NTM/MAC/MAI: We must advocate for ourselves

Posted by boomerexpert @boomerexpert, Aug 16, 2016

Throughout the US & its territories, a total of 8580 people are infected with Zika, a virus that is easily prevented and does not harm adults - it can cause birth defects in unborn children of infected people, but that can be prevented. The US is spending hundreds of millions of dollars to search for a vaccine.

In contrast, 1 of every 100,000 people (not including people with HIV) in the US are diagnosed with some form of NTM, most prevalent is MAC/MAI, and that figure is increasing. Under "NTM Facts, A Growing Problem" (https://www.ntmfacts.com/prevalence), here's a few alarming statistics:
"Currently, there are an estimated 86,000 cases of NTM lung infections in the US, and that number continues to grow more than 8% in prevalence every year. (with no requirement to report NTM infections as there is for TB, most researchers believe the number is far higher).
With the rise of NTM infections, data has shown that NTM is now more prevalent than TB in the US...it has been found that incidences of NTM are increasing while TB is decreasing around the US. ...The rates of NTM infection are increasing in patients aged 65 and over, a population
that is expected to double by the year 2030."

The infection went from one considered as opportunistic (effects mostly those who are very compromised, like the HIV infected) to one that has now invaded the general population.

Yet, by all research and medical standards, treatment with first 2, and now 3 (and in some cases 4) extremely powerful antibiotics is grueling (side-effects similar to those experienced with chemotherapy) thus difficult (for some impossible) to sustain as it must be taken 3X/day for at least 1 year, thus its effectiveness as a cure in many patients is spotty; for an increasing number it can only manage the infection, causing them to be on strong antibiotics for the rest of their lives.

In essence, the bug has become more prevalent (and perhaps stronger), and the medical community's response has been minimal research to ID current antibiotics that may work better than others, then increase the number used to treat it rather than find more appropriate treatments designed to kill this particular bacteria. Exacerbating the problem is the medical conundrum that taking these medications orally has a reduced impact on this infection deep in the lungs. Most researchers agree that the best solution is something that can be introduced directly to the lung via aerosol or inhalant.

Over the past 18 years, no significant research beyond that mentioned above has been conducted to find a more effective cure. The only clinical trial conducted over the past 5 years for an inhaled treatment, Amikacin, is generally being tested on those who have already failed traditional treatments, thus not supplanting them.

I believe that patients who endure the impact of this medical vacuum must push for more research, and better treatments, not just more clinically effective, but with far less side-effects. We can start by contacting top research facilities for this condition (U TX, National Jewish, Mayo Clinic, and the NIH, FDA) asking for more research. We can also talk with our physicians about better treatments, asking them to push for more research. Finally, we can continue to search for, and share, information on clinical trials for new NTM treatments, and our ideas for treatments that could work.

If these facilities continue to hear from a great number of people suffering from this insidious infection, it may have the "squeaky wheel" effect. Most assuredly if we remain silent, willing to trudge along with the existing treatments without asking for something better, we are likely to get nothing better.

I believe patients themselves can have a great impact on improving research. But...only if they hear from us.

Thoughts? Ideas?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

@boomerexpert

Here's a great "how-to" to get you started: http://sternstrategy.com/sell-ideas-media-insights-former-cnn-producer/
Here's a few ways to contact CNN: http://www.wikihow.com/Contact-CNN - I've left a message for Dr. Gupta's on FB
To reach 60 Minutes: http://www.9jumpin.com.au/show/60minutes/send-a-story/
I also left this on 60 Minutes' story idea form:
"Formerly relegated to those with HIV as an opportunistic infection, NTM's (Non-Tuberculosis Mycobacteria) - found in everyone's water or soil - are now infecting the general population at an alarming rate. As Zika, which is fully preventable, occupies headlines and top stories, this under-reported, poorly treated, and deadly infection is just heating up. For a bit of an overview: https://connect.mayoclinic.org/discussion/we-must-advocate-for-ourselves/
Not only must people be aware, but raised awareness could lead to more effective treatments."

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How about getting better doctors that want to care for the sick and use the knowledge and research that is at there hands.

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@boomerexpert

Here's a great "how-to" to get you started: http://sternstrategy.com/sell-ideas-media-insights-former-cnn-producer/
Here's a few ways to contact CNN: http://www.wikihow.com/Contact-CNN - I've left a message for Dr. Gupta's on FB
To reach 60 Minutes: http://www.9jumpin.com.au/show/60minutes/send-a-story/
I also left this on 60 Minutes' story idea form:
"Formerly relegated to those with HIV as an opportunistic infection, NTM's (Non-Tuberculosis Mycobacteria) - found in everyone's water or soil - are now infecting the general population at an alarming rate. As Zika, which is fully preventable, occupies headlines and top stories, this under-reported, poorly treated, and deadly infection is just heating up. For a bit of an overview: https://connect.mayoclinic.org/discussion/we-must-advocate-for-ourselves/
Not only must people be aware, but raised awareness could lead to more effective treatments."

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Canderson12.....are your drs this way tdrell

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@heathert

Thanks Paula, very interesting. Does anybody know if this years NJH videos for ntm are up yet?

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@heathert I keep checking jewishnational.org/NTMvideos.....so far only 2015 videos posted....i will give it a little more time before calling to ask the CE dept what the status is.

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Indeed finding excellent doctors gets more difficult, particularly outside the major urban areas (NY, Philly, DC, Boston, LA, Chicago). I have found, however, that with diligent searching, and a refusal to accept mediocre care, I can find the few good ones. Takes time & patience, as sifting through the poor to adequate ones means giving them a try, then moving onto the next when they come up short. They can be found, though.

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Hi all,
I just came across the journal article led by Mayo Clinic's Dr. Timothy R. Aksamit. http://www.resmedjournal.com/article/S0954-6111(13)00379-X/fulltext

@boomerexpert, I think you'll appreciate how it is structured and outlines the developments at the time of writing, which was 2014. Here's the intro:

"This review will utilize essential questions about nontuberculous mycobacterial (NTM) lung disease to succinctly address important new developments in the pathogenesis, diagnosis and management of NTM lung disease with a focus on practical information and “bottom line” answers.

1)What do I tell my patients who ask, “where did I get this infection” and, “should I take showers”?
2)What is the connection between bronchiectasis and the acquisition of NTM lung infection?
3)What other factors are important in the pathogenesis of NTM lung disease?
4)Why does it seem that am I seeing more new NTM lung disease patients?
5)Why is the diagnosis of NTM lung disease so complicated and does the diagnosis of NTM lung infection obligate specific treatment?
6)Unlike traditional tuberculosis, what is behind the irrelevance of most in vitro susceptibility testing reports for NTM infections?
7)Is there anything new for the management of patients with Mycobacterium avium complex lung disease? How does the radiographic appearance influence treatment?
8)Is there anything new for the management of patients with Mycobacterium abscessus lung disease?
9)What about the management of other NTM respiratory pathogens?
10)Is there a role for the use of macrolide monotherapy for non-cystic fibrosis bronchiectasis?"

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@colleenyoung

Hi all,
I just came across the journal article led by Mayo Clinic's Dr. Timothy R. Aksamit. http://www.resmedjournal.com/article/S0954-6111(13)00379-X/fulltext

@boomerexpert, I think you'll appreciate how it is structured and outlines the developments at the time of writing, which was 2014. Here's the intro:

"This review will utilize essential questions about nontuberculous mycobacterial (NTM) lung disease to succinctly address important new developments in the pathogenesis, diagnosis and management of NTM lung disease with a focus on practical information and “bottom line” answers.

1)What do I tell my patients who ask, “where did I get this infection” and, “should I take showers”?
2)What is the connection between bronchiectasis and the acquisition of NTM lung infection?
3)What other factors are important in the pathogenesis of NTM lung disease?
4)Why does it seem that am I seeing more new NTM lung disease patients?
5)Why is the diagnosis of NTM lung disease so complicated and does the diagnosis of NTM lung infection obligate specific treatment?
6)Unlike traditional tuberculosis, what is behind the irrelevance of most in vitro susceptibility testing reports for NTM infections?
7)Is there anything new for the management of patients with Mycobacterium avium complex lung disease? How does the radiographic appearance influence treatment?
8)Is there anything new for the management of patients with Mycobacterium abscessus lung disease?
9)What about the management of other NTM respiratory pathogens?
10)Is there a role for the use of macrolide monotherapy for non-cystic fibrosis bronchiectasis?"

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Wow, Colleen! Thank you for thinking of us that struggle with NTM (nontuberculous mycobacterial lung disease). I'll be sure to read this article at http://www.resmedjournal.com/article/S0954-6111(13)00379-X/fulltext
Paula

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@heathert

Thanks Paula, very interesting. Does anybody know if this years NJH videos for ntm are up yet?

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thanks for that terrid

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Everyone.......the videos from the 2016 NTM patient workshop at National Jewish are on line!
Go to NAtionalJewish.org/NTMvideos2016
TDrell

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@heathert

Thanks Paula, very interesting. Does anybody know if this years NJH videos for ntm are up yet?

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@heathert....they are out... nationaljewish.org/ntmvideos2016.tdrell

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The CBS affiliate in Cleveland, Ohio is doing a story on NTM.

The following information was posted on the Facebook page of NTM Info & Research organization: https://www.facebook.com/NTMinfo

ATTN OHIO NTM PATIENTS: Catherine Bosley, a reporter at the CBS affiliate in Cleveland, Ohio is doing a story on NTM. If you are a patient, especially newly diagnosed, within driving distance to northeast Ohio and would like an opportunity to raise awareness by sharing your story please contact Catherine asap at cbosley@woio.com

Is anyone out there with NTM or MAC from the Cleveland area?

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