antibiotic or not

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I have been having a cough and a lot of mucus in my lungs lately. No fever. I don't know if it's an infection or not because I don't have the typical taste that I usually taste when I got an infection and what I get up is clear. the only real reason I'm concerned it might be an infection is because the very first time when I was diagnosed with bronchiectasis I had these exact same symptoms and all of my doctors kept saying it was probably just allergies. but when I saw my pulmonologist they decided to do a chest x-ray and then CT which then gave him my diagnosis. the doctor then performed a bronchial scope and when he took samples the samples came back with an infection. I had not been running a fever and everything I could get up which at the time was pretty minimal was clear. he treated the infection with augmentin and between that and my breathing treatments I was golden. that was back around June or July 2018. since that time I have had a couple of infections that were very obvious and again Augmentin saved the day. I've talked to my pulmonologist and he wants to wait. I don't want to take an antibiotic if I don't need it for the obvious reasons but I'm also really sick of this cough and congestion.

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  • Posted

    I sometimes get a chest infection without feeling ill as such (ie. no cold or fever accompanying it) and my chest specialist says this can occur with bronchiectasis. I generally go on to antibiotics if it doesn't clear on its own but doctors have always seemed reluctant to prescribe augmentin (I think as it is so broad spectrum and powerful, and a while back was linked in some way to MRSA, but I'm not sure about this); I find a week's doxycycline usually does the trick.

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  • Posted

    Hi, I have the same problem, bronchiectasis and allergies, I find now that even when I need antibiotics I don't always have a temperature. It can be awkward trying to diagnose.

    I usually know as I cough blood which can be quite scary, but if I'm unsure I give the respiratory nurse a call for advice.

    You will in time get to know, I also cough clear sputum which is sometimes due to an allergic reaction to something.

    My infections seem to come every 5-6 months.

    As I say now, you control the illness, don't let it control you.

    Hope you feel well soon.

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    • Posted

      I have heard of people coughing up blood. I am very happy that I have not had that happen. I've been sneezing alot too so it probably is allergies. The weird thing is that my allergy test only showed an allergy for mold. And it's been pretty cold and snowy here so I can't imagine there being any mold growth.

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  • Posted

    I've had the disease for about 10 years now. Anytime I had a cold with congestion, my doctor prescribed a course of antibiotics. Last year it wasn't caught in time and I developed a pseudmonis (sp?) infection, which really damaged my lungs. I'm now on azithromycin 3x a week and TOBI 3x a week, every other month. I'm concerned about all of the antibiotics, too. However, i got a second opinion from National Jewish Health in Denver, and they concurred. I can't afford more lung damage. if you have doubts, a second opinion from the doctors at NjH might be worth it.

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    • Posted

      I am in Kansas so Colorado is our neighbor. I recently called them and I'm waiting to hear back. My sister told me it took them nearly a month for a nurse to call her back. Was that your experience too?

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  • Posted

    I've had the disease for about 10 years now. Anytime I had a cold with congestion, my doctor prescribed a course of antibiotics. Last year it wasn't caught in time and I developed a pseudmonis (sp?) infection, which really damaged my lungs. I'm now on azithromycin 3x a week and TOBI 3x a week, every other month. I'm concerned about all of the antibiotics, too. However, i got a second opinion from National Jewish Health in Denver, and they concurred. I can't afford more lung damage. if you have doubts, a second opinion from the doctors at NjH might be worth it.

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  • Posted

    I was diagnosed as well, likely linked to my Sjorgrens syndrome.

    I had had my "morning" cough for years, which I thought was just dry mouth from the SS.

    If I get an infection I must go and get antibiotics.

    In the meantime I am on Qvar inhaler twice a day, and then ventolin with the inhaler duirng the say as required. Seems to work. And he says I also have asthma.

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    • Posted

      You and I are almost identical. I also have SS. In addition I have rheumatoid arthritis both of those diseases can result in bronchiectasis. I have to be honest, I sometimes have doubts in my pulmonologist's opinions. he's a nice enough guy but he's very conservative with his treatments. and sometimes he even makes things up. And I'm not blowing things out of proportion by saying that. on September 25th of last year I had a procedure done called kyphoplasty. the surgeon made a mistake and injected bone cement into my pulmonary artery. that cement traveled to my lungs where it stays as a permanent embolism furthering my breathing problems. so anyway because it's so rare there's very little to go on as to how to treat this condition. when I Googled it I found case studies where doctors have treated it with six months worth of blood thinning medication and oxygen. so when my pulmonologist said I could stop after a month I asked him why just a month. he admitted he really did not know how long I should stay on it and he just pulled that out of the air. Then I told him what I had read online and he asked me if I wanted to stay on it. I told him I did not and I got off of it and have not regretted it since. But that gives you an example of what I mean when I say he makes things up. I'm happy that he was honest with me but I was a little surprised by his answer. And of course it makes me wonder if he makes up other things too. I would actually like to change pulmonologist but I don't know if there's one out there that is any better. at the moment I'm pretty down on doctors. Mostly because I've been let down by a few of them recently.

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    • Posted

      How true. I always check the consultant/clinic report and ensure that whatever they tell my doctor should be done, gets done. In the past, if I had not done this, I don’t think my husband would be still alive, or on the right medication (two years on, that has been changed time and time again). We have a very good Lung centre here at Wythenshawe hospital, S Manchester. My consultant, purely by chance has a young daughter the bosomest pal of my own grandaughter. It's a little disconcerting when your doc is the same age as your son, but he is excellent. Doesn't do private, nor would he leave my Ct RESULTS TO BE INTERPRETED BY OUTSIDE AGENCY (oops, caps left on). He wanted them interpreted by his own dept. staff. And repeated one I'd failed, to be certain.

      It's the GP we don't really trust. I have my rheumy's letter from 3-4 years ago and an appointment to discuss why some of her recommendations haven't been implemented????

      Keeping myself informed via forums is my best route quite often.

      Onwards and upwards, hopefully. I also have arthritis with degenerative spine disease giving acute sciatica. IbS and diverticulitis. All more or less invisible and under self management. e.g We have melamine kitchenware which is lightweight, and doesn't break or chip so easily. That sort of thing.

      all the best x

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    • Posted

      I agree that you have to stay on top of what is being communicated between GP and specialist; it was only on my instigation that I secured a follow up appointment to check on the progress of my Bronchx (since it was diagnosed 6 years ago) when I moved from Berkshire to Kent (there's no communication between hospitals within the UK, so I had to scan the letters I'd got from the Royal Berkshire Hospital and email these to my new specialist at the William Harvey Hospital in Ashford). Had I not requested this follow up, then my acid reflux condition would not have been picked up via the CT scan (and dealing with this has significantly improved my health) and nor would it have been discovered that I have a 'nodule' on one lung; this is currently not sinister, but will need to be monitored. NHS is a brilliant thing, but - because of its straightened circumstances - I think it's up to patients to sometimes take the initiative when seeking & securing treatment.

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    • Posted

      Thanks for your reply. I also have bad acid reflux. Im curious as to how it was picked up on a ct scan though? . Did you also have an endoscopy?

      What are you taking for the acid reflux and how did it help the Bx? ID appreciate your input.

      ROBYN

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    • Posted

      Hi Robyn

      The CT scan revealed a slight hiatus hernia (so the stomach area was intruding into my chest cavity a bit), but I don't think that was the only reason that my specialist suspected acid reflux as, apparently, it's often seen in those with bronchX. The acid reflux diagnosis answered the problem as to why I so often had a dry cough (allergy tests had all come out negative), the theory being that acid reflux would irritate the back of the throat throughout the night, causing a dry cough throughout the day. My specialist advised that I use a bed wedge (to lift the whole of the upper trunk - not just the head - above the rest of the body), and to not eat or drink for the 4 hours before I got to sleep. I have to say that the results have been staggering - doing these two things has made a huge impact on my health as I'm no longer troubled by the dry cough. I don't need to take any drugs for it either.

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  • Posted

    I don't run fevers, or else the round-the-clock Tylenol A.S. or high dose ibuprofen takes care of them. I didn't run fevers before i had to start working so hard to stay ahead of arthritis pain, so who knows? My pulmo goes a lot by how my lungs sound, with him reminding me to inhale & exhale deeply thru open mouth while he listens. A lot of wheezing goes unheard if he listens while i just breathe deeply thru my nose and he believes that wheezing needs to be treated when accompanied by reports of tons of coughing and/or mucus & strict adherence to spending half my waking hours on neb & other treatments. If i could take tablet steroids ,,, but i can't for more than a 3 day burst. I always meant to check at my in-person AI support group to see whether other SS folk don't run fevers. I find the SS forum here too vicious and hormonal to spend more time in it.

    My pulmo also seems to go by the rule that if a BX person thinks they're sick, they probably are. He, & everyone who ever fills in for him, just treats what's happening, mostly w/doxy but also other ABs -- i can't take azithro. If only i'd come across him 20 yrs ago, i'm quite sure my lungs would be better off now. I haven't answered your question exactly, Amkoffee, except to say that some pulmos trust us more than others.

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    • Posted

      What type of arthritis are you trying to treat ? I have terrible arthritis in my hands and I have chronic pain in my back partly because of arthritis. My rheumatologist thinks I have rheumatoid arthritis but I definitely have osteoarthritis too. I was on opiates until recently and now I'm just trying to treat the pain with CBD oil and Excedrin Migraine . if you're not in the US or or are familiar with it, it is it's a combination of aspirin caffeine and Tylenol . So I never really thought about it but I guess that could be hiding a fever . But honestly I don't run a fever very often . I have never run a fever with a lung infection since I was first diagnosed.

      you know it's pretty weird about doctors listening to my chest with their stethoscopes . I'm afraid I have lost all faith in that method of checking my lungs . One of the reasons is because they have never heard anything in my lungs since I have had bronchiectasis . that's been a little frustrating because they always say I sound clear and yet I'm coughing and you can hear the mucus . secondly I have heard a lot of other BX patients say the same thing. just today I had my regular doctor tell me lie lungs sounded good for someone with my lung problems... But I has not been this congested in a long time.

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    • Posted

      I have osteoarthritis, beginning w/one knee in my teens & now in many sites. C-spine is the worst. Left untreated it never stops hurting, hence Tylenol (acetaminophen) Arthritis Strength, 650 mg/tablet. Mostly i get by w/1 tab 3 x day, plus an occasional ibuorofen or 3. I keep Exc Migraine in reserve for migraines as my stomach cannot have that much aspirin & caffeine around the clock. Exc Mig, 2 tabs = 500 mg ea of acetaminophen & aspirin, 130mg caffeine. That's the same amount of acetaminophen as in 1 tab of Tyl Extra Strength. I used to take 2 ea regular tylenol & ibuprofen together, which is pretty much the same as what you're taking but the ibuprofen bothers me more now so just the high dose tylenol. I always have RX pain med on hand.

      Ten yrs ago i started telling docs that maybe all the tylenol masked fevers because they weren't treating sinus infections due to my lack of fevers. In my entire life i've never run much fever, mainly because we documented in some drug studies that my normal temp, taken every day at the same time, no pain meds, same digital thermometer, was 96.7-97.4. Docs don't give a rat's bottom about that & continue to apply the "must break 100°F" standard. My pulmo doesn't take my temp unless i complain of feeling feverish.

      As to allergies, allergy tests can be a complete waste of time tho not always. We can have "allergic rhinitis" without being technically allergic to anything. I'm allergic to a bunch of medicines but not officially to anything docs test for, or at least not within the usual timeframe. There is some evidence that some of us take 6-14 hrs to show a skin reaction. Since docs don't label what they sampled at each spot on our backs, they shrug if you go back many hours later & ask what that huge welt is about.

      Nonetheless, we react to things and any mucus issue in the upper respiratory system can become a BX flare or infection. we need to pay close attention to these alkergic-like reactions.

      There is another possibility with all the sneezing. There's been a new cold-like virus in the US this year, RPV. Comes with a ton of sneezing. I got it at Thanksgiving because all the kids & teens at Turkey Day were still recovering. Again, pay attention lest it travel down & settle in your lungs..

      Docs & pulmonologists expect BXers to have a lot of mucus, and they expect to hear that mucus when they listen to our lungs. My gp recently said something new: Lungs are pretty junky but resolve on coughing, as in the mucus moves along in the right direction when we cough. If they can't hear it move, or if they hear wheezing or crackling/rales, then they feel the need to change things. This is why my pulmo says to breathe deeply thru open mouth, which gives him the chance to hear everything.

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