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Have to start the big three

MAC & Bronchiectasis | Last Active: Jan 26, 2018 | Replies (97)

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@jenblalock

Hi Joann, I've been on the big 3 plus some others. I was lucky and did not have bad side effects. Well, I should say that the Rifampin did not agree with me so they took me off that and put me on Clofazimine. Later I tried Rifabutin which I tolerated well so that was added. The meds did make me tired early in the day and I changed my taste buds so that foods didn't taste the same and my appetite was less but for me that wasn't a bad thing. For once in my life I didn't have to watch everything I ate or gain weight. 🙂 I was on the meds for 15 months and have been off since April of this year. They did eradicate the NTM so treatment was successful.

They should start each med separately adding the new one each week. That way if you don't tolerate one they'll know which one it is. You'll get your blood tested and eyes checked while on the meds. The doctors should explain all this to you. Ethambutol can affect the eyes and all the meds can affect liver and kidneys. Also if you end up on Amikacin you'll want to get your ears checked regularly.

Best to you and let us know how it goes.

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Replies to "Hi Joann, I've been on the big 3 plus some others. I was lucky and did..."

Thank you . It is good to hear some not so scary responses. I get my baseline eye exam today and then will be starting. Jo Ann K

@jkiemen - Hi, Jo Ann, I agree with the above. I was on rifampin, ethambutol and azithromyacin and did pretty well for the first 7 months until I noticed I was experiencing confusion which is a side effect of rifampin. I went off the meds half way through the 14 months my doc wanted me to take them. I've had 4 clean sputum cultures in the last 12 months and am waiting for my latest one to come back sometime in the next couple of weeks. While on the meds, I had my blood drawn every month to check liver and kidney functions and had eye exams every 6 weeks or so for the first 6 months, then was going on quarterly but went off the meds so stopped. I had my hearing checked for a baseline and then went every 3 months for checkups. Everyone's body reacts differently so I guess the main thing is to not expect to have horrible side effects but to go into it with a positive attitude - no fear! Keep us posted on how you are doing. Linda

Thanks. I am glad I am hearing some not so bad information. Will keep you all posted and probably ask for more advise along the way.

@jenblalock, Hi Jen. It is good to hear success stories from those who have taken the BIG 3. I hope that you will stay with us even though you are not infected. Your story can inspire others. I am glad to know that that worked for you. - Hugs!

Hi @jenblalock
My mom has just been diagnosed with MAC. She is an active, healthy 65 year old woman. She is on three drugs:
Ethambutol, Rifabutin, and Azithromycin (not Clofazimine). Is there anything else you recommend for a successful eradication? Is there anything else you attribute to your defeating this disease? Thanks for any thoughts or recommendations you or the group can provide.

Hi @rosecurran I remember the confusion when I was diagnosed last year. I was diagnosed with MAC, bronchiectasis and a couple of cavitary lesions (holes in the lungs). I've been a runner and a former triathlete and have always been super healthy so I was floored! I can only speak for myself as I am definitely no expert on this disease.

Was your mom also diagnosed with Bronchiectasis? After research, I learned that while the MAC infection can be arrested with the meds, bronchiectasis is with us forever.

I was put on Clofazimine because I didn't tolerate one of the meds. So, if she is tolerating the 3 meds okay, I doubt she'll take that.

For myself, I did nothing special. I took the meds and did my lung clearance (which is for life if a person has bronchiectasis) and tried to get some exercise because that is good for the lungs. Because of the cavitary lesions I also was put on a drug called Amikacin, first by IV with a PICC line and then inhaled. My first sputum culture after 3 months came back negative and all sputum cultures after that came back negative also, although that is not the case for everyone. I stayed on the meds for a total of 15 months.

I have been off meds since April this year and doing pretty well. Started working out again although lately I've been rather lax (note to self: get back to it). Right now I'm going through some sort of little thing but lungs look no worse so I take that as a win. I am still adjusting to my lungs never being 'normal' and trying to be satisfied that there have been no negative changes in my CT scans.

So, all in all, it is a long learning process and a new normal. I just turned 63, by the way and was 61 when diagnosed. I'm sure others will chime in here. Best to you and your mom.

I am newly diagnosed with MAC and was at the gym every day and working with a
Personal trainer. Recently my severe Crohn’s disease flared. I was hospitalized 5 days last week at Mayo Florida.
My question: since you were athletic, did you suspect any problems with your lungs? I am still stunned. If I were to have a doctor listen to my lungs they sound clear. I cough up nothing and in fact, don’t even cough. My question is: once the 3 medicines start to work, will I ever cough up anything? Is there something in there to loosen up and I don’t know it exists. This is so frustrating to me to have to go on antibiotics for 18 months when I feel fine concerning my lungs. Meanwhile, I cannot start my Remicade for my Crohn’s, which is severe , until the MAC is treated.

I have similar symptoms. I exercised every day treadmill, elliptical etc and was doing OK. In fact, a week before my last CT I was climbing mountains in California with my 25 year old son. I rarely cough and when I do it seems it is more of congestion in by throat from what feels like post nasal drip. I can't cough anything up with inductions, mucinex and my Aribika device. Then I got the CT results and the prescription. Now I feel like an invalid in just one week. Maybe part if it is feeling vulnerable. I don't know. It is all overwhelming.

@jenblalock Thank you so much for your reply! I didn't see it somehow beforehand! I am so pleased to hear you are doing well. I imagine, as a former athlete, it came as quite a shock when you learned of your illness. My mom was not diagnosed with bronchiectasis, just MAC.

She walks on the treadmill daily and I know she feels this is very important for keeping her lungs strong.

She did have a question for you and the group--how close together do you take the medicines? She said she takes the first, then goes back to sleep (it makes her feel the worst); two hours later she takes the next, goes to the gym, and when she gets home eats a big bowl of oatmeal and takes the third. I think she should be taking them closer together--does anyone know? When she has taken them close together, it makes her much more sick, which is why she doesn't like to (although I think she needs to). Love any thoughts.

Thanks again for your reply!!

@jenblablock - Correction - she DOES have bronchiectasis but not severely. She also has "shattered glass effect" rather than a hole in her lung but it can develop into a hole. I will ask her to ask about it at her next appointment.