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Aspergillosis with Hemoptysis - doc wants me to use I use 7% saline

Posted by sig3 @sig3, Jun 22 10:27pm

In 2010, after many mis-diagnosis, I was diagnosed with ABPA. Multiple doctors through the years were treating ABPA, but now that seems to be at bay. Theory is ABPA caused Bronchiectasis. Per doctor it is not an extreme Bronchiectasis case, but scans prove I have it. Most alarming issue is I occasionally spit up blood (3-4 times per year) . It typically passes and I have never been admitted to a hospital for it. I never feel short of breath or dizzy when the blood occurs - I feel ironically fine. If I take a short dose of prednisone with antibiotics it almost immediately clears - if no meds I continue to produce blood. I can live a somewhat normal, active life but the blood can be scary. I am on a few meds to limit mucus. Doctor wants to start me on 7% saline (nebulizer). I am concerned this may accelerate bleeding. I am also looking for others with similar symptoms and wondering if there are any other solutions out there. Thank you.

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Sue, Volunteer Mentor | @sueinmn | Jun 23 8:58am

@sig3 Welcome to Mayo Connect. You seem to have a good handle on what caused your bronchiectasis, and a good treatment plan.
I suspect the doctor thinks that using saline and airway clearance might help clear the Allergic Bronchopulmonary Aspergillosis (ABPA) from your lungs and limit the number of exacerbations you get.

The bleeding you describe is called hemoptysis, and it is possible that 7% saline can increase episodes. But there are lower concentrations you can use that seem to carry less risk. Maybe you can ask about starting with 0.9% or 3% to see how you tolerate it?

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sig3 | @sig3 | Jun 23 2:56pm
In reply to @sueinmn "@sig3 Welcome to Mayo Connect. You seem to have a good handle on what caused your..." + (show)
Profile picture for Sue, Volunteer Mentor @sueinmn

@sig3 Welcome to Mayo Connect. You seem to have a good handle on what caused your bronchiectasis, and a good treatment plan.
I suspect the doctor thinks that using saline and airway clearance might help clear the Allergic Bronchopulmonary Aspergillosis (ABPA) from your lungs and limit the number of exacerbations you get.

The bleeding you describe is called hemoptysis, and it is possible that 7% saline can increase episodes. But there are lower concentrations you can use that seem to carry less risk. Maybe you can ask about starting with 0.9% or 3% to see how you tolerate it?

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@sueinmn Thank you for the reply. My doctor agreed with the plan to go with 3%. We shall see how it goes.

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sig3 | @sig3 | Jun 23 10:22pm

I would like to share the medications I am on to treat my condition. Curious if anyone has any feedback for me:
- Advair (daily)
- Montelukast (daily)
- Nucala (monthly, targeting ABPA))
- Zyrtec (daily)

When hemoptysis occurs:
- 5 day prednisone treatment
- 2 weeks antibiotics
After the antibiotics I will start a daily regimen to clear out lungs.

Misc:
- Albuterol as req'd
- Atenolol (daily for minor unrelated issue)

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