Hello,
Onset of symptoms 12/22. Frequent dry, barking cough, fatigue, wheezing, multiple respiratory infections
PMD unable to see me. Treated at a Urgent Care facility. Symptoms persisted, advised see PMD no appointments available.
2/23 Endocrinologist (annual exam- hypothyroid, osteoporosis. ROS and exam Frequent dry, barking cough, fatigue, wheezing, multiple respiratory infections ordered a CT of Abdomen and Pelvis concerned about weight loss and issues with pancreas.
Findings: Infectious or inflammatory process seen in right middle middle lobe
3/23 PCP ordered CT of Chest w/ contrast
Findings: Bronchiectasis of right middle lobe, centrilobular and grouped in tree-in-bud clusters suggestive of an atypical mycobacterial infection, though not exclusive to that set of pathogens.
Referred to MD Pulmonary Specialist who also specializes in Pulmonary Disease Pulmonary Critical Care. Internal Medicine, Neurocritical Care. He is the clinical lead for Bronchiectasis and CP. Board certified in 4
specialties.
4/23- 10/23
Stated on inhaler and nebulizer.
Cultures x 3 sent, MAC, Pseudomonas, and 6 other pathogens.
Nothing grew.
6/23
Bronchoscopy- Right Middle Lobe Bronchiectasis
Bronch-Alveolar Lavage to obtain cultures, therapeutic aspiration

Cultures sent noththing grew.

PFT- low moderate compromised .

Immunized 9/10/2025- Moderna mNEXSPIKE and Fluzone HD.

9/20/2025- Positive for Covid and Flu A
Recieved treatment- very ill for 1 month. Seen by Pulmonologist.

11/2025- 12/21- Increasing symptoms but unable to be seen- Daughter- Pre eclamptic with second son (Born 12/2/2025- Emergancy C section, daughter needed care for newborn and 5 yo son before and for 5 weeks post-partum.
On 1/8/2026 Appointment with Pulmologist-
Chest x ray- no worsening, lungs hyperinflated.
Remain in inhaler and nebulizer.
Discussed Binsupri and initiated approval.

I realize this is long. I feel a through explanation might be helpful in order to get feedback re: Binsupri.
Thank you for your help