Hemoptysis Questions

Had a couple questions from a reader that I thought I would share regarding hemoptysis (coughing up blood). Hemoptysis does not happen to all CFers, but if it happens to you, it wouldn't be considered out of the ordinary. I answer all questions to the best of my ability - based on fact, combined with what I've picked up over the years and with a little dash of hoping I'm close:

What do you do after you've coughed up blood?

If I cough up blood I have a pretty standard routine...no pulmozyme for 24 hours. no vest for 12 hours. If clear for 24 hours I resume pulmozyme. I will exercise at 25% the day after the blood.

50% two days after. And if blood free, I resume all activity as normal the third day.

Hemoptysis seems to happen to me a lot at night time, is that the case for you?

It can happen because of the pressure change with laying down. Try sleeping propped up if you can...I've spent many nights sleeping sitting up!

Do your doctors know the source of your hemoptysis? I have bronchiectasis in my right upper lobe, and I understand that it is common amongst CF'ers, and my doctors believe that's what is causing the blood. Could you tell me more about bronchiectasis? Is it the cause for hemoptysis for most of us CF'ers?

Bronchiectasis is just a fancy word for damaged lung. Most all CFers have a varying levels of it and it really just a matter of when not if it will happen. That's what CF can do over time, damage lung tissue and airways. We must focus on doing everything we can do to keep our lungs open and clear. The more closed off and full of junk our lungs are, the faster damage happens.

Bleeding is often a result of infection or blood vessel thinning. Our vessels/veins have a tougher time getting blood to where it needs to go because of our damaged lungs and over time get bigger and thinner. If you look at them under CT, they look like big worms instead of how they should, spider webs or spaghetti noodles. As they get bigger, the walls of the vessels get thinner and are more apt to tear. When they tear, this can result in bright red blood coming from our lungs.