Hi: I was diagnosed in March also, and am on Mestinon and Imuran. I also have phlegm, and coughing it up is a real challenge. I wish I had some advice to pass on. Hopefully some good advice will turn up. I wish you all the best. Take care.

In my own personal case, phlegm and difficulty coughing it up, was an early sign of a developing pneumonia.
During hospital stays and at home, I had to use a suction pump for many, many weeks.
Even today I still have a suction pump at home, in the event it is needed again.
This is a symptom you want to watch very closely, keeping your Neuro and other doctors aware of the situation.
Remember that we're all ''Snowflakes" and that my situation - may not translate directly to your situation.
But your situation and my situation sound enough alike, for me to want to tell you about my experience.
- Ross

I forgot: some of my problems with phlegm, do result from reactions to some medications that I take.
The problem comes and goes, without any definite reason.

If the fluid is clear, I just put up with matters - and don't worry about it.
However, if you show any sign of continuing infection: that's what you want to be concerned about.
Benedryl: can you tolerate Benedryl? Run this idea, past your Neuro or doctor.
Then try a pill or 2, and see if that provides any relief.
Benadryl can be a relatively benign solution to the problem, if Benadryl itself does not bother you.

Mestinon can increase airway secretions-- my nuisance is runny nose at its height, but coughing has disappeared except occasionally when first lying down. I think that is due to esophageal problems since it happens when the Mestinon level is low. Echoing Ross, clear phlegm is of less concern, but in any case run this by your doc. b.

Yes - secretions most definitely can be caused by personal reaction to medications. With this situation, Benadryl can be helpful.
Yet sometimes Benadryl may not be beneficial. If you need to get rid of secretions? A OTC med like Benedryl, drying out your membranes - is not likely to help in that regard.
Benedryl (or something similar) - helps me with reactions to the many meds I take. Prednisone and Mestinon are chief among these meds. (Mestinon is such a problem for me, that I cannot take it.)
However, if I have a cold, that I want to keep from turning into pneumonia? I avoid Benedryl during those few times, concentrating instead on keeping the airway clear.

Thanks, for all the advice. I've read the report on esophagel problems.I'm going to purchase some benedryl and more closely moniter my mestinon. Alot of the time it's not always clear that I'm coughing up so I'll have to check with the dr.

Yes - medications and our reactions to them - are a very individual thing, especially so for people with MG.

Unfortunately, none of my doctors, even those that have provided me with wonderful treatment and therapy - seem to care much about my problems with secretions and/or phlegm.

They see this problem routinely, in other patients - and probably view the situation as something with many, many causes, and not worth an investment of time and testing, as long as the lungs are not impacted yet.

I understand the doctors' point of view. Yet this does nothing to help me, with a problem that has caused considerable distress, over a long period of time. With a constant concern for pneumonia, and the awful, major side-effects - that can result from treatment for severe pneumonia with strong antibiotics.

So I do the best that I can, to cope with the situation. That's all any of us can do.

Hopefully someone here, will benefit from these experiences. And then, taking into account - their own personal knowledge of their situation - along with the best advice that can be gotten from their doctors - hopefully they can find some sort of relief from a distressing symptom.
- Ross

Almost forgot: there is a variety of esophogeal ailments, that can also cause problems with secretions and phlegm.
In these various illnesses, stomach acid can back up, climbing up the esophogus. While this can cause heartburn, it may also irritate various membranes. Causing the membranes to produce secretions, sometimes in sizeable amounts.
This situation may seem counter-intuitive to a lay-person, someone similar to myself.
Yet in recent years, I've come to know many people - with this problem. And most of them - do not even have to deal with complications, caused by MG.