Pulmonologist in the Austin/SA Area and Airway Clearance Devices

susanp64, I live north of Austin in Ceorgetown, which is a 4 hr commute to Tyler.You must be near San Marcos or New Braunfels.

I go to UTHSC in Tyler to see Dr. McShane. She focuses exclusively on bronchiectasis and MAC and is highly regarded in her field and by her patients.

When I got no guidance from a local pulmonologist and did not have all of the proper testing, Tyler did everything to set me on the right path. You need an excellent physician who is well versed and experienced with your issues. I cannot say enough about the excellent care from Dr. McShane and her staff. Then when you are not there and have questions, you can use their MyChart to communicate with the nurse or doctor. Dr. McShane also does televisit, but your first visit should be a thorough and in person evaluation.

The Aerobika can be completely taken apart and boiled, so you can rally clean it. I was given a PARI Green compressor and PARI nebulizing kit as well as 7% saline. (by the way, I order my prescription and saline from the UTHSC hospital pharmacy, and they mail it for only $5 shipping charge! The pharmacy staff is great. The previous doctor denied me the devices and saline when I read about them, so I went months without clearance. You are right, the active cycle of breathing along with the Aerobika (or other device) and nebulizing saline is extremely effective, as is exercise. Dr. McShane prescribes their use to all of her patients and says that studies prove their efficacy in reducing bacterial counts.

I am so relieved for you that you do not have MAC, and I encourage you to be very vigilant about airway clearance and avoiding exposures to any bugs going around. Your bronchiectasis puts you at higher risk of contracting respiratory bugs, and your airway clearance goes a long way towards protecting you.

There is a University of Virginia microbiologist named Falkingham, and he came up with some guidelines to help people avoid or reduce exposure to MAC. It is very enlightening and provides a lot of information on how to protect yourself.

The drive to Tyler, by the way, is a pleasant one, once you are out of Austin! After Georgetown, you will go through only two smaller cities of Temple and Waco, after which you turn off and head northeast through a lot of rural areas before reaching Tyler. Since the lung center is more on the outskirts of Tyler on the northeast side, you don’t even need to approach Dallas.

I encourage you to make the drive. Consider staying in a hotel for the night. The first visit consisted of x Ray, CT scan, pulmonary function testing, labs, and a thorough evaluation and discussion with Dr. McShane. All of this is done in one day. Since it is a research facility as well and a highly regarded center for lung disorders, they have an advanced lab. They have microbiologists on staff working with the lung center, so you do not need a separate infectious disease specialist there. The doctor knows all the meds and how they work, and the lab is first rate. She will want to do her own sputum testing to fully evaluate the findings.
I mail in a sputum sample monthly for my MAC but can also send in samples whenever I feel that I may be coming down with an infection due to the bronchiectasis. ( They supply you with sputum kits and mailing tubes. I take mine to a postal annex and mail them through UPS for around $12). Lung hygiene techniques and avoiding unnecessary exposures has kept me pretty free of infections. I am on a 2 drug protocol for the MAC now.

You will need to have your pulmonology records forwarded to her with a CD to bring with you, if you have had CT scan and/or x-rays. When you contact UT, you will be sent a packet of information that is very helpful.

My appointments have always been at either 11:00, 2:00, or 3:00. An early appt might require you to drive up the night before. Otherwise, you could drive up in the morning. Testing is done before your scheduled visits with the doctor. Sometimes the appts run late because the staff is always so, so busy.

Since you will be tackling the Austin traffic on your return home and then even the Georgetown and around Rock before that, you will maybe want to time it so that you miss that. If you want to stop for food or restroom on the way to Tyler, the last good outpost before then is Waco. Just something to think about. I always enjoy the rural drive!

I hope that this helps.

Thank you so much for all of this information! Your experience with UT Tyler is very helpful. You are the third person to recommend Dr. McShane. I contacted UT Tyler today and her next availability for a new patient is January or February. I started the referral process with my primary physician today. I don’t mind waiting if it means I get a great doctor added to my team. I definitely feel like I need to do this now and become established before I am in a crisis.

My pulmonologist told me to order saline from Amazon. I asked my primary to prescribe it and I was able to get what I needed for much less money. I am very grateful to her for that!

You guessed right. We live in New Braunfels. We brave the Austin traffic regularly to enjoy the good food and music!

Thank you again for your help!

Yes it is one product. The sodium bicarbonate is an added to the saline. My sinuses seem to get less irritated with at combination. I buy the CVS store brand that is the equivalent to Simply Saline.

I buy the CVS brand equivalent to Simply Saline. The directions from the Simply Saline website are:

Tilt head to the side over sink. Insert nozzle into one nostril, depressing on the textured area at the base of the nozzle so a gentle mist fills sinus passages and flows out nostrils. Repeat in other nostril.

Susanp64, I am glad to hear that you are being proactive with your treatment. Dr. McShane had told me that cases of MAC are increasing. The first time I met with her was last September, and since then I have noticed quite an increase in patient loads there. It could be that word has gotten out about this care center in Texas, and patients are not necessarily limited to having to travel across the country for care. I remember the doctor telling me one time that she has patients coming from out of state because there is nobody where they live who treats MAC. I don’t know the bronchiectasis stats, but I do know that misdiagnoses often contribute to delayed appropriate treatment.

I really believe that a campaign of awareness for doctors is so important. Addressing and treating these illnesses early on is important in order to minimize progression.

When you do travel to Tyler, I recommend exiting to Hwy 130 toll road after Buda and continuing there to help bypass some of the congestion around the cities of Austin, Round Rock, and Georgetown. The growth has been explosive. Even Tyler has experienced tremendous growth, but it is still a very manageable drive. I wish you well and am so glad to hear that your primary has been so helpful.

Thank you very much. I will get it soon.

Hi Susan and welcome to our group! I know it has been an invaluable resource for me, as my doctor gave me very little education about BE or MAC and NONE about airway clearance. I have learned practically everything from this group so I am glad you found it! I use the Aerobika and find it exceptional. I nebulize with the 7% saline (discovered because of this site and not my dr!) two times a day and I attach the Aerobika to the nebulizer so you can do airway clearance and nebulize at the same time. I cough up A LOT of mucus when doing this. It is a godsend. I also use a HillRom compression vest but find that I bring up very little mucus when using it. As you will find, we all vary in what works. A book I highly recommend is "The Be Clear Method to Living with Bronchiectasis" by Linda Esposito. She is a valuable resource. And, now she has her own youtube channel with helpful information on how to manage and live well with BE. She has BE and will provide a treasure trove of information. I wish you well and hope you find the expert care you so deserve.

I too have nothing but good things to say about Dr. McShane and her staff. I live in Southwest Missouri and saw her last Fall. She will follow up with telephone visits and yearly in person visits. She has me sending sputum cultures every two months.
Best of luck to you- sounds like you’re on the right track!

Thank you so much for this information. I ordered the book by Linda Esposito and look forward to reading it. I want to try many different means of controlling this condition rather than letting it control me. I’m trying acupuncture for the first time in my life next week. I don’t know if it will help, but I figure it’s worth a try!

Thank you to everyone who has responded to me. I’m very excited to see Dr. McShane. I feel blessed to have a world-class doctor living within 6 hours of my home.

This group has taught me so much in the past two weeks! I am so happy to have a great support system. Thank you seems inadequate. My heart is truly overflowing with joy because I no longer feel alone in this!

Thank you for the uplifting post!
Many of us came here, new to MAC and Bronchiectasis, scared because we never heard of it before, read all the dire tale of it being "incurable" , the stories about the horrors of treatment. Even our doctors didn't seem to knowledgeable (over the past 5 years, I taught my primary a lot about it - thankfully she loves to learn.)
First we tip-toed in and began reading. Then we started knowing what questions to ask and began asking them. And not too much later, we were able to share what we learned, what worked for each of us, and were able to begin encouraging our fellow travellers!

As you meet your new doc, explore treatments, and read more, always remember there are nearly 1000 of us here, each with a unique experience to share. In chatting with us, you will become more comfortable with issues surrounding airway clearance, exercise, medications (other than the Big 3), precautions to take, and how to live your life.

The very best advice I got, early on, from my ID doc was "Bronchiectasis is a disease you live with, not die from. Do what makes sense for you to stay healthy, then go out and live your best life."
Sue