(MAC/MAI) Mycobacterium Avium Complex Pulmonary Disease: Join us

Katherine, you have been so inspiring. Has your MAC/MAI come back at all since your antibiotic treatment? You were on antibiotics for 3 years? Are you willing to give me your contact information? I have just been diagnosed with MAI and I am supposed to start the 3 antibiotic treatment real soon. Is this disease curable? I have read yes a 30% chance, and I have read "no", just manageable. What has your doctor mentioned? Thank you SO much for your help! You seem to be such a kind lady and we are lucky to have someone so caring on this site.

I am new to this forum as of yesterday..I live in Houston and feel I have excellent Doctors...
My quest for answers actually began by accident...Long story short I was in the office of a renowned ENT.doctor with one more problem in a long list...I had very large crater like lesions on my tongue.. This came up suddenly and were very painful... This Doctor told me when he had seen these in his practice they seem to always signal underlying disease... usually an immune disease..He sent me to an immunologist ... She diagnosed me after many extensive blood panels and a CT scan with a immune deficency...CVID.. by this point I had extensive lung damage... I am treated for the immune disiorder with IG infusions... and I do stay free of pneumonia etc...but the lung deterioration continues.. so i was sent to a pulmonary Dr...and she susoected MAC...i have only now had tthe bronchosopy and will have to wait for all the test to come back and cultures....
I am in a city with a very excellent medical center but...I have learned to try to seek out the best care I can find and try to be my own advocate.... Doctors are so specialized now that you could present with a broken arm and no one would notice if it was not their specialty....
I feel fairly well but... my lung function ( I have had two CT scans since first of year) is going so fast that for the last two weeks I have stayed inside my home .. almost bed fast...because of extreme fatigue and no breath..
My primary Doctor has an excellent reputation and I have gone to her for several years...she did send me to the ENT doctor who sent me to the immunologist... thus the chain finally started working if maybe by accident...

Katherine, you have been so inspiring. Has your MAC/MAI come back at all since your antibiotic treatment? You were on antibiotics for 3 years? Are you willing to give me your contact information? I have just been diagnosed with MAI and I am supposed to start the 3 antibiotic treatment real soon. Is this disease curable? I have read yes a 30% chance, and I have read "no", just manageable. What has your doctor mentioned? Thank you SO much for your help! You seem to be such a kind lady and we are lucky to have someone so caring on this site.

Dear All,
This is the question form I use when I see my MAC/Bronchiectasis doctor. This is merely the form I put together for myself .. cut/pasted from numerous sources .. use it .. redesign it for your own needs or whatever. You could easily copy/paste/ADD SPACES FOR NOTES/redesign it for your own use. Hope it helps someone! Hugs! Katherine
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Questions to Ask Your Doctor-LUNGS-MAI- Bronchiectasis
DOCTORS’ NAME: PHONE #: FAX #:

_______________________________________________________________________________________________________________________

Questions To Ask Your Doctor
DOCTOR: _________________________________SPECIALTY______________________ DATE_______________
1. Where is the MAI/Bronchiectasis located currently? Are there new areas or new changes? At what stage would you say it is on a scale of 1 to 10? How does it compare to my last appointment for each.

2. Are the drugs I am taking currently effective for the two mycobacterium/Bronchiectasis ?
a. Are the dosing level for each medication effective or do they need to be adjusted? b. What period of time before one of the medications can be adjusted or eliminated?

3. Based on the current progress how long would you project that I would me to be on the medications?

4. What monitoring will I continue to need? When will I need my next:
a. Follow up appointments with you? b. X-rays/ CT scans
c. Monthly Lab work
d. Hearing testing
e. Vision testing
f. Monthly salt induced Sputum Cultures (Hypertonic Saline Induced Sputum Culture)

5. How long would you anticipate the side effects of night sweats/sleep disturbance/fatigue/oral thrush/dry mouth/geographic tongue to continue? a. Do you have any suggestions for coping with the less serious side effects?

6. Do you agree with the current Medication Schedule I am following?

7. Do you suggest any other lung clearance devices? How often/when?

8. Can I still take my stated over the counter medicines/vitamins/supplements?

IF SUGGESTED NEW Medication:
a. Spelling of new drug I will be taking
b. dosing level of each new medication
c. what period of time before the next medication
d. how long do you expect me to be on the medications
e. any new monitoring will I need
f. any side effects will I likely to have
g. which side effect should be reported immediately
h. when/how do I take each of these medications/ what schedule should I follow

TESTING RECOMMENDED FOR ANTIBIOTICS:
IMPORTANT! https://labtestsonline.org/understanding/analytes/susceptibility/tab/test/
Make sure your Pulmonologist is doing a 'susceptibility panel' IN ADVANCE of going on that particular antibiotic to tell EXACTLY what your MAC will respond to and WHICH one of the few drugs that will work on that particular mycobacterium. This panel is done from a positive sputum culture or lavage of lung. Susceptibility testing is often ordered at the same time as a culture.

Susceptibility Testing for Mycobacteria
http://www.mayomedicallaboratories.com/interpretive-guide/?alpha=A&unit_code=34805
http://cid.oxfordjournals.org/content/31/5/1209.full
http://www.mmmig.nl/static/filebank/d073522b5602729078139d641a4cf987/antimicrobial-susceptibility-testing-drug-resistance-mechanisms-and-therapy-of-infections-with-nontuberculous-mycobacteria.pdf
TESTING-baseline and periodic
1. Ethambutol – color vision and visual acuity: GET BASELINE PRIOR TO STARTING .. THEN QUARTERLY
2. Azithromycin – hearing and balance: GET BASELINE PRIOR TO STARTING .. THEN QUARTERLY
3. Rifampin - CBD (blood counts), liver and kidney function tests: GET BASELINE PRIOR TO STARTING .. THEN MONTHLY

OR TESTING:
BASELINE: HEARING AND VISION (Vision: Additional testing for eyes are use of the “eye chart” with letters read at 20 feet, and a red-green color book to distinguish changes in the ability to visualize colors.)
MONTHLY: BLOOD COUNTS, LIVER AND KIDNEY FUNCTION TESTS, SPUTUM CULTURES
QUARTERLY: HEARING and VISION
NOTE: Ethambutol – color vision and visual acuity – monthly ( Additional testing for eyes are use of the “eye chart” with letters read at 20 feet, and a red-green color book to distinguish changes in the ability to visualize colors.)

**** Lab tests:
CBC- Complete Blood Count (CBC)
ALT- Alanine Aminotransferase (ALT) LIVER
alk phosphatase- Alkaline Phosphatase - LIVER
serum creatinine-. Creatinine and Creatinine Clearance-SERUM CREATININE - KIDNEY

TESTING-AFTER ANTIBIOTIC TREATMENT ENDS I can ONLY speak for myself about what testing is correct after going off antibiotic treatment. Personally I had quarterly check ups with my doctor including sputum cultures initially .. then as he put the 'puzzle' together based on the results of the sputum culture/Xray/Pulmunary Testing ..deciding when to go to semi annual .. then to annual .. sometimes then back to semi annual. It is ALL up to your GOOD Infectious Disease doctor who is KNOWLEDGEABLE about MAC. But it is my understanding there SHOULD be follow up check ups to CONFIRM that the MAC in your lungs is STILL negative/NOT colonizing. Without CONTINUING checkups (I expect for my life time) we have NO idea if the MAC is colonizing .. OR IF we are still negative! Those nasty critters DON'T disappear .. just lie there in waiting .. that is why it is so important to take good care of ourselves .. eat healthy .. exercise .. stay positive .. be serene! Hope this is helpful. Katherine

TESTING RECOMMENDED FOR VITAMIN LEVELS
1. Ask for your VD-3 level to be checked .. they can get too low. Speak to your Doctor first .. but I took: NATURE MADE brand 5,000 IU of Vitamin D-3 (NOT VD) *From our member @tdrell Terri, my Primary Dr at NJH doubled the VD I take to 4000 units a day... my lab test showed I was at 50 and she said she likes to see it at 100.
2. Ask for your B-12 level to be checked .. they can get too low
3. Personally I always purchase the brand Nature Made vitamins for it's quality .. ' Nature Made is the first brand to earn the USP Verified Mark on one of its products, an independent certification for quality and purity.'

THINGS TO CONSIDER:
• Keep copies of all your lab work
• Keep your x-ray/CT scan films yourself, or consider having them done where they can be put on a CD http://ntminfo.org/files/QuestionsToAskYourDoctor.pdf http://ntminfo.org/index.php?option=com_content&view=article&id=50&Itemid=52

Katherine, you have been so inspiring. Has your MAC/MAI come back at all since your antibiotic treatment? You were on antibiotics for 3 years? Are you willing to give me your contact information? I have just been diagnosed with MAI and I am supposed to start the 3 antibiotic treatment real soon. Is this disease curable? I have read yes a 30% chance, and I have read "no", just manageable. What has your doctor mentioned? Thank you SO much for your help! You seem to be such a kind lady and we are lucky to have someone so caring on this site.

Katherine, you have been so inspiring. Has your MAC/MAI come back at all since your antibiotic treatment? You were on antibiotics for 3 years? Are you willing to give me your contact information? I have just been diagnosed with MAI and I am supposed to start the 3 antibiotic treatment real soon. Is this disease curable? I have read yes a 30% chance, and I have read "no", just manageable. What has your doctor mentioned? Thank you SO much for your help! You seem to be such a kind lady and we are lucky to have someone so caring on this site.

I am new to this forum as of yesterday..I live in Houston and feel I have excellent Doctors...
My quest for answers actually began by accident...Long story short I was in the office of a renowned ENT.doctor with one more problem in a long list...I had very large crater like lesions on my tongue.. This came up suddenly and were very painful... This Doctor told me when he had seen these in his practice they seem to always signal underlying disease... usually an immune disease..He sent me to an immunologist ... She diagnosed me after many extensive blood panels and a CT scan with a immune deficency...CVID.. by this point I had extensive lung damage... I am treated for the immune disiorder with IG infusions... and I do stay free of pneumonia etc...but the lung deterioration continues.. so i was sent to a pulmonary Dr...and she susoected MAC...i have only now had tthe bronchosopy and will have to wait for all the test to come back and cultures....
I am in a city with a very excellent medical center but...I have learned to try to seek out the best care I can find and try to be my own advocate.... Doctors are so specialized now that you could present with a broken arm and no one would notice if it was not their specialty....
I feel fairly well but... my lung function ( I have had two CT scans since first of year) is going so fast that for the last two weeks I have stayed inside my home .. almost bed fast...because of extreme fatigue and no breath..
My primary Doctor has an excellent reputation and I have gone to her for several years...she did send me to the ENT doctor who sent me to the immunologist... thus the chain finally started working if maybe by accident...