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Bronchiectasis in teachers & health care workers
MAC & Bronchiectasis | Last Active: 3 days ago | Replies (32)Comment receiving replies
Yes @tcd518 tgere is the issue of access to healthcare. But lack of aware of Bronchiectasis as a chronic lung disease is missing although next to COPD and asthma, it is often mentioned in medical journals and on medical websites.
Replies to "Yes @tcd518 tgere is the issue of access to healthcare. But lack of aware of Bronchiectasis..."
4 dr's diagnosed me with asthma problems for over a year. However, allergy Dr. said that she didn't know what was wrong with me but it wasn't asthma. That's when I sought out an infectious disease Dr. It was Pseudomonas. None of the other 4 Dr.'s even considered sending me to a specialist or doing cultures/sputum samples, they just medicated me to the hilt. It was to late for me by that time that I found the Infectious Disease Doc. All the cilia were either destroyed or deformed so badly that I could no longer move mucus out of my lungs. I now use a vest 2x per day for 30 minutes each time. Still picking up one infection after another even though I take precautions. It truly is a fight.
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I think that we need to think about awareness by providers as an exercise in probabilities.
When it comes to lung conditions, depending on age, symptoms and general health, the most common causes are considered and treated first - in order of commonality, these would be virus, bacterial infection, allergy, asthma, sinusitis or GERD causing drainage to the lungs, COPD, Emphysema or chronic bronchitis and lung cancer, each of which affects millions of people in the US, and is seen daily by primary providers. These are the conditions that should be top-of-mind when they see patients.
Way down the list, each affecting one-half million people or fewer, would be Bronchiectasis, Pulmonary Fibrosis and Cystic Fibrosis. That is where specialists come in - they have the training to diagnose and treat these rare conditions.
Just to put a number on it, there are an estimated 350,000-500,000 with Bronchiectasis in the US and about 100,000 or so with NTM. In comparison, there are 25 million with Asthma, and about 15 million each with COPD or Emphysema/chronic bronchitis.
Primary medical care is too overwhelmed and understaffed to expect them to know everything, or even to have the time to learn and use every diagnostic tool or medical article that comes along.
I think where the under-diagnosis comes in is with primary providers who are reluctant to order more diagnostics (insurance issue) or to recognize they need another set of eyes, or with practices that are afraid of insurers and their response to "too many referrals", or patients who resist referral due to costs or the hassle of getting appointments.
There are no easy answers here, but adding more to the primary care burden is just not likely to be fruitful.