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@cwal @irenea8 I'll do my best to answer these questions. Pulmonary treats the patient and not only the sputum culture. In other words, increased cough, increased and darkening sputum feeling crappy for well over a week, all these symptoms drive the decision to treat. My sputum culture showed: excellent specimen quality (no epithelial cells), increased polys means strong inflammatory response (lots of neutrophils), rare mixed bacteria (nothing dominant), no specific pathogen isolated, low level infection likely. Also waiting for tests on fungi and NTM (which take longer).
Could it be a viral thing? Yes. Often exacerbations start out as triggered by some virus. Then, it progresses to bacterial due to weaknesses in my lungs (bronchiectasis). Sometimes I can fight it off and sometimes not.
Do you think the Brinsupri caused the issue? I sort of doubt it. If anything the brinsupri helped as recovered more quickly than usual and did not get as sick.
Replies to "@cwal @irenea8 I'll do my best to answer these questions. Pulmonary treats the patient and not..."
@scoop
Still wonder since the most common side effect of Brinsupri was upper res infections. None of us wants to think it is causing side effects so we may talk ourselves out of it, but we also need to remember that it was not tested on people with MAC or Pseudo etc. I guess only time will tell for sure.
@scoop Scoop- I had my visits with the two pulmonologists and showed them and told them what I was bringing up...the soft yellow/green tint pieces. Both said to me....yes they are mucus plugs.
AI info said....for what it is worth: "Yes, mucus can change from soft and pliable to hardened and even solidify over time in the lungs. This hardening can occur due to a variety of factors that cause mucus to become thick, stagnant, and dehydrated, such as infections, certain medical conditions like cystic fibrosis, and dehydration. In severe cases, this can lead to the formation of hardened "casts" that block airways."
My Pulmonary Function Test, thankfully, continues to be good. Lower lobe plugging is worse than a year ago and both said to me when I mentioned my thought of it being caused by my sleeping on the wedge on my left side every night....both said yes it is possible and more than likely contributing to the build up in that area. Which of course means I need to concentrate postural drainage on my side...right side for left and left for right side drainage. If I've got that correctly.
Scoop I have not any pulmonologist mention "increased polys". I do see you mentioned "lots of neutrophils". I guess that means neutrophils/polys are one in the same.
I think sometimes we forget this...that which you said "Pulmonary treats the patient and not only the sputum culture. "
Present Decision Consideration: So far I feel well, no exacerbations, sputum clear, low load MAI, overall physically strong for my age with very little to no fatigue. energy level is fine (but sure not like it was in my early years) and still not started the antibiotics. At 83 I continue to give thought to starting the antibiotics. Some of our comrades here on Mayo have had parents that had BE and feel/felt sorry and glad their Mom did or did not go on the antibiotics late in life and questioned my going on it at my age with a low MAI load. I certainly understand their question to me early on "why" you feel well and it's a low load. etc. etc. "why do the antibiotics." I am now giving thought to the idea of 'trying' the antibiotics .....I am beginning to feel I need to go for it and try to clear the low load of MAI. Decisions, decisions....they probably will not end due to the BE and living life with it and time dealing with the changes of the body with time.
All thoughts are welcomed and appreciated.
Barbara
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@scoop
Good point about progression to bacterial weakness due to the status of our lungs since bacteria is always hanging out somewhere close by. I was only thinking in "black and white" as in it was bacterial or not. Like you, I doubt Brinsupri is the culprit.