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Medical otters: phleme?

Old 05-29-05, 06:46 PM
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Medical otters: Phlegm?

Why do our bodies produce this stuff when we're sick?

Does the color of Phlegm matter? green vs yellow?

Last edited by Mole177; 05-29-05 at 06:52 PM. Reason: spelling
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Old 05-29-05, 06:47 PM
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Originally Posted by Mole177
Why do our bodies produce this stuff when we're sick?

Does the color of phlegm matter? green vs yellow?
Fixed.

http://en.wikipedia.org/wiki/Phlegm
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Old 05-29-05, 07:03 PM
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When phlegm is clear, white or pale in color it is most likely due to a viral infection. If it is green, yellow, etc it may indicate bacterial infection and a need for antibiotics.
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Old 05-29-05, 10:20 PM
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Originally Posted by nazz
When phlegm is clear, white or pale in color it is most likely due to a viral infection. If it is green, yellow, etc it may indicate bacterial infection and a need for antibiotics.
Nazz, I know that is the traditional way to look at things, but wasn't there a study that showed it didn't matter if it was clear vs. colored in regard to it being viral vs. bacterial? That was my understanding as it is one of those things like renal dose dopamine that just keeps being taught though the literature doesn't support it. I'm not a primary care doc so I could be wrong about the color thing but that is my understanding.
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Old 05-29-05, 10:24 PM
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Originally Posted by Ketamine
Nazz, I know that is the traditional way to look at things, but wasn't there a study that showed it didn't matter if it was clear vs. colored in regard to it being viral vs. bacterial?
Yeah, that's how I look at it. I asked an ID friend of mine once for her opinion and she said she doesn't put much weight on the color either.
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Old 05-29-05, 10:36 PM
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I guess I was just spouting the traditional response really. I'd say the only sure way to tell would be by culture after a wet prep to make sure the sample is not primarily saliva. The color is produced by leukocyte released peroxidase I think and indicates infection but I stand corrected on the distinction between bacterial and viral origin. I should have put more thought into my reply.
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Old 05-29-05, 11:17 PM
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Originally Posted by nazz
I guess I was just spouting the traditional response really. I'd say the only sure way to tell would be by culture after a wet prep to make sure the sample is not primarily saliva. The color is produced by leukocyte released peroxidase I think and indicates infection but I stand corrected on the distinction between bacterial and viral origin. I should have put more thought into my reply.
No problem. I would guess 95% of PCPs would have said the same thing. Interesting to look at medicine and how much is science vs. tradition. I was at a conference a week ago. Barash (big anesthesia name) looked at some of the literature of some of the things we do every day in medicine and take as fact. One example was the NPO guidelines (how long you must fast before surgery) and all he could come up with was a study tens of years ago involving rats and crushing their testicles to stimulate pain. From that we now say you have to wait at least 6 hours after eating to have elective surgery. He had many more example like this. Just crazy if you think about it.

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Old 05-29-05, 11:28 PM
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Originally Posted by Mole177
Why do our bodies produce this stuff when we're sick?

Does the color of Phlegm matter? green vs yellow?
So to try and basically answer your questions in layman's terms:
1) When you are sick, phlegm is a combo of infectious agent (viral, fungal, bacterial, etc) and your body's means of attacking it and getting rid of it. That stuff builds up in your lungs and you cough it up. When you aren't sick, it is just mucus that your body produces on a daily basis to help clear stuff that you breath in (dust, smoke, etc.).

2) No it doesn't matter what color it is (though most people doctors included think color does matter). As Nazz said, really only way to know if the color matters is by clinical exam and lab tests.
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Old 05-30-05, 12:51 AM
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Originally Posted by Ketamine
One example was the NPO guidelines (how long you must fast before surgery) and all he could come up with was a study tens of years ago involving rats and crushing their testicles to stimulate pain. From that we now say you have to wait at least 6 hours after eating to have elective surgery.
That's wild. How did they make a connection between crushing the rat's testicles and the liklihood of pulmonary aspiration of gastric contents?
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Old 05-30-05, 01:14 AM
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Originally Posted by nazz
That's wild. How did they make a connection between crushing the rat's testicles and the liklihood of pulmonary aspiration of gastric contents?
Not sure all the details but they were looking at some type of tracer looking how long it took things to move through the rat's stomach. They crushed the testicle at some point to stimulate pain. I guess 6 hours was when they saw movement of gastric contents out of the stomach so that is where Barash thinks they got the 6 hour rule on solids. It turns out that more recent studies have shown that 6 hour rule is about right, but it originally sounds like there wasn't much actual science to back up the recommendation that everyone followed.

Steroid replacement prior to surgery for those on chronic steroids was another example. There were 2 case reports of cardiovascular collapse in patients on chronic steroids. From those 2 case reports, basically everyone gets a "stress dose" of steroids at least prior to surgery if not also intra-op and post-op. The data really didn't support that practice though it is still common today to give stress doses. More current recommendations say only need to give steroids if having difficulty with blood pressure that doesn't respond to fluids and/or inotropic agents. Ask 99% of surgeons (and almost as many anesthesiologists) if stress doses are need pre-op and they would all say yes (likely not knowing the original recommendation came from only 2 case reports). Old habits are hard to break and new information often takes years to change people's practices.

Boring to most otters but I find it pretty interesting.
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Old 05-30-05, 06:29 AM
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phlegm = lube for deep throat blowjobs.

Last edited by Giantrobo; 05-30-05 at 06:32 AM.
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Old 05-30-05, 10:00 AM
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Originally Posted by Giantrobo
phlegm = lube for deep throat blowjobs.
I'm guessing your body makes its fair share? zing
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Old 05-30-05, 10:32 AM
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Originally Posted by Ketamine
I'm guessing your body makes its fair share? zing
I get no complaints.....
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Old 05-30-05, 01:57 PM
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Originally Posted by Giantrobo
I get no complaints.....
Oh, so you are ...? Touche. Well played my friend, well played.
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