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CT Scans vs Sputum Cultures, which is more important?

Posted by mch (Marycarol) @mch, May 31, 2023

I've seen lots of comments focused on sputum culture results as a determinant of whether treatment is successful or not.  I understand the relevance of these cultures, but I'm wondering about the relative importance of CT Scans.  Seems like the sputum culture results can be somewhat erratic, including false positive and false negative potential, and highly dependent on successful sputum production which introduces considerable variability in the quality of the sample.  Can't help but question the reliability of lab results.  I tested positive for MAC based on bronchoscopy, but my pulmonologist seems much more concerned with my CT scan and almost downplays the value of sputum cultures.  I did have 2 small (less than 2cm) cavities on my initial scan so that might be why he's focusing on the scans rather than cultures going forward.  I would appreciate hearing from anyone who's had cavities and what your experience has been with treatment (Big 3 and/or Arikayce) improving (or not) your CT scans.  Thank you.

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blm1007blm1007 | @blm1007blm1007 | Nov 7 8:30am
In reply to @healthybon "I just saw your post. I have not taken the antibiotics. They make me very sick,..." + (show)
@healthybon

I just saw your post.
I have not taken the antibiotics. They make me very sick, and I also get C Diff. I have had Mac and Bx for two years now.

I nebulize two times daily with Levabuterol and. 7% Saline..morning and night. I also do a procedure called “the squeeze”, that I learned from watching a video on the blog LUNG MATTERS. When I do this, I get up a lot if mucus that nebulizing does not get up. I do it once or twice daily.

It is VERY important to do these things on a daily basis…because our lungs do not work properly in terms of getting the secretions out every day. Because the sticky mucus is in there, it stops the little hairlike things in the lungs from moving the gunk out, so, we have to do it ourselves.

If we do not keep our lungs cleared out daily, we are leaving, in there, an environment for bacteria to grow, hence INFECTION COMES.

I also get sputum samples done once a month, AFB and one that shows if there is infection. VERY IMPORTANT to keep track of this. I get a CT scan done at least once a year at which time the dr compares it to the year before. I have NTM and bronchiectstasis.

So far, this regimen I am on is working. Before I started this strict routine, I was in two stints in the hospital for five days each with infection.

Feel free to message me anytime if you need to…..

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Yes, can you somewhat explain what the squeeze is that seems to help you. Are you squeezing the area just above your waist when you huff cough????
Barbara

REPLY
reneemc | @reneemc | Nov 7 12:55pm

I describe the squeeze as a long hard exhale and tighten the stomach

REPLY
lorrainewenn | @lorrainewenn | Nov 8 6:08pm

I’m seeing Dr Chalmers at the Mayo Clinic in Rochester, Minnesota and we are doing monthly sputum samples and CT scans every 6 months. I take albuterol inhaler prior to nebulizer with 7% saline twice daily. Unfortunately , I have 2 stress fractures in ribs 6 and 7 and struggle with stomach issues so it’s been a rough 2 months. I’m not on antibiotics, been diagnosed with MAC /bronchiectasis for 14 months. My sputum results vary. My CT scans are considered stable, some areas improved one area a little worse. It’s difficult at times to drain the lower lungs since the best way for me is postural drainage. My personal opinion is that the CT scan is the best indicator of lung status, sputum samples help me determine how effective my airway clearance is at removing mucus. I believe the squeeze technique caused the rib stress fractures. Hoping to have beater luck with postural drainage. I also use an Aerobika when nebulizing.
Has anyone dealt with rib fractures?

Lorraine

REPLY
1 reply
bamaqueen | @bamaqueen | Nov 9 8:35am
In reply to @lorrainewenn "I’m seeing Dr Chalmers at the Mayo Clinic in Rochester, Minnesota and we are doing monthly..." + (show)
@lorrainewenn

I’m seeing Dr Chalmers at the Mayo Clinic in Rochester, Minnesota and we are doing monthly sputum samples and CT scans every 6 months. I take albuterol inhaler prior to nebulizer with 7% saline twice daily. Unfortunately , I have 2 stress fractures in ribs 6 and 7 and struggle with stomach issues so it’s been a rough 2 months. I’m not on antibiotics, been diagnosed with MAC /bronchiectasis for 14 months. My sputum results vary. My CT scans are considered stable, some areas improved one area a little worse. It’s difficult at times to drain the lower lungs since the best way for me is postural drainage. My personal opinion is that the CT scan is the best indicator of lung status, sputum samples help me determine how effective my airway clearance is at removing mucus. I believe the squeeze technique caused the rib stress fractures. Hoping to have beater luck with postural drainage. I also use an Aerobika when nebulizing.
Has anyone dealt with rib fractures?

Lorraine

Jump to this post

I have an old rib fracture and five thoracic back compression fractures. I wouldn’t be surprised if coughing caused some of them. I do know the airway clearance routine aggravates my back and rib cage. I do not use a percussion vest because of my back fractures. It gets better as you heal. Just do the best you can and make sure you get the deep breaths in there.

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