Newbie here. Scared and overwhelmed by MAC treatment plan

Posted by ccarter1004 @ccarter1004, Jul 26, 2025

I will soon be doing 12 weeks of IV Amikacin plus big 3 for a year to 18mo. How do you muster the mental strength to battle all of the side effects? What is the reality of what you can physically do day to day. Will I be incapacitated by the fatigue and side effects? How much of my day to day life will be compromised? Please share your experience especially what a “good day” looks like and how often those happen. I have visions of being bedridden with nausea and fatigue.

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

Profile picture for terrimn @terrimn

Of course I'll share! I wake up at 5 for sunrise yoga for postural drainage/airway clearance and 1 cup of coffee. Get my run in-which encourages lung clearance, then shower, etc. I take the 500 mg of Zithromax 2 hours after my morning coffee, but at least 1 hour before breakfast. (Max absorption/benefit on empty stomach). Go about my day, and dinner at 5. I prefer to get the Arikayce (w/2 puffs of Proventil beforehand) done before 6:30 pm because it brings up lots of "airway clearance huffing" mucus and I don't want that new "activity" to keep me from a great night's sleep! Ethambutol and rifampin immediately before bed.
Honestly for me, after my diagnosis, I treat this as just another adventure to add to my already fun and full life of daughter, wife, mother, and grandmother to 4 beautiful and busy boys! A positive, upbeat attitude goes a very, very long way in this particular health journey. I'd be happy to answer any specific questions, and know there's a ton of support here for you.

Jump to this post

Her daily itinerary is wonderful. I intend to copy it. Her attitude toward this illness is uplifting. I'm seeing my doctor on Monday and will know what to ask him for in terms of medication. I have been given Azithromycin 500 MG daily and Amox-Clav 875-125 MG, Generic for Augmentin, one tablet every 12 hours. I am no better after a year or more of this regimen, still profuse sweating, fever, fatigue, lots of mucus, coughing, and frequent naps. My grandson has cystic fibrosis; my daughter and I both have the SCNN18 Gene. I would give her a big hug!

REPLY
Profile picture for terrimn @terrimn

Hi, It's my first time commenting on here, and I wanted to share with you specifically. Dx in March 2025 with MAC and mild BE, 64 yrs young, and daily runner. Started on all Big 3 immediately and after 4 months, ID doc started Arikayce. With the exception of very slight fatigue on some days, I have had zero side effects from these four antibiotics. It took me 1 week to make med schedule fit my daily routine, not the other way around!!! After looking at other posts and realizing there's way more to be hopeful for than despair over, my initial fears of the unknown were mitigated. Though the daily regimen of meds/boiling water/airway clearance is a pain in the arse, I have chosen to not let MAC interfere with my schedule of enjoying my life in every aspect. Good luck to you in this new adventure. Terri

Jump to this post

Thanks for your positive feedback about treatment experience. Your fitness level and positivity contribute, massively, to how you’ve managed so well! I’ve just got to stop fretting and get on with it but it’s not an easy decision - for anyone.

REPLY

It was scary for me, as well, when I started the big 3. I started the first on August 1, added the 2nd on August 4 and the third on Aug 8. At this point I haven't been told/asked to do the IV drugs. I haven't experienced any nausea which is great. I'm so pleased with that. After adding drug #2, I had with a low-grade fever off and on for several days but it has mostly subsided. I still wake up at night in a sweat but I can get back to sleep after not too much time. I'm taking probiotics and really focusing on eating well as I don't want to lose weight. My energy is not as good as it once was but its not bad and I am going to the gym on a regular basis. Still, I'm fearful as they're monitoring my blood, my heart etc. It's intimidating but I'm getting support from friends. One day at a time is how I'm tackling it. I hope it goes well for you ... and for me.

REPLY
Profile picture for irist @irist

It was scary for me, as well, when I started the big 3. I started the first on August 1, added the 2nd on August 4 and the third on Aug 8. At this point I haven't been told/asked to do the IV drugs. I haven't experienced any nausea which is great. I'm so pleased with that. After adding drug #2, I had with a low-grade fever off and on for several days but it has mostly subsided. I still wake up at night in a sweat but I can get back to sleep after not too much time. I'm taking probiotics and really focusing on eating well as I don't want to lose weight. My energy is not as good as it once was but its not bad and I am going to the gym on a regular basis. Still, I'm fearful as they're monitoring my blood, my heart etc. It's intimidating but I'm getting support from friends. One day at a time is how I'm tackling it. I hope it goes well for you ... and for me.

Jump to this post

Thank you! I’m so glad the big 3 is going better than expected! And you go to the gym! That would be a huge improvement for me. I feel I have less energy all the time. Really working hard at eating well pre treatment. I can’t lose any more weight. It is the IV that has me the most worried. Thank you for sharing. Every ounce of encouragement is appreciated.

REPLY
Profile picture for ccarter1004 @ccarter1004

Thank you! I’m so glad the big 3 is going better than expected! And you go to the gym! That would be a huge improvement for me. I feel I have less energy all the time. Really working hard at eating well pre treatment. I can’t lose any more weight. It is the IV that has me the most worried. Thank you for sharing. Every ounce of encouragement is appreciated.

Jump to this post

For those of us who have been slim our entire life and can't afford to lose an ounce, the very best way to maintain or gain weight is going to the gym! Pump the iron!!! Working out is paramount for good energy levels to combat fatigue (if you have it), and for mental health maintenance to get through this "bump" in our lives. A bright and positive outlook will go miles in accepting your BE/MAI dx; after all it's not cancer-nor a death sentence-woo hoo!

REPLY
Profile picture for terrimn @terrimn

For those of us who have been slim our entire life and can't afford to lose an ounce, the very best way to maintain or gain weight is going to the gym! Pump the iron!!! Working out is paramount for good energy levels to combat fatigue (if you have it), and for mental health maintenance to get through this "bump" in our lives. A bright and positive outlook will go miles in accepting your BE/MAI dx; after all it's not cancer-nor a death sentence-woo hoo!

Jump to this post

Is appetite still a problem for you?

REPLY
Profile picture for ccarter1004 @ccarter1004

Is appetite still a problem for you?

Jump to this post

Nope. I eat every 2 hours making sure I don't interfere with the meds absorption (which is absorbed best on empty stomach). My metabolism is very high, so I eat whatever and how much I want whenever I want. Still easily maintain my 116 lbs. I'm not a fretter or debbie-downer, so that helps tremendously as well.

REPLY

Hi, I just started my treatment last week as an inpatient. I came home Tuesday night and started home IVs of Amikacin and Imipenem until the oral pill is approved and then received. Plus taking oral Linezolid daily. My first home IV of Amikacin 1,500 mg (3 times week) took 4 hours. I did message my doctor and he is checking with the ID pharmacist about increasing the dial setting on the IV. Medicine bag says 250 mL/hour, and that was our first one at home so maybe didn’t have the tubing inserted as much as needed. My second dose is this afternoon. I also ask my home health nurse and she wasn’t sure if okay to increase the setting for Amikacin.
What is the setting on your medicine bag and how many hours is your IV treatment?
And I would appreciate anyone else’s experience. Thank you.

REPLY
Please sign in or register to post a reply.