Have MAC with pseudemonas

Posted by pamelasc @pamelasc1, Nov 8, 2024

Hello - this is Pam in Sudbury, MA. I have not been on the site for some time now, but was when I first came down with MAC in 2015. Recently I have been getting many pseudemonas infections and my lung doctor wants to try the inhaled drug "Cayston". I have several questions: 1. Has anyone also had numerous cases of pseudemonas and how did you deal with it? 2. Has anyone used Cayston, how long did you use it, and did you have any side affects? The doctor feels that even though I can get rid of the pseudemonas taking the drug Levofloaxin (which I have been taking on average every 2 to 3 months), it now comes back because it is either getting resistant to the Levo or that it really never goes away and just sits there until something urges it to rear its ugly head. Has anyone used other therapies to keep the pseudemonas at bay, such as taking in the nebulizer albuterol once a day, and the saline solution once a day?
Any advice will be greatly appreciated. Thanks, Pam

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@happy2023

Even though I was sensitive to most antibiotics, Cipro did not get rid of my Pseudomonas. I took Levaquin for years each time I got a chest infection, most likely building up some resistance to it.
My PCP says the Pseudomonas colonizes in the lungs.
My pulmonologist at National Jewish laid out a plan for me to just keep the Pseudomonas knocked back. This plan is.....
morning and evening: 2 puffs Levalbuterol inhaler; followed by 7% nebulized saline; followed by Symbicort steroid inhaler (low dose 85 mcg/4.5 mcg) 2 puffs morning and 2 puffs evening.
I used a SmartVest for 4 months, sustained spinal compression fractures, now switching to a wrap, not vest, by Electromed with settings very low to begin with. Am going to try the Volara which nebulizes saline and oscillates in the same treatment.
I do pharmacologic airway clearance morning and evening (in the plan mentioned above).
Mid-day I do postural drainage airway clearance with supine exercises, deep breathing, huff coughing, manual percussion, Aerobika.
So far so good.....no exacerbations for 1 year now.
I have started wearing a mask every time I go out, and especially when I walk my dog, just to keep the dust and particles out of my lungs. I wear an N95 insert anytime I am around people, as at a grocery store or visits to the doctor.

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Hello - very interested to hear about the "N95 insert" - can you tell me where you get those and what the specific brand is? Also, I was given this device (see attachment) when I was in the hospital and I am not sure how to use it, and want to know if any of you use this on a regular basis and find it helpful. How is it helpful? Pamela

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@irenea8

Why was the Symbicort prescribed? Was that specific to Pseudo?? When you do try the Volara, would love to hear what you think. Thanks!

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Symbicort or its generic equivalent is the long-term treatment of choice for chronic asthma and many types of COPD. It has a long-acting beta agonist plus a low dose corticosteroid (LABA/ICS.) It is thought to be better at keeping inflammation down and airways open than a short-acting beta agonist (SABA) like albuterol or levalbutrol.

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@blm1007blm1007

Sue-
When you say you have stable bronchiectasis, can you explain. I think I know what you mean but not sure I am right.
My Oct. CScan showed two areas of improvement but one new area showing plugging in the lower left lobe. Working harder to get better CScan results next time, which means, apparently, I won't fully know until a year if I improved due to the once a year CScan.
Barbara

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"Stable" means the new CT shows little or no change from the previous scan. In my case, all that changed was some former active nodules in the lower lobe have hardned into scar tissue.

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@pamelasc1

Hello - very interested to hear about the "N95 insert" - can you tell me where you get those and what the specific brand is? Also, I was given this device (see attachment) when I was in the hospital and I am not sure how to use it, and want to know if any of you use this on a regular basis and find it helpful. How is it helpful? Pamela

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An incentive spirometer is a handheld device that helps you practice taking slow, deep breaths to strengthen your lungs and keep them healthy:
https://www.google.com/search?q=incentive+spirometer&oq=incentive+spi&gs_lcrp=EgZjaHJvbWUqCggAEAAYsQMYgAQyCggAEAAYsQMYgAQyBggB
Barbara

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hi Pam , How long have you had the pseudomonas? My name is Pam too ! 🙋‍♀️ . I also have pseudomonas . I don’t do well with texting and computers and was wondering if you would like to speak by phone ? my username is p1000 . i’m looking forward to hearing from you, Pam 🙋‍♀️ stay well😎

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@sueinmn

Symbicort or its generic equivalent is the long-term treatment of choice for chronic asthma and many types of COPD. It has a long-acting beta agonist plus a low dose corticosteroid (LABA/ICS.) It is thought to be better at keeping inflammation down and airways open than a short-acting beta agonist (SABA) like albuterol or levalbutrol.

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Thank Sue, I understand that but I asked Happy 2023 with respect to her comment that it was part of a plan laid out by NJH for keeping the Pseudo knocked back. I wondered if in that context it was prescribed or if she already has some sort of asthma etc. I know Pseudo causes very bad inflammation and perhaps airway constriction as a result so wondered if it was part of a plan for someone without actual Asthma who had Pseudo? Does this make sense?

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@pamelasc1

Hello - very interested to hear about the "N95 insert" - can you tell me where you get those and what the specific brand is? Also, I was given this device (see attachment) when I was in the hospital and I am not sure how to use it, and want to know if any of you use this on a regular basis and find it helpful. How is it helpful? Pamela

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It is difficult to find N95 inserts, so I order a box of 35 pieces of Halyard Fluidshield 3 N95 Particulate Filter Respirator and Surgical Mask with So Soft Lining from http://www.wellbefore.com. Then I cut them down to fit inside a cloth mask with a pocket insert. You can cut 2 pieces from one of these masks to act as an insert.
Their phone number is (214) 416-9009. They are located in Dallas, and I've ordered from them since the beginning of the pandemic.
If you email me at phamshari@yahoo.com, I can send you a photo of the box and mask.....I'm not good at uploading a photo to the computer.
I also have PM2.5 inserts that I use when I walk my dog, to keep dust and pollution at bay. I order these from Amazon.

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@irenea8

Thank Sue, I understand that but I asked Happy 2023 with respect to her comment that it was part of a plan laid out by NJH for keeping the Pseudo knocked back. I wondered if in that context it was prescribed or if she already has some sort of asthma etc. I know Pseudo causes very bad inflammation and perhaps airway constriction as a result so wondered if it was part of a plan for someone without actual Asthma who had Pseudo? Does this make sense?

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Irene, I am Pam from Arvada, just outside Denver, and am treated by NJH. My Bronchiectasis was diagnosed in 2013, and I did not find helpful care with any of my pulmonologists until I became a patient at NJH in November of 2023. From that time with the plan my pulmonologist laid out, I have had no exacerbations nor had to take any antibiotics. Prior to that I would have chest infections at least 2 times a year and for the most part was prescribed Levaquin.
NJH has a yearly lecture series in the spring which can be attended online for a reasonable fee. The takeaway from their last lecture series was this.....Airway Clearance, Airway Clearance, Airway Clearance!!

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@irenea8

Why was the Symbicort prescribed? Was that specific to Pseudo?? When you do try the Volara, would love to hear what you think. Thanks!

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Symbicort is prescribed to keep down inflammation in the lungs. It is for long term use.
I will let you know how the Volara works. I think it will be like a combination of nebulized saline with the Ombra and using the Aerobika, all in one 10 minute treatment.

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@happy2023

Symbicort is prescribed to keep down inflammation in the lungs. It is for long term use.
I will let you know how the Volara works. I think it will be like a combination of nebulized saline with the Ombra and using the Aerobika, all in one 10 minute treatment.

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Was the Smbicort specific to the inflammation caused by the Pseudo? Or do you have some sort of Asthma already on top of Bronchiectasis. That is what I am trying to figure out! I have no Asthma history but I have chronic Pseudo and BE. I know I have alot of inflammation as a result. Would the Symbicort be part of a Pseudo knock back plan for me or just for people with a history or current Asthma or COPD causing airway constriction?

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