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Suggest Treatment For Bronchiectasis When Lung Function Is At 32%
Question: I was diagnosed with bronchiectasis when I was 8. I am 51 now, and have 32% lung function, and am out of breath a lot. I have a pulmonologist in XXXXXXX where I live, but am looking for a specialist in bronchiectasis and will travel anywhere. I do not cough or have any mucus, which doesn't really fit the mold. When i was younger I did cough a lot - I'm not really sure when or why this changed. I am looking for ways to either make my lungs stronger, or to at least not let them get any worse. Any suggestions?
Thank you,
XXXXXXX XXXX
Thank you,
XXXXXXX XXXX
Brief Answer:
Get done adult Pulmonary vaccination.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Bronchiectesis is permanent dilatation of airways. It is irreversible condition.
If it is localised then surgical removal of part of lung (lobectomy) can be done. But it is not effective in all cases.
Measures to improve your lung functions are
1. Enroll yourself in Pulmonary Rehabilitation center where chest physiotherapy and deep breathing exercises are done. This will improve your lung functions and reduce symptoms.
2. Get done adult Pulmonary vaccination with Influenza and pneumococcal vaccine to prevent recurrent infection.
3. Quit smoking if you are smoker.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Get done adult Pulmonary vaccination.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Bronchiectesis is permanent dilatation of airways. It is irreversible condition.
If it is localised then surgical removal of part of lung (lobectomy) can be done. But it is not effective in all cases.
Measures to improve your lung functions are
1. Enroll yourself in Pulmonary Rehabilitation center where chest physiotherapy and deep breathing exercises are done. This will improve your lung functions and reduce symptoms.
2. Get done adult Pulmonary vaccination with Influenza and pneumococcal vaccine to prevent recurrent infection.
3. Quit smoking if you are smoker.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My doctors have never recommended the surgery, so I'm guessing it is not localized. I do not smoke, and I always get the vaccine - both flu and pneumonia. I am looking for a specialist who knows more about treating this illness. Also, beyond pulmonary rehab, is there anything else I can do? But the bigger questions are:
1. why do I have no mucous or cough?
2. I haven't had a respiratory infection for a few years, why am I getting worse?
3. my doctor says my CT scan doesn't look "that bad" - so why the 32% lung function? That seems really bad to me.
4. I don't want to be on oxygen, or have a lung transplant (both suggested options for the future) - so what can I do to live to at least 80 without either of these?
Thank you!
1. why do I have no mucous or cough?
2. I haven't had a respiratory infection for a few years, why am I getting worse?
3. my doctor says my CT scan doesn't look "that bad" - so why the 32% lung function? That seems really bad to me.
4. I don't want to be on oxygen, or have a lung transplant (both suggested options for the future) - so what can I do to live to at least 80 without either of these?
Thank you!
Brief Answer:
Do you have upper lobes bronchiectesis?
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
There is no specialization in bronchiectesis. Pulmonologists are considered as specialists.
Bronchiectesis is considered as orphan disease in our field. It is like orphan child because it is not curable. No further advance or research is going on in the field of bronchiectesis. These all sound depressing but this is reality about bronchiectesis.
No progress in management.
Pulmonary Rehabilitation, vaccination, inhaled treatment, mucolytic, expectorant and antioxidants are still the treatment available for bronchiectesis.
Answer to your 1st question.
For this please let me know if you are having upper lobe involvement or not.
Answer to your 2nd and 3rd question.
You are getting worse due to inflammation not by infection. And this persistent inflammation causes more symptoms and look worse on PFT more than CT scan. CT denotes only parenchymal lesion. It can not tell functional severity. For this you need to do PFT.
Answer to your 4th question.
Sorry to say but long term oxygen therapy (LTOT) and lung transplantation are the only options in late stages.
Please let me know
1. Do you have upper lobes bronchiectesis?
2. Do you have Pulmonary hypertension?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Do you have upper lobes bronchiectesis?
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
There is no specialization in bronchiectesis. Pulmonologists are considered as specialists.
Bronchiectesis is considered as orphan disease in our field. It is like orphan child because it is not curable. No further advance or research is going on in the field of bronchiectesis. These all sound depressing but this is reality about bronchiectesis.
No progress in management.
Pulmonary Rehabilitation, vaccination, inhaled treatment, mucolytic, expectorant and antioxidants are still the treatment available for bronchiectesis.
Answer to your 1st question.
For this please let me know if you are having upper lobe involvement or not.
Answer to your 2nd and 3rd question.
You are getting worse due to inflammation not by infection. And this persistent inflammation causes more symptoms and look worse on PFT more than CT scan. CT denotes only parenchymal lesion. It can not tell functional severity. For this you need to do PFT.
Answer to your 4th question.
Sorry to say but long term oxygen therapy (LTOT) and lung transplantation are the only options in late stages.
Please let me know
1. Do you have upper lobes bronchiectesis?
2. Do you have Pulmonary hypertension?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your answers. I guess I knew there was no "specialist", but perhaps there is someone who is more interested in this disease, and maybe considering new options for treatment?
So my questions back to you:
1) What can I do to prevent inflammation, if anything? And if I can prevent continued inflammation, can I keep the bronchiectasis where it is now? I would be so happy to just stay where I am now and I guess that's what I am trying to learn - of possible, how can I prevent further damage?
2) I am not 100% sure, but I am pretty sure I do not have upper lobe bronchiectasis. A report I saw that accompanied my last CT scan (which was 3 or 4 years ago) talked about "emphesemetous changes" in the lower lobes. Again, I can't be certain, but I can find out. What does this mean to you? I have also read that "dry" bronchiectasis is generally in the upper lobes.
3) I do not have pulmonary hypertension - at least not that anyone has mentioned. Should I be concerned?
4) I know this is hard to answer without really knowing my history, but can someone with 32% lung function (I still think I can get it up a little:) keep from getting worse, steer clear of O2 and a transplant, and live maybe....30 more years?
Thank you!
So my questions back to you:
1) What can I do to prevent inflammation, if anything? And if I can prevent continued inflammation, can I keep the bronchiectasis where it is now? I would be so happy to just stay where I am now and I guess that's what I am trying to learn - of possible, how can I prevent further damage?
2) I am not 100% sure, but I am pretty sure I do not have upper lobe bronchiectasis. A report I saw that accompanied my last CT scan (which was 3 or 4 years ago) talked about "emphesemetous changes" in the lower lobes. Again, I can't be certain, but I can find out. What does this mean to you? I have also read that "dry" bronchiectasis is generally in the upper lobes.
3) I do not have pulmonary hypertension - at least not that anyone has mentioned. Should I be concerned?
4) I know this is hard to answer without really knowing my history, but can someone with 32% lung function (I still think I can get it up a little:) keep from getting worse, steer clear of O2 and a transplant, and live maybe....30 more years?
Thank you!
Brief Answer:
Yes, you can live for 30 years.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Answer to your 1st question.
You need to take regular inhaled corticosteroid to prevent Inflammation and you are doing this correctly by taking symbicort and oral prednisone (as and when required).
Answer to your 2nd question.
Yes, you heard it right. Dry bronchiectesis is known as bronchiectesis sicca. It is considered dry because mucus will be gravity driven and easy to expectorate. It is common after tuberculosis.
You are worsening because you are having emphysema along with bronchiectesis.
Answer to your 3rd question.
In my opinion, you should get done 2 d echo to rule out Pulmonary hypertension. This is common with long standing bronchiectesis and emphysema.
Answer to your 4th question.
Yes, you can still live for 30 years, if your lung function decline can be halted.
So please let me know
1. Have you ever undergone 2d echo?
2. Do you have edema feet?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.
Yes, you can live for 30 years.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Answer to your 1st question.
You need to take regular inhaled corticosteroid to prevent Inflammation and you are doing this correctly by taking symbicort and oral prednisone (as and when required).
Answer to your 2nd question.
Yes, you heard it right. Dry bronchiectesis is known as bronchiectesis sicca. It is considered dry because mucus will be gravity driven and easy to expectorate. It is common after tuberculosis.
You are worsening because you are having emphysema along with bronchiectesis.
Answer to your 3rd question.
In my opinion, you should get done 2 d echo to rule out Pulmonary hypertension. This is common with long standing bronchiectesis and emphysema.
Answer to your 4th question.
Yes, you can still live for 30 years, if your lung function decline can be halted.
So please let me know
1. Have you ever undergone 2d echo?
2. Do you have edema feet?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for actually reading and responding! I have not undergone 2d echo, that I can remember? And I think I would remember?
And I do not have any swelling, anywhere - feet are fine.
I look like a healthy adult. Until 4 years ago I played tennis regularly. I have taken a few hiking trips with my mother (74 and in way better shape than me!) through Italy. While the one this past XXXXXXX was more difficult (going up hills is tough), I hiked for at least 5 miles a day, including walking up over 300 steps on the Amalfi Coast. The steps probably took me about 20 minutes longer than they took everyone else, but I did it. I can walk on flat terrain or downhill forever - but even walking up the stairs in my house can make me breathless. I work part-time plus, volunteer, love my animals, have three kids (2 in college, one just out). I weigh 128 lbs, eat 80% of the time very healthy meals, and am trying to make exercise a part of every day. But I can't say I actually do that, but I am trying!
Another interesting fact, last year I had to get hearing aids - kind of unexplained hearing loss, they are guessing scar tissue. I don't know of there could be any correlation?
There' s a department at U XXXXXXX hospital that focuses on CF and Bronchiectasis, have you heard anything about it?
You are my new friend, thank you so much for your quick responses! XXXXXXX
And I do not have any swelling, anywhere - feet are fine.
I look like a healthy adult. Until 4 years ago I played tennis regularly. I have taken a few hiking trips with my mother (74 and in way better shape than me!) through Italy. While the one this past XXXXXXX was more difficult (going up hills is tough), I hiked for at least 5 miles a day, including walking up over 300 steps on the Amalfi Coast. The steps probably took me about 20 minutes longer than they took everyone else, but I did it. I can walk on flat terrain or downhill forever - but even walking up the stairs in my house can make me breathless. I work part-time plus, volunteer, love my animals, have three kids (2 in college, one just out). I weigh 128 lbs, eat 80% of the time very healthy meals, and am trying to make exercise a part of every day. But I can't say I actually do that, but I am trying!
Another interesting fact, last year I had to get hearing aids - kind of unexplained hearing loss, they are guessing scar tissue. I don't know of there could be any correlation?
There' s a department at U XXXXXXX hospital that focuses on CF and Bronchiectasis, have you heard anything about it?
You are my new friend, thank you so much for your quick responses! XXXXXXX
Brief Answer:
Do you have dryness of mouth?
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Thanks for your kind words and considering me your new friend. I am truly obliged. It's always encouraging for doctors to hear positive feedback from patients. So thanks again.
Sorry to say but I have not heard of U XXXXXXX hospital.
I have heard of XXXXXXX clinic and it's Pulmonary department.
Please let me know, do you have dryness of mouth and throat?
I will be happy to help you further. Wish you good health. Thanks.
Do you have dryness of mouth?
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Thanks for your kind words and considering me your new friend. I am truly obliged. It's always encouraging for doctors to hear positive feedback from patients. So thanks again.
Sorry to say but I have not heard of U XXXXXXX hospital.
I have heard of XXXXXXX clinic and it's Pulmonary department.
Please let me know, do you have dryness of mouth and throat?
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hmm, that's kind of a tough question, mainly because when I am asked about symptoms I can kind of feel them! I can't say I have severe dryness of mouth and throat, but I am thirsty a lot, and I guess slightly dry feeling. But not to any great extent. What are you thinking about?
Brief Answer:
No need to worry much for this drying.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry for this drying.
If you have drying problem in mouth and throat then this can explain your dry bronchiectesis.
But since you are not having much dryness and more of thirsty feeling, no correlation I am seeing.
So consult I XXXXXXX hospital and work out the possible options.
Please let me know, if you have ever tried specific Pulmonary anti oxidant like N acetyl cysteine (NAC) or pine bark extract.
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
No need to worry much for this drying.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry for this drying.
If you have drying problem in mouth and throat then this can explain your dry bronchiectesis.
But since you are not having much dryness and more of thirsty feeling, no correlation I am seeing.
So consult I XXXXXXX hospital and work out the possible options.
Please let me know, if you have ever tried specific Pulmonary anti oxidant like N acetyl cysteine (NAC) or pine bark extract.
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have not tried either pulmonary anti oxidant, but I'm happy to! Any guidelines?
Brief Answer:
You should start Pulmonary antioxidants.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, pulmonary antioxidants are good for chronic lung diseases like bronchiectesis.
At present there are two Pulmonary antioxidants available.
1. N acetyl cysteine (NAC).
2. Pine bark extract (Picnovit).
You should try them. In my clinical practice, these have shown great results.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
You should start Pulmonary antioxidants.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, pulmonary antioxidants are good for chronic lung diseases like bronchiectesis.
At present there are two Pulmonary antioxidants available.
1. N acetyl cysteine (NAC).
2. Pine bark extract (Picnovit).
You should try them. In my clinical practice, these have shown great results.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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