Is Anyone Else Confused About All Those Inhalers?

While a steroid can help MAC and asthma, it can worsen a fungal infection. I was on Symbicort for 3 1/2 years and beat MAC but now fighting a fungal infection (I do have cavitation). I will never take a steroid again.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475467/

@rstel7272 Sorry to hear about the fungal infection. Systemic or localized?
Did you repeat the culture just in case? What was your dose of Symbicort?

The article refers to injected steroid, which is different than inhaled steroids.

Steroid inhalers need monitoring especially with asthma. I wish there was some concrete way of figuring out the correct dose in the bronchiectasis/asthma world. Not too much not too little. I have less mucus with more inhaled steroid, and more mucus with less steroid, quite a trade off. Less mucus feels better but long term low dose steroids can have several negative effects so it's wise to be cautious.

Localizes in lung. Multiple cultures, blood tests and topped off with a confirming super dimension bronchosopy. 160/4.5 dose for almost 4 years. I was in bad shape late last summer when NJH pulminologist added Spiriva to my treatment. I took both and kinda got worse. Then I stopped Symbicort by myself and have started getting better almost immediately (but slowly of course). All my Dr's then agreed to stop the Symbicort

@rstel7272 Thanks for explaining, good it’s not beyond the lungs. My understanding about the treatment for fungal infection is oral steroids along with an anti-fungal. Is that correct? If so, it’s ironic about the steroid inhaler and confusing. Hope you knock it down as quickly as possible.

Scoop, are you a member of the facebook group "lung matters"? If not, you should join and read the guide lines, especially the chapter "𝗕𝗿𝗼𝗺𝗶𝗱𝗲𝘀 & 𝗦𝘁𝗲𝗿𝗼𝗶𝗱𝘀". This chapter saved my life.

That site is something I'll revisit. Since we suffer with "rare" disease it's difficult to know if something works for one if it will work for the other. The creator seems to have significant co-morbidities, further blurring things. While medicine today is far from perfect, it is evidence based, with many drugs taking years to research, develop, test and approve. How I wish I could throw away the inhalers, and only use albuterol and 7% saline! Have you tried doing that?

I was on Trelegy for two years and I'm convinced that the steroid in it dialed down
my immune system and that's why I got MAC.
Harry

@harrynsc Well you are probably not wrong. Steroid inhalers do a lot of good, but steroids as a whole increase your risk. I only recently learned that - well within the past year after getting RSV. @scoop is correct about the albuterol and saline. It’s a catch 22 really. You need to get rid of all the yuckiness in your airways. There is a great article @rstel7272 shared a few months ago on the subject. Pulmonologists who know this fact about steroids ( all should) try to do a balancing act with it all, but we do need to breathe! @irene5

I read over this post and the other comments and I must say it was enough to make my head spin! I am very thankful I do not have asthma to deal with along with MAC and Bronchiectasis. I empathize with those that have a more complicated picture to sort out. I did want to ask, after reading, I saw Albuterol (which I use twice daily followed by 7% saline as part of routine airway clearance) was listed as a rescue inhaler. However, it is not a steroid, just a bronchodilator? Just making certain as I don't want to have anything to do with steroids if not necessary! Some things are unavoidable, as with those with asthma must use something, but in my case I don't want to unnecessarily complicate the situation.

Albuterol is available in vial form for use in a nebulizer and also in a inhaler.
I prefer the nebulizer as it is mixed with saline and slowly administered over 10 minutes but is difficult if you are in the go. The small handheld inhaler is good for traveling or rescue type applications