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Thoughts about “the watch and wait” approach.
MAC & Bronchiectasis | Last Active: Dec 20, 2023 | Replies (53)Comment receiving replies
I’ve been recently diagnosed with MAC and my Pulmonologist recommends a watch and wait approach with a 3.5% saline solution nebulizer treatment twice per day. We found this accidentally from a CT scan which showed lung nodules and some bronchial damage.
How can a saline nebulizer treatment help this serious disease? Should I get a second opinion from the Mayo Clinic? Also would like some advice on where to find comprehensive disease information.
Thanks, Lorraine
Replies to "I’ve been recently diagnosed with MAC and my Pulmonologist recommends a watch and wait approach with..."
And yes- a second opinion is always a good idea.
In response to your question of how nebulizing saline can help with a serious disease, many on this site use it and have been successful to keep from going on the antibiotic treatment. 7% saline is used. 3% is used by those who can’t tolerate 7% or are working their way up to using 7%. The benefit is twofold. First, nebulizing the saline loosens mucus so you can get it out better. The nasty NTM and other bacteria set in and grow in the mucus. Second, the saline helps make the lungs inhospitable to the bugs. You may never get rid of the infection but the nebulizing of 7% saline can keep the bacteria tamped down and keep you from getting worse. Those who don’t have symptoms or mild symptoms do this as part of the wait and watch. If you have serious symptoms or it is really affecting your quality of life, then it may be best to be treated.
Do you know what strain? I would get another opinion from an infectious disease doctor and another pulmonologist. Not all MAC is slow growing. My left upper lobe grew a 10 cm cavity in it within 30 days of "waiting". Then you're looking at an even longer journey. The antibiotic treatment along with the nebulizing now can put you ahead of this.
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A watch and wait approach is recommended by some doctors and in some states. In Connecticut my doctor recommended that. In Tennessee my doctor said, “Here we treat!” MAC has a slow progression so watch and wait is ok. It is my opinion that unless you have symptoms a watch and wait approach is probably ok. Once you start on medication it is a long journey- I suppose it is a long journey regardless, As a veteran of this disease now I think I can say that time is on your side in terms of making that decision. I’d say read all you can, but depending on your personality that could be a bit unnerving. If you trust your doctor then follow his lead. Hopefully it is an infectious disease doctor who recommended the watch and wait. You really need both a pulmonologist and an ID doctor to make an informed decision. Good luck.