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Airway Clearance Help and Bronchoscopy Prep
Firstly, I am thankful to have found this forum. I've been looking through the discussions and have learned a lot, but still have a lot to learn. Thank you for sharing your experiences and advice. Everything I know about this I've learned from you and the internet, so please excuse my ignorance.
I've been diagnosed with Bronchiectasis, Pseudomonas and Abscessus -- primary symptoms were fatigue and SOB. My first pulmonologist (in September) really was a disappointment and didn't give me any real information at all. Just did a bronchocoscopy, said there was a LOT of mucus and started the cultures. Might be MAC he said. When Pseudomonas showed up he prescribed Levoquin x 10 days. In December he told me the culture results for abscessus and after I asked about airway clearance started me on nebulizing albuterol and aerobika.
Just saw a new pulmonologist at University of FL in Gainsville. She seems very knowledgeable and I have more confidence. She now wants to do another bronchoscopy (Jan 10th) and added 3%saline to the routine. My Pulmonary function test was normal.
I just want to know if I'm doing airway clearance right, as I've only been doing it for 10 days. My fatigue has lessened, but no change in SOB. Early on with this routine, I expelled a fair amount of darkish tan colored sputum kind of floating in frothy, thick clear stuff. Recently it's only been clear, thick sputum. Does that mean I'm not getting things from down in my lungs? Or could that mean that it's good news that there's a lot less tan stuff?
Two questions about the bronchoscopy: When he goes in there and does the lavage and sampling in multiple spots, can he be spreading the infection around? And, can/should I ask him to suck out excess mucus? Anything special I should ask him?
Thanks for your help.
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jml6812 @jml6812 What is the reason for the second bronchoscopy? Have you've been leaving regular sputum samples? Have you had a CT scan?
Diagnoses of bronchiectasis and pseudomonas and MAC for that matter are made by sputum cultures, CT scans and clinical symptoms. I am not sure that a bronchoscopy is necessary especially since you've had one recently.
Lots of folks here have had them and hopefully you'll hear from them. Lung Matters Facebook group discourages bronchoscopies because they think that the bronchoscopy equipment cannot be properly sterilized. They think there's a risk to "pick up" something from a prior patient. Some of these germs are only killed by boiling and hospitals/clinics generally do not use boiling for sterilizing. I would encourage you to read about what they have to say but keep in mind they tend to be "absolutists".
In the meantime keep clearing your lungs twice a day!
I would like to add a Welcome to Mayo Connect - it sounds like you have already absorbed a lot of information.
It is difficult to say why the second doc wants to do a bronchoscopy, but I suspect she may want to confirm exactly which MAC variant you have, and in which lobe(s). Abscessus requires different drugs than typical MAC. If you are producing enough sputum to culture, maybe you can ask why a repeat bronchoscopy is necessary?
Let me try to put your mind at ease a bit about infection risk. Once it was discovered that bronchoscopes were a potential source of infection, many places have switched to using sterile, disposable parts that are inserted into your body - you can ask the facility where the procedure will be done. When the lavage is performed, sterile saline is injected and then suctioned out, so they will actually be removing mucus and not spreading it around. A
When I had both MAC and Pseudomonas, my green/brown sputum changed to yellow after the pseudomonas was treated. But it did not get clear until months into treatment for MAC.
Sue
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5 ReactionsI’ve had three ct scans and the cultures for the diagnosis. I’m not sure, but I think the new pulmonologist wanted to re-do cultures and basically start over. I’m assuming that sputum samples will happen after that.
Thanks for the info on the broncoscopes. I’ll definitely ask.
Hi JM,
Below is a link to airway clearance techniques, referred to me by another much appreciated group member. Also, I would consider checking into the Aerobika device to help with mucus clearing. I use it daily and really find it to be very effective.
https://bronchiectasis.com.au/resources/airway-clearance-videos
Best of luck to you and happy holidays!
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2 ReactionsThanks, I do use the Aerobika, but haven’t had any training, just from their website. Just fooling around with the settings. I’m going to have to ask for a referral to respiratory therapy I guess. I’ll definitely look at your link. I see that this group says to replace the nebulizer tubing monthly instead of the six months from the Pari website. Is that because of infection control?
There are conventional bronchoscopy's and there are Superdimension Navigation System (ENB) bronchoscopy's.
I doubt an insurance company would authorize 2 of the same close together. Could you be getting a SuperDimension? I got both, but 4 years apart.
Boy, I don't know. I did verify with the bronchoposcopy center that they'd run it through my insurance and let me know if there are any problems with coverage. I suppose it might depend on what reason she put down for the medical need. The first bronchoposcopy only showed a few abscessus colonies in one of the four samples taken and she wants to chase that down before any treatment plan's developed.