How do you explain your disease to the uninitiated?

Posted by coffcoff @coffcoff, Aug 10 1:33pm

Sooner or later we have to explain to people why: 1) we're taking our own water to the restaurant, 2) we can't enjoy their new jacuzzi, 3) we'd prefer to eat early in the evening and have to be home earlier to do our airway clearance 4) we can't sit on the patio because of the mister, 5) we need to wear a mask if it's windy outside, etc etc etc.

I'd like to be able to tell folks who ask about my bronchiectasis and NTM infection without having their eyes glaze over. Some people (like family and close friends) may want the long explanation, but for everyone else I'd like a very short and precise down-and-dirty few words.

What are all of you saying out there about your health problems?
Thanks!

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

Profile picture for Sue, Volunteer Mentor @sueinmn

@raintyler I'd say you are on the right track when you say "I’m trying to get my PCP to refer me to a NTM and BE center..."

It can be difficult to find the right docs - Bronchiectasis occurs rarely compared to COPD or asthma, so a generalist pulmonologist rarely sees it. Where generally are you located? Maybe someone here knows a "hidden gem" near you that doesn't require travel.
Here is a really good video about living with Bronchiectasis:
https://www.youtube.com/watch

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@sueinmn
Thank you for that resource. I have a lot to learn. I’m located in southern Delaware, about 2+ hours from both Baltimore and Philadelphia.

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Profile picture for coffcoff @coffcoff

@raintylerI'm so sorry to hear that the lack of care you've been receiving has caused your health to deteriorate. It's happened to many of us of this forum. I strongly recommend you see someone who specializes in bronchiectasis and NTM. There may not be such a person in your community or even your state so you may need to travel. If at all possible I suggest National Jewish Health in Denver. They are the leading experts. People from literally all over the world with respiratory problems find their way to NJH. But going there can be expensive considering that the first visit will be a week or more long. (Though there are ways to do it without spending too much.) In that time, however, you will get exemplary care and learn everything you need to know about your disease and how to treat it. You do not need a referral to be seen there. If interested, there is lots of info on this forum about what goes on there, where to stay, etc.

If you can't make that trip there are other institutions around the country, called respiratory Centers of Excellence, that treat NTM and bronchiectasis. You can search this site for something near you. Or let us know where you live and someone on the forum can help you out.

Wishing you good health and the best of luck!

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@coffcoff
Thanks for the suggestion but I am on the east coast and Denver wouldn’t be feasible. I am trying to get my PCP to complete the required referral to Johns Hopkins NTM and BE clinic. I live equal distances from Baltimore and Philadelphia (2 to 2 1/2 hrs).

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Profile picture for jessed @jessed

@lilianna I also tell people that I have a rare and chronic lung disease that is not contagious.

For closer friends/family I may explain more about taking care of myself by doing airway clearance and a breathing treatment using a nebulizer 2x day. For a few, I share what a great pulmonologist said to me: that I will die w it but not from it! (I’m 82 and was dx w Bronchiectasis/NTM 11 years ago but probably had it 10 years bf I was dx).

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@jessed Just diagnosed (age 65) but relate to your saying you probably had is 10 years before dx. I feel the same way; that I've had it a long time wo anyone paying attention. My CTs were showing "chronic infection" but PCP and initial pulmonologist treated as asthma to no avail. My fault for not finding another doc. Can you share your tricks for not letting this chronic illness get the best of you?

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Profile picture for pgpunch @pgpunch

@jessed Just diagnosed (age 65) but relate to your saying you probably had is 10 years before dx. I feel the same way; that I've had it a long time wo anyone paying attention. My CTs were showing "chronic infection" but PCP and initial pulmonologist treated as asthma to no avail. My fault for not finding another doc. Can you share your tricks for not letting this chronic illness get the best of you?

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@pgpunch
We had common experiences.

Great question. Thanks!!! Hmm. Today I am slacking but your question got me back on track!

Tips to keep BE-Mac chronic illness from getting the best of me,
1) our middle son’s philosophy: “mom, We all have something but we still prevail.” He has schizoaffective disorder, a severe and chronic mental illness and lots of meds.
2. A pulmonologist at UNC chapel hill gave me hope and a good plan. She said it was slow growing and that “I would die w it but not from it.” I believe her. If I have a plan I’m usually golden. Marcie Wiener’s recent webinar and Dr Pamela McShane’s tips and this group have been so helpful. Thanks for asking. You helped me! What helps you?

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Profile picture for jessed @jessed

@pgpunch
We had common experiences.

Great question. Thanks!!! Hmm. Today I am slacking but your question got me back on track!

Tips to keep BE-Mac chronic illness from getting the best of me,
1) our middle son’s philosophy: “mom, We all have something but we still prevail.” He has schizoaffective disorder, a severe and chronic mental illness and lots of meds.
2. A pulmonologist at UNC chapel hill gave me hope and a good plan. She said it was slow growing and that “I would die w it but not from it.” I believe her. If I have a plan I’m usually golden. Marcie Wiener’s recent webinar and Dr Pamela McShane’s tips and this group have been so helpful. Thanks for asking. You helped me! What helps you?

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@jessed Glad I helped in a small way - u never know what’s around the proverbial corner!
My way of distraction is putting myself out in nature. Thank you for sharing your personal life’s learnings! I hope your son is finding relief

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Profile picture for pgpunch @pgpunch

@jessed Glad I helped in a small way - u never know what’s around the proverbial corner!
My way of distraction is putting myself out in nature. Thank you for sharing your personal life’s learnings! I hope your son is finding relief

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@pgpunch. You did help me. I felt so much better after I did my airway clearance. Yes, nature or just hanging out on our balcony fussing w my flowers is my respite also. Thanks for kind thoughts 🙏

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Profile picture for raintyler @raintyler

I am new to this group. I was diagnosed with BE after a CT for an abdominal issue revealed it. I was told it was mild and was never told to take any precautions ( except to make sure to stay UTD on my vaccines) and never told about airway clearing techniques. Now, 7 years later, I have a worsening cough, night sweats, chest pressure, and shortness of breath with physical activities. A new CT scan showed progression of the BE and was suggestive of a MAC infection. I asked my pulmonologist for a PEP device. I also requested hypertonic saline and nebulizer to help loosen my sputum so that I can successfully bring it up for a culture. I requested a bronchodilator and was told it wasn’t necessary. I have not been given any cautions about drinking water, hot tubs, etc. What should I know?
I do not have any confidence in my pulmonologist and I’m trying to get my PCP to refer me to a NTM and BE center.
Thanks in advance for any advice.

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@raintyler I sympathize with your situation. At least you knew what to ask for, which is great. I had (had is operative word) a pulmonologist who wasn't listening to my constant complaint of immovable mucus and was sick for two months while he did little despite my requests. So I fired him, got another pulmonologist, and a culture and a bronchoscopy confirmed MAC infection. I drive 2.5 hours to get care - would go farther if needed - altho that's not within everyone's reach.

Airway clearance is key. MAC lives in mucus, BE creates space for mucus to accumulate, and mucus removal is the game. You need a PEP- you can get one on Amazon w/o scrip, Aerobika is best but scrip is required (I'm still waiting for mine to arrive), vest if that's needed. 7% hypertonic saline is best. I specify 7 because my pulm would only give me 3. I researched as soon as I learned the culture was + for MAC and immediately implemented all environmental changes I then read about (I'm a project manager and very risk averse ;-). I've read some ID doctors support environmental controls, some don't. But if I know the primary vectors of transmission are potting soil and aerosolized water, I'm going to avoid them. I now only take baths instead of showers. I turned my water heater up to +130 degrees (MAC grows in biofilm and high heat retards growth), replaced my dishwasher with one that sanitizes, bought a LifeWater bottle and countertop pitcher to filter my water (you need a .02 micron filter). I wear a mask when around people- sometimes just surgical, sometimes N95 depending on situation. Exercise supports airway clearance and your immune system so I exercise daily now altho I couldn't when first diagnosed as I was too sick. I do postural drainage to aid airway clearance - bridge pose is great.

You need a pulmonologist and an Infectious Disease doctor to properly treat (imo) and they need experience in this area. To provide perspective, NTM infection occurs in very low numbers of the population, depending upon the region in which you live. In areas where it's prevalent, it's still only ~30 / 100,000 people but avg's about 20 / 100K nationally. The CCN at NTM Fndn has a list of providers and hopefully one is near you. Otherwise read doctor profiles and look for those which specifically state they treat NTM infection. Interview providers you find and keep searching to find one you can work with and with whom you're comfortable. Best of luck to you.

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You definitely are right about airway clearance being the answer to dealing with Bronchiectasis and MAC. I have been living with both diseases for six plus years as well as Pseudomonas and have been using 7% sodium chloride with my Aerobika twice daily. My sputum samples used to show a lot of MAC but are now showing very few. I credit this to the airway clearance as well as walking 4 to 5 miles daily and eating healthy. I am also on 25 Mg Brinsupri which has helped reduce the mucus production. I feel fortunate at age 79 to be able to live an active life without my lung disease keeping me down. Best of luck to you in your journey.

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Profile picture for snoei @snoei

Unfortunately the add for Brinsupri has caused a few friends who know I have bronchiectasis to ask me if the condition is really that horrible. I explain that, like many conditions, there are mild to severe cases and mine remains mild. Some advertisers have a tendency towards using scare tactics to sell their product.

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@snoei I don’t find that the commercials for Brinsupri use scare tactics. Many with bronchiectasis have a very challenging time. Brinsupri is (currently) targeted for this patient population, the frequent exacerbators. You are fortunate that this does not include you, but that doesn’t make the marketing of Brinsupri inappropriate.

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Profile picture for pgpunch @pgpunch

Because I’m new to the diagnoses, I have burdened many with a LONG explanation about BE and MAC - thank you for some nice succinct responses! I did reduce my answer to atypical tuberculosis a few times, but that scared folks. 😕

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@pgpunch
LOL I thought of that, too, but decided to just say, " It is a rare lung condition that is not contagious, but makes me susceptible to infection"
I was just diagnosed as well. I have just begun treatment a week ago.
Someone else said it well....others' eyes glaze over and they just can't take too long of an explanation!

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