Infection or Viral?Cold/Flu

​My consultant said if I start "feeling" unwell and the symptons last for more than one day, then start taking antibiotics.

The short answer to your question is, in my case, undoubtedly antibiotics. Others will argue correctly that colds are viruses but that may or may not be a pre-cursor to a bacterial infection of the chest, susceptible to antibiotics. But my main purpose is to recommend azrythromycin not for bug killing per se but because it has a powerful anti inflammatory effect, unique to that drug and not to others in its class. B will always increase mucous if you get a cold and whilst A is not a miracle, it helps enormously. I have a rescue does always on hand, prescribed by my GP. There is much to be said to warding off a cold and it is possible. My recent post on that subject gives the formula of OTC drugs/ vitamins and zinc which achieves better than 50% success. To avoid repeating myself, I suggest a thorough read of this forum.

i hope this helps

Firstly if you have bugs in yr mucus it's normally a sign of an infection. It actually sometimes doesn't show bugs but you can still have an infection (I was told this but the top consultant at Papworth ) your gp doesn't sound very sympathetic or helpful. I would ask what bugs are in the sample you sent off then look them up on the Internet.

Personally I would change yr GP . The trouble is many gp's don't know much about bronchiectasis so getting referred to a good chest clinic and building up a rapore with them helps. I'm lucky that my gp is now fully aware of bronchiectasis and all it brings an my consultant is always a text message away if I need her. This helps me deal with things so much better.

Hope this helps you Simon. Feel free to message me anytime.

Kind regards

Rachel ☺

The rule of thumb is this...

Have you seen a change in the following

Production of mucus

Colour of mucus (clear -> cream -> green -> brown)

Drop in peak flow (more than 10% or so)

General feeling of malaise / tiredness

Worse sensation of breathlessness

Pain in chest

If yes to three of these, especially production and colour and if it has been going on for more than 3 days with no improvement / getting worse then you should give in a sample.

You should then start your emergency antibiotics, of which you should have a stash and which should treat whatever you tend to grow. For instance, I often get haemophilus influenza and moraxella catarhalis which are frequently immune to penicillin, so I have co-amoxiclav.

You can then change your drug depending on the test results.

In general a GP would insist on a week or ten days or more before going for antibiotics, and in general that is the right thing to do. However, with Bx the recommendation by NICE, BTS and everyone else is aggressive early treatment with antibiotics. If you need documentation to show to your GP then I / we can point you in the right way.

Finally it is very important to get vaccinated. Always get the flu vaccine as early in the season as you can. Also you should get Hib vaccine every couple of years.

Good luck!

Sam

If we get a cold/flu, we'll end up in the hospital with pnuemonia.

So as soon as you see a change in the color of the mucus, energy level starts to decrease, more congested, see your gp as soon as possible.

Elizabeth

I am doing all I can including trying to stay positive, attending the gym and doing clearence, but I am so fatiuge and tired a lot of the time aswell as bloated which dosn't help at all. My specialist hasn't given me a stash of antibiotics for emergencys so I can't do that, and when I initially started with it, they over treated me with antibiotic which caused me to develop asspirigillus (which was not affecting me apparently) so they left it be as my body wasn't reacting. The specialist simply said he was not suprised I had developed that after a lot of antibiotic which was to kill the bug hamaphelius influenza I think. So after that I kind of stopped doing the samples and have tried to be tuffer about it and only see my G.p when I feel really bad. I guess with a cold your gonna feel bad though, right?

What a complicated condition. The specialist says I have it (mild) if this is mild I would not like to have it severely. My peakflow remains at 500, a drop from 540 I use to get 4 or 5 years ago. I have damage apparently on both of my lungs but not badly. I am just scared the damage will increase. I just wish I had a good care plan. I will follow things up with the specialist asap.

Thanks again guys.

Simon

Well you've got the thin end of it  for sure. And I'm very sorry to hear it. 

I am surprised that you were  massively treated for haemophilus influenza. It's one of my frequent fliers and I know the little bugger well. Often resistant to penicillin but usually sensitive to co-amoxiclav and - as far as I know - always sensitive to the flouro-quinolones like ciprofloxacin or moxifloxicin. A week and it's done.

What bugs to you tend to grow? If you're not sure, ask your doctors receptionist to print them out. Just say it's for your consultant and they'll usually be fine with that.

Getting aspergillosis is a bit of a bind, but steroid inhaler should keep it under control. The relvar should sort you out nicely there.

I have a little sympathy for the doctor - if he can't hear the typical sounds of lower lung infection he may, with some justification, feel that is likely to be a virus. Therefore no antibiotics.

However, the way to be sure is a sputum sample. And you should persist even if the first sample shows nothing. If you're still unwell a few weeks later, do or again . Sputum sample microbiological tests can miss a bug  20% of the time.

Consultant: if you have Bx (by the way 'mild' just refers to the damage they can see in the ct scan, not the frequency of infections or anything else) you need a respiratory consultant who knows what they're doing. There are specialist teams at the Royal Brompton in London, at Papworth in Cambridge (i think Rachel is with them). Where do you live - someone here will know a decent consultant and you can use NHS Choice to go to them.

Also, if you don't mind answering, how old are you? With age and height you can work out what your peak flow should look like and then what is a trigger level for action.

Your point in your last paragraph is the key one - an action plan. We don't get cured, we manage Bx. Hence the barrage of instructions in these responses.

And the primary objective is to break the vicious cycle of infection -> damage -> inflammation -> mucus -> infection. So don't tough it out, get all informed patient on your GP, tell him what for, hand in the samples, take the antibiotics (given the protocol mentioned above), get a specialist consultant.

For  information, a good place to start is to Google 'bronchiectasis chest heart stroke Scotland'. Very very good pamphlet. It's the second result at the moment, and is at chss dot org.

Good luck

S

I have just seen my g.p again this morning. She said my chest sounds clear and is convinced i have a virus that my body off fighting off and that it's upper respitory and only lower causes scarring. I will get a sample in also as you have advised so they can take a look. It's so annoying,you go on a good run of no infections a while building your immune back up and then it has to be wiped away with lengthly antibiotics : ( i remain positive though and xmas is iust around the corner so i am hoping to be well by then. Thankyou again for all your great advice.

Much gratitude and respect.

Simon

For peak flow you are set the bottom edge of normal given age and height. The normal curve would be at about 600 ish, and anything within 100 of that is considered normal. It's about the same as me. So if you drift down to consistently below 500, say 470 and below, that should be a red flag.

The consultant you're seeing is not a specialist in Bx. That group looks more like a lung cancer specialist group with  some general medicine thrown in.

I note however that the Leeds Centre for Respiratory Medicine has  a specialist bronchiectasis service headed by Dr Daniel Peckham and Dr Ian Clifton. It is based at Seacroft Hospital. Google for Leeds specialist bronchiectasis service and you'll get to their website.

 I don't know anything about them, maybe someone else here does, but it is explicitly set up to provide secondary and tertiary care for bronchiectasis for west Yorkshire, so I would give it a go.

Hope that helps

Sam