Gardening with Bronch and MAC

@cate123456 I have been an avid gardener all my life, and didn't want to give it up when I was diagnosed with MAC, Bronchiectasis & Pseudomonas in 2018. Based on the strain I had, the suspected origin of my infection was the feral chickens in the yard of my Texas winter home, scratching under my fruit trees and around my garden. My pulmonologist was pretty angry with me about this refusing to give up gardening completely; he even wanted me to toss my house plants. We eventually parted ways for another reason.

I appealed to my PCP & ID doc for guidance. Their philosophy on living with MAC/Bronch is a little different - 1) reduce the most obvious risks, 2) take reasonable precautions, 3) use your meds & do airway clearance, 4) eat, rest & exercise & 5) GO LIVE YOUR LIFE.

Here was the advice from the ID doc: MAC and other germs that are risky to bad lungs are everywhere, but we cannot stop living because of it; just take prudent precautions. So, stay away from that Texas dirt - plant ground cover & leave it alone. Let someone else maintain it, and stay indoors while they do it & until it is watered down. Been doing that for 4 years now, and simply garden in pots, on the other side of the house, while I am there.

What about my big Minnesota gardens? No chickens there. His advice: Mask, gloves and long sleeves. Take them off before you go in the house. Water down the soil before you dig in it to keep airborne NTM & other germs from flying. Leave the compost and mulch handling to someone else & stay away while it is being spread, until it is watered down. Watering is fine - the outdoor air will dilute any NTM sufficiently.

We added the following (my husband also has Bronchiectasis, but has never had MAC): Masks when mowing too. No shoes from yard/garden in the house (don't trip - they are on the garage step!) HEPA air filters, in addition to HEPA furnace filter in the living areas. Close the windows when windy, dusty, during mowing, etc. Oh, and I covered the soil in my house plants with gravel to reduce flying dust.

What has been the result? Off the meds for 32 months with no reinfection. I know we have heard from other gardeners hers over the years - has anyone else done things differently?
Sue

Thanks Saint Sue!
Nice to know about the watering, as I thought the mist from watering might be full of MAC. We are in VA and don’t need to water often as lots of rain and humidity here. I also do “no till” gardening so the soil rarely gets disturbed in the raised beds.
We also have chickens, but my husband now deals w them, and I make him wear an N95 mask even though his lungs are good.

Yes, there might be MAC in the mist - however, there is also a great deal of dilution - if you don't stand in/near the spray, it shouldn't be a problem. We water early & late on timers, or with ground soakers, so the mist is not an issue for us. Daytime watering is usually filling holes while planting, which I do with either a bucket or a direct stream from the hose.
You said, "We also have chickens, but my husband now deals w them, and I make him wear an N95 mask even though his lungs are good." That is a great choice - my niece and her young family keep chickens, they got started through 4-H, and masking & sanitation are part of the training material.

If you do a little reading here, you will find that many of us have found ways to pursue our passions in spite of our challenges. For example, little things can now set of an asthma attack or a coughing fit - any scented products, ANY aerosol (like sunscreen or spray starch), the odor from anti-bacterial wipes - so I either need to be out of the area or find an alternative. In the winter we live about 40' from a communal laundry - so we keep the windows on that side of the house closed all the time.

I will do ANYTHING not to go back on the Big 3, and my docs agree that as long as we can keep my lungs clear, that should be possible.

Sue

I too am glad not to have to give up my outside potted flowers and few houseplants. Thanks for all the good suggestions. I do wonder about the chickens though. Is it because they scratch the dirt, the chicken poop and or more? We don’t have chickens but we sometimes visit friends with chickens and where we stay is usually next to the chickens. They have a very small barn and the chickens roost on one side but run free near it. When we visit, we usually park our small camper just in front of the barn because we can hook up to water and electricity there. We basically just sleep there and walk across a pasture (grass, no bare dirt) to the house each day. We don’t open our windows there but run the a/c or heat depending on the weather. I know this is such an odd scenario. Is it safe to be staying so close to chickens?

Hello, I can see you have been with us on Mayo Connect for a while, and this is your first post - Welcome!

When considering risk in any situation concerning airborne pathogens, unless it is something extremely toxic, the elements to assess are LENGTH of exposure, NEARNESS to the source, and CONCENTRATION of the toxin.

So digging in the dirt, with your face near it, for a relatively long time, exposes you to a higher level of the toxin. Staying in a closed building next to the source, not handling or interacting with the birds, where the airborne contaminant is highly diluted & becoming more so as it travels away from the birds, exposes you to a lower level.

It is a situation that I would be comfortable in - it pretty well describes my long term proximity to the feral chickens where I live. We took one more step to protect ourselves, we bought a well-rated HEPA air filter, sized for our home, and run it full time. One additional advantage - it protects my silly lungs from mold spores, dust mites & other things that inhabit seasonal dwellings, no matter how careful we are.

Do you have MAC or bronchiectasis?
Sue

When my spouse was diagnosed with aspergillosis his ID said it was from working in the yard. Most of what he did was transfer from pot to beds for me. We had landscape architect remove most flower beds and filled much of those areas with sod or permanent plantings requiring little attention. He was told not to go outside and I was told to take off all yard clothes in garage, shower before contact with him. We live rurally on water and have a lot of wild animals in our yard which could have been a source of aspergillosis. Aspergillosis is now in the psst leaving behind Bronchiectasis.
Now he hasn’t the energy to work outside. Our children and grandchildren have potted tomatoes and herbs for us several years which has brought much joy and required little of us.
Since then when I tell a physician that he acquired aspergillosis from the soil I am always told that is only one of many possibilities. I was told recently I could return to yard work! Happy days and I am very careful not to bring the outside in.
Someone, perhaps Sue, recently wrote on this site that we have to take necessary precautions and continue to live our lives as fully as possible which is very encouraging.
We are adopting her attitude!

Thanks for your response Sue. Now I won’t start feeling paranoid staying with our friends. Yes, I have bronchiectasis and MAC, specifically MAI diagnosed after a CT and bronchoscopy last Oct. The CT was for something else but ended up showing the bronchiectasis. Of course I wonder if I may have other MAC bacteria because I was unaware of the precautions needed to take to prevent further infection other than told to change my shower head by my pulmonologist. However, she did start me on airway clearance (albuterol & 7% saline) but didn’t explain the importance of it other than to get the mucus out which is a difficult concept when you don’t feel like you have any. I have learned many of the things to do or don’t do (and how important airway clearance is now) through support forums and watching webinars. I didn’t cough up sputum until a month ago and then it’s not every time. Otherwise I have no symptoms other than just feeling low energy but not fatigued. I have not agreed to go on the antibiotics yet even though the pulmonologist and ID doctors want me to do so.

Hello!
I was just diagnosed a couple of months ago, so I am still learning about this disease. I am doing okay. No meds now. No coughing. I am an avid gardener. I do not understand some of the ways we could have gotten this. We have it now, so what is going to matter if we still dig in the dirt? Will it get worse? So many things I have not been told. What do you think? Thank you!

Good questions! I assume that to continue to dig in the dirt etc will expose us to more of the bacteria increasing our bacterial load of MAC or infecting us with other bacteria. If others have a better answer ( or maybe I am incorrect) let us know!

There's a well known paper by Dr. Falkinham on mycobacteria in the environment that circulates around here every now and again but I can't locate it. Bottom line is that NTM (non typical mycobacteria) are everywhere -- soil, air and water pipes. There are mitigation strategies, they take some doing but are very possible. Some people here continue to garden but take precautions (masking, wetting soil first to cut down on dust, etc).