my recommendation but I started slow and worked up to that amount (I don't know why I was suppose to go slow ... it doesn't seem to be a supplement that can cause problems).

And the typical stuff - drink as much water as possible to hydrate and thin the mucus and keep coughing to bring it up.  If you can put some blocks under your bed frame to raise up the head of the bed it may help you sleep better.

Feel better soon!

[scheeler]

Thanks you taking the time to write, caregiver.

It does put me in a quardany, though. Yesterday I saw my own doctor, as an emergency patient, and after giving me some mucus-thinning drugs he said, "I know this is very frightening for you, but be assured, no-one has ever died this way". So in a way I'd rather not have read that!

As an aside, when I had the first episode the previous Sunday, I went to casualty at the local hospital. When the doctor wouldn't give me mucus-thinning drugs I said to him, "Look, if this happens again I'm frightened I'll die".

Then he just smiled at me and said, "Well, let's hope that doesn't happen".

I sh*t you not.

[caregiver222]

Yes. You can die from excess mucus production. In general the mechanism of death is a laryngospasm, completely sealing the airway when the mucus plug exceeds a certain limit. A susceptible person can develop such a spasm from only a few droplets of water or food in the trachea. Consult your physician for medications to thin and reduce the mucus. The squeaky wheel gets the grease. When you show up for an examination you may be breathing fairly well and the doctor doesn't grasp the seriousness of the situation. When you have mucus issues, do not lie down, and do not hesitate to call 911. Bacterial infections in the lung can be life-threatening.