Bronchiectasis in teachers & health care workers

“Untreated infection and repeated infections can lead to Bronchiectasis eventually. “ @irenea8

I agree with your comments. Sorry your infections were left untreated or not properly treated. Our body types might predispose us to lung issues possibly, but a simple test - a sputum test - to provide the scientific information about which antibiotic must be used to target the bacteria, would be helpful.

Broad spectrum antibiotic treatment simply doesn’t work at times and can be harmful to patients. How many of us got multiple, short dose prescriptions? If there are other symptoms, it should warrant a sputum test or nasal swab? It could also save the insurance companies money in the long run.

Maybe doctors could just check that “sputum” box a bit more frequently for certain cases where they might be stumped by symptoms over many months / year?

@pamlw I agree that occupation, frequent exposure and perhaps those other risk factors such as body type etc could help alert practitioners with just a very basic awareness.

Women certainly are well represented in the school systems and healthcare in most countries.

I mentioned a cardiologist’s comments about healthcare and teaching professions in another post.

Perhaps other cardiologists might see the connection based on their experience. Anecdotal evidence to be sure.

The number of diagnosed cases of Bronchiectasis of course is a fraction of reported cases of COPD and asthma.

Some cases evidently go undiagnosed as some research has stated and now we have an aging demographic with post Covid infections which might present another risk factor.

The Dr was a GP and no he did not run any sputum tests and he did not know much about that particular antibiotic. I think he knew of my GI history and yet that particular antibiotic is one of the worse for causing C-Dif . I should have seen a good pulmo or ID from the outset. But I did not know better. I have never found GP's to be of much help with anything. Perhaps I have just been unlucky. And the ones I have seen since then, know so little about Bronchiectasis...

Just going to play devil's advocate here for a minute...aside from the current issue of insurance coverage for additional tests, MOST patients want an "instant answer" - as in, I walk out with a prescription in my hand. They do not want to hear "we'll send in this sample and call you in a week."

So, most doctors do just that. Even today, I am often appalled when antibiotics are demanded and given for what are clearly viral illnesses, even without seeing the patient. Recently, we did a culture and "watch and wait" with my grandson for a week before his Mom and I were convinced he needed antibiotic.

This past year, I had 3 staph (not MRSA) infections in wounds. After the first course of antibiotics each time. I insisted on a culture - two out of 3 times, a different med was prescribed that cured the infection. Each doc pushed back, saying X was the drug of choice, broad-spectrum, just needed more time... I stood my ground and got what I needed.

But I suppose if it works "most of the time" there is little reason to change their practice.
That's why we patients need to be informed consumers of health care.

This is a great discussion

@sueinmn I appreciate your comments and with your arm in a sling!

I agree that people typically want a quick fix. I’m still concerned though with how so many of us had lingering, developing or worsening symptoms that were left untreated without sputum or other basic tests and without targeted antibiotics.

I know some clinicians might provide one antibiotic, test and then have patients switch to more efficacious antibiotic afterwards. Even that would be helpful in cases that have been ongoing for some time.

With your depth of knowledge, you still had to recently push back. Many of us were not so well equipped, although we’ve since learned.

I know doctors are taught to be certain about their diagnosis and decision making. It is part of the medical culture in schools and afterwards, as is the specialist vs general practitioners dynamics in the treatment of patients.

We can hope that more awareness might help, but in the meantime, some are only lucky to have a physician who will explore options. Of course, I’m aware physicians are busy.

I’m especially grateful for specialists and this forum. Thanks again Sue.

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.

@1fancydancer I’m so sorry to hear about your struggles to remain free of infection, despite the airway clearance you do. It is a life changing diagnosis.

With four doctors who never thought to do a simple sputum/ culture test for you, it is perhaps a sign of a larger problem. How often do doctor’s check off these boxes for sputum cultures?

If it isn’t often, perhaps it would be useful to provide residents in training with more rationale for using this basic diagnostic tool. What a great opportunity it could be, to then mention Bronchiectasis, MAC and other disease.
Always hopeful..

Hello All.
I have read through quickly all of the posts. I will add my story and 2 cents worth.
Causes for possibly coming down with BE...
.1. Living life in all the enviroments we found ourselves in. One of my examples of the many possible enviorments: I taught school for a short time....meaning sick children and illnesses passed onto teacher, and as well not the "healthiest of building enviorments."
2. Possibly colds, bronchitis etc. etc. and or other so called "not to worry' small illness with lungs involved throughout life and all adding up in a cumulative way in our system.
3. Having asthma, allergies, flu, pneumonias, viruses that add up in a cumulative way in or system.
4. Living in a home with second had smoke or being a smoker.
5. Not know one is low in Vitamin D until it has affected one in different ways including the lungs.
6. Being a farmer or home gardner and dealing with soil, leaves, animal droppings, cleaning out bird houses etc. etc. (More women than men develop BE....I think there are many reasons why.....one possibly being DIFFERENCES in how we handle life's journey, life experiences and in general involvments)
7. Immune system weakened at different times throughout life and possibly causing a cumulative affect.
I think there are other possible things that we don't realize all add up in a cumulative way, however, some people develop BE early on and that could be due to extreme situations/environments....hard to know. I was going on 80 when finally diagnosed with having BE.
Now regarding doctors.
Long story short as soon as I was told via an XRay that said I had emphysema I on my own, (no suggestion by the primary doctor) made an appointment with a local pulmonologist who said "No you don't have emphysema you just have large lungs." Well, ignorant me I left it at that. Nearly a year later after losing 35 pounds and many visits to my PCP saying "something is wrong", he ordered the CScan, result BE. WE KNOW WHEN SOMETHING IS WRONG THEY JUST DON'T BELIEVE US TOO OFTEN, after all we don't PRACTICE MEDICINE. After the diagnosis I was on the internet day and night trying to get as much information as I could and looking for a reason of WHY etc.
After searching the internet, with next to no help from the local pulmonologist after being told I had BE. and knowing previously of NJH (Mother died of emphysema) I on my own made arrangements and went to NJH...glad I did that due to all the tests they did to allow a better understaning of my health and systems.
However, by the time I was in the offices of NJH I very much knew a lot of the things to do, thanks to the internet, (wedge pillow, foods etc.) that we need to do. I just didn't know about the nebulizing, vest, and Aerobika and did not fully understand all that, especially air way clearance, until I found MAYO CLINIC CONNECT after my visit to NJH.
Yes, Sue you are so right.....we need to be our best advocate and speak up time and time again...although it ain't an easy road at times for many reasons.
Sue..P.S. .......I did ask the BE specialist I see who is five hours away from my home if she knew of a local pulmonologist here that could work with us...she and I. It didn't go over very well. Reply: "I can't help all my patients find local pulmonologists." Must have been a trying day for her. I do like her and she knows her stuff!
Luckily I think I found a local pulmonologist after that reply via my eye doctor suggesting the one her Mother In Law had due to her having had BE. Lucky me, he said he would be very happy to work with us and that he had a patient or two involved with the same BE specialists. When you speak up to your doctors and they are personable you do get help....my eye doctor was also personable.
To All....keep posting, for it helps in so many ways....... including from keeping us from feeling alone and as well not letting us give up.
THANKS,
Barbara

Fabulous post Barbara! You put so much thought into it, and laid things out so clearly.

I was raised by parents who taught us to think for ourselves and stand up for ourselves-not common in the 1950's, especially with daughters. It made for some interesting times when we stood up to authorities, but if we were right they backed us. I have spent my life coaching others to do the same, just like here on Connect.

So to everyone here, we have your back, but you need to speak up, here and with your doctors!

Interesting...ill have to start researching.more with that in mind.