Tiny Black or Dark Brown Flecks in Sputum

[CrohnieToo]

I have COPD. I used to cough often and easily brought up phlegm. My family doctor scripted Spiriva and immediately the coughing stopped and the few times I do cough I don't bring up phlegm. What I did encounter with the Spiriva was a constant feeling of phlegm in my throat and was almost constantly trying to clear my throat. I quit using the Spiriva regularly and only rarely use it on occasion now.

I encountered a DVT after a PIV push of phenergan and toradol in ER. I was hospitalized for 3 days on heparin and warfarin and then released on oral warfarin the end of July. I'm having no problem with bruising or bleeding with the warfarin and I do have to give myself a daily injection of Forteo for osteoporosis and once weekly of B12.

Since sometime after the DVT hospitalization, I sometimes first thing in the morning do cough and sometimes bring up phlegm. When I do the phlegm is opaque yellow and contains a few tiny dark brown or black flecks in it. Later in the day if I do cough and bring up any phlegm the phlegm is opaque white with no flecks.

I am in Pulmonary Rehab. It is not one of the better PR programs. General education is very good but getting individual questions or information is not. I finally had to complain about not being given enough personal information as to why I have been told NOT to exercise at home, to ONLY do the theraband stretches 3 x a week at home. I've been told I push too hard and work too fast at my own normal pace but have been given no guidelines to know when I am pushing too far in my daily life. I've always just relied on how I "feel" and quit or slow down what I am doing if I feel I'm doing to much or "pushing it". I did buy my own pulse oximeter, a good one, and each time we've checked it against PR's oximeter it has been right on. There has been no progression of time or effort on the treadmill or exercise bike and nothing but the 4 theraband stretches to build up the chest and arm muscles. We managed to get that cleared up last week and hopefully there will be no more problems along that line. I've been increased to 1.8 on the treadmill for 7 minutes which I do easily. The bike at 5 for 5 minutes still gives me a workout. We will be adding the arm machine. I now know what sats and HR to watch for at home to know when to stop and take a breather until they return to an acceptable level. I am on 2% oxygen at PR during exercise but not on oxygen at home.

I mention this only because I don't know if the PR has any effect on my question about the phlegm and flecks. I did send my family doctor a note about these flecks in the phlegm and since I heard nothing from his office called today to ask if this was something I should be concerned about or not. His staff said nothing to worry about or doctor would have contacted me. I'd like your opinion just to be sure as I've found office "desk dragons" aren't always accurate in relaying messages to the doctor or in replying back to the patient.

At this point I am assuming that the flecks might be old blood from the DVT moving thru thanks to the warfarin. But what do I know? I'm just a patient.

[HawaiiRRTRN]

CrohnieToo,

You didn't mention if you were and/or still are a smoker. If so, I would say the brown or black specs in your sputum are from that. Also, it is common for people with COPD to have a more productive cough in the AM after waking.

Hope this helps,

HawaiiRRTRN

I have COPD. I used to cough often and easily brought up phlegm. My family doctor scripted Spiriva and immediately the coughing stopped and the few times I do cough I don't bring up phlegm. What I did encounter with the Spiriva was a constant feeling of phlegm in my throat and was almost constantly trying to clear my throat. I quit using the Spiriva regularly and only rarely use it on occasion now.

I encountered a DVT after a PIV push of phenergan and toradol in ER. I was hospitalized for 3 days on heparin and warfarin and then released on oral warfarin the end of July. I'm having no problem with bruising or bleeding with the warfarin and I do have to give myself a daily injection of Forteo for osteoporosis and once weekly of B12.

Since sometime after the DVT hospitalization, I sometimes first thing in the morning do cough and sometimes bring up phlegm. When I do the phlegm is opaque yellow and contains a few tiny dark brown or black flecks in it. Later in the day if I do cough and bring up any phlegm the phlegm is opaque white with no flecks.

I am in Pulmonary Rehab. It is not one of the better PR programs. General education is very good but getting individual questions or information is not. I finally had to complain about not being given enough personal information as to why I have been told NOT to exercise at home, to ONLY do the theraband stretches 3 x a week at home. I've been told I push too hard and work too fast at my own normal pace but have been given no guidelines to know when I am pushing too far in my daily life. I've always just relied on how I "feel" and quit or slow down what I am doing if I feel I'm doing to much or "pushing it". I did buy my own pulse oximeter, a good one, and each time we've checked it against PR's oximeter it has been right on. There has been no progression of time or effort on the treadmill or exercise bike and nothing but the 4 theraband stretches to build up the chest and arm muscles. We managed to get that cleared up last week and hopefully there will be no more problems along that line. I've been increased to 1.8 on the treadmill for 7 minutes which I do easily. The bike at 5 for 5 minutes still gives me a workout. We will be adding the arm machine. I now know what sats and HR to watch for at home to know when to stop and take a breather until they return to an acceptable level. I am on 2% oxygen at PR during exercise but not on oxygen at home.

I mention this only because I don't know if the PR has any effect on my question about the phlegm and flecks. I did send my family doctor a note about these flecks in the phlegm and since I heard nothing from his office called today to ask if this was something I should be concerned about or not. His staff said nothing to worry about or doctor would have contacted me. I'd like your opinion just to be sure as I've found office "desk dragons" aren't always accurate in relaying messages to the doctor or in replying back to the patient.

At this point I am assuming that the flecks might be old blood from the DVT moving thru thanks to the warfarin. But what do I know? I'm just a patient.

[suzanne4, RN]

this is not a medical advice bulletin board.

this is a board for nurses and nurses-to-be to discuss primarily nursing issues. this is not a free medical advice board. please be aware that allnurses.com cannot be responsible for problems resulting from reliance on medical or nursing advice received here. if you have a medical problem, please seek attention from your health care provider."

the tos of theis site prevent us from offering medical advice..........you need to contact your physician.

[CrohnieToo]

Thank you, Suzanne. I didn't mean to intrude. If you read my post I had already contacted my doctor. I was just curious as to what this could be since my doctor didn't consider it to be a concern but I didn't have the opportunity to ask him directly what the cause might be.

And thank you, HawaiiRRTRN, for responding. My curiosity often gets me into trouble, certainly didn't mean to cause any problems in this forum.

[suzanne4, RN]

I didn't take your post as intruding. We still cannot offer medical advice here. Simple as that. It is part of the Terms of Service of this forum.

To answer you, then we have to answer every other post, and it is not permittted.

Simple as that.