Prednisone for flare-up - Bronchiectasis with asthma

Posted by wsbme74 @wsbme74, May 15 7:42am

Hi. I have mild Bronchiectasis (diagnosed last year) and moderate but usually well-controlled asthma. The 2 times I have had the start of an exacerbation (low-grade fever, tight chest/reduced stamina, more mucus production, and this time some Hemoptysis for the first time) my local pulmonologist has prescribed 5 days of amox/clav and 5 days of 40mg of prednisone. I would love to avoid taking prednisone each time something is starting up but I wonder if it's necessary with the complication of asthma.

Also, for Hemoptysis (maybe 1/4tsp), I am worried about doing saline and huff coughing/aerobika, etc. in case it makes it worse. But I know that increased airway clearance is important during exacerbations/infections. How do others manage this balance? Thanks!

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liz440 | @liz440 | May 15 10:47am

5 days of prednisone 40 mg is what my doctor prescribes in these situations. It is for the inflammation. It is unlikely that this dosage and length of time could do any body harm IMO but people fear prednisone for whatever reason. I have an autoimmune disease and have been on low dose prednisone for probably 40 years and at 78 I'm still walking around with no broken bones and periodically I have to increase the dosage to 40 mg for 5 days then 5 days at 20 then 5 days at 10 then back to my normal 5 mg. You want the inflammation in your lungs due to an infection to subside and the prednisone is the way to achieve that. I'm not a doctor. This is just my opinion.

sweethighland | @sweethighland | May 15 1:07pm

In reply to @liz440 "5 days of prednisone 40 mg is what my doctor prescribes in these situations. It is..." + (show)

Do you have Asthma too?

wsbme74 | @wsbme74 | May 15 1:24pm

In reply to @liz440 "5 days of prednisone 40 mg is what my doctor prescribes in these situations. It is..." + (show)

Thanks so much for your very thorough and reassuring answer. I really appreciate it!

wsbme74 | @wsbme74 | May 15 1:24pm

In reply to @sweethighland "Do you have Asthma too?" + (show)

I do, usually mild-moderate.

liz440 | @liz440 | May 15 1:28pm

In reply to @sweethighland "Do you have Asthma too?" + (show)

yes I have asthma

dstella | @dstella | May 16 10:43pm

I’m so nervous about taking steroids for my asthma it definitely effects my care…
When complicated with Bronchiectasis and MAC , prednisone can be like a double edged sword.

wsbme74 | @wsbme74 | May 17 4:14am

In reply to @dstella "I’m so nervous about taking steroids for my asthma it definitely effects my care… When complicated..." + (show)

Yes, that's definitely how I feel about it.

Sue, Volunteer Mentor | @sueinmn | May 17 10:48pm

In reply to @dstella "I’m so nervous about taking steroids for my asthma it definitely effects my care… When complicated..." + (show)

@dstella & @wsbme74 As a person with Asthma and Bronchiectasis, who has also been treated for MAC & Pseudomonas, I too have found it necessary to weigh the choice between steroids and the possibility of more infection.

Here is what I decided with the help of my pulmonologist - unrelenting asthma further restricts my already damaged airways. It also leads to air hunger, chest discomfort, rapid heartbeat (especially when I need to neb repeatedly)- all of which are in the "here and now" when I have an exacerbation. So comparing the actual problem of not being able to breathe with the possibility of infection, steroids win.

Remember, you can die of uncontrolled asthma, or from the strain on your heart and circulatory system from long-term lack of control. It actually happened a few years ago to my 50-something neighbor.

Every treatment has a downside - just think of the side effects some of us tolerate for the Big 3 antibiotics, or what people experience with chemo - you need to weigh the risks and benefits in making your own decision.

What did you decide about steroids?

Sue

bdr | @bdr | May 19 7:31am

In reply to @dstella "I’m so nervous about taking steroids for my asthma it definitely effects my care… When complicated..." + (show)

I agree that caution is warranted. I’ve been steroid dependent for years and am now suffering the health impacts from that.

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