Diagnosis of mild bronchiectasis in 93 yr female

Posted by migizii @migizii, Apr 3 8:42pm

This is a question regarding the decision to provide treatment. There has been a diagnosis by a CAT scan with no follow up determined by gp. The woman is in good physical health with mild cognitive disorder. I realize there would be a need for further input from a medical professional, but I am interested in learning people’s opinions. She is experiencing daily breathlessness with some impact with daily living (minimal at this point). Thank you for any input.

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@migizii At this point in her life, I doubt that any doctor would choose to treat her, except possibly to try an inhaler of some sort. Or short term (single) antibiotics for an exacerbation. MCI would likely rule out any active airway clearance efforts on her part, 7% saline nebs would be harsh.

For the record, my Mom at 80 had mild bronchiectasis and recurrent pneumonia. She lived several more years being treated with albuterol, and oral antibiotics if she developed pneumonia. She died several years later of (unrelated) heart disease. Knowing what I do now about Bronchiectasis, I would never have chosen anything more difficult for her - aging is hard enough, and progression of the disorder is usually not the cause of death among the (not my term) "very elderly".

If this was my Mom, Aunt or friend, I would probably not encourage further medical intervention.
Sue

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My mom was about 90 at diagnosis and was thought to have MAC based on CT. She was referred to a kind pulmonologist who told us the benefit of treatment wasn’t worth the risk of even pursuing a bronchoscopy for diagnosis. I think he started her on Mucinex, but am not certain. She also had occasional antibiotics for respiratory infections.
Mother’s main issue was dropping her O2 saturation with activity, but she recovered quickly with rest and was never started on oxygen.
I believe he made the correct call. She died about 3 years later-other causes.

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Thank you Sue and cacathy for your thoughtful comments, borne out of personal sadness.
It is so heartening to hear of physicians who treat the whole person; balancing all medical interventions with the present situation and abilities of the patient.
It is the true Practice of medicine.

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Thank you all for your kind and compassionate input on this issue. At this point, no interventions are being considered but I think the possibility of mucinex maybe useful, if it would be useful for aiding her lungs. What do you, Sue and Christine think?
I am a daughter in law with very little say in anything the family does with her care. She is a wonderful lady and I would like to offer something, if possible, that maybe helpful without causing disruption.

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In all lung diseases, keeping the sputum moving 'up and out' is so important.
I am on Guaifenesin 600 mg twice daily - it is just the medication in a gluten free capsule. I get this compounded. I wanted to avoid the other unnecessary ingredients in the Mucinex, as I am on a lot of other medications and did not want any 'extra stuff' if this could be avoided.
I ran out of this for one week and was amazed, and horrified, at how much more thick the mucus became -- and how much more coughing was required to 'clear'. I won't run out of this again!
I believe this has been very effective in keeping things moving.
I get

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@thisoldewe

In all lung diseases, keeping the sputum moving 'up and out' is so important.
I am on Guaifenesin 600 mg twice daily - it is just the medication in a gluten free capsule. I get this compounded. I wanted to avoid the other unnecessary ingredients in the Mucinex, as I am on a lot of other medications and did not want any 'extra stuff' if this could be avoided.
I ran out of this for one week and was amazed, and horrified, at how much more thick the mucus became -- and how much more coughing was required to 'clear'. I won't run out of this again!
I believe this has been very effective in keeping things moving.
I get

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I have been taking the iiquid guaifenesin, it is helping. However, I have not liked taking it because of the dye they put in it...nor do I like taking anything with dye in it or other added ingrediants that aren't necessary for your health, or bad for one's health, condition etc.....as added sugar for taste.
Your post gives me hope to be able to avoid all that.
I called the local compounding pharmacy to inquire, they indicated I need the doctor to write a specific prescription of what to put in it or not put in it. Any information you can share regarding, how and what, of your compounded guaifensein will be greatly appreciated. I am in OKC not NYC or Rochester etc. etc., so more limited in medical resources etc. Barbara

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@blm1007blm1007

I have been taking the iiquid guaifenesin, it is helping. However, I have not liked taking it because of the dye they put in it...nor do I like taking anything with dye in it or other added ingrediants that aren't necessary for your health, or bad for one's health, condition etc.....as added sugar for taste.
Your post gives me hope to be able to avoid all that.
I called the local compounding pharmacy to inquire, they indicated I need the doctor to write a specific prescription of what to put in it or not put in it. Any information you can share regarding, how and what, of your compounded guaifensein will be greatly appreciated. I am in OKC not NYC or Rochester etc. etc., so more limited in medical resources etc. Barbara

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Compounding pharmacies sometimes will do mail order if the medication is stable at normal temperatures, so you are not necessarily limited to local vendors. However, many major hospitals also offer compounding.
Sue

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@blm1007blm1007

I have been taking the iiquid guaifenesin, it is helping. However, I have not liked taking it because of the dye they put in it...nor do I like taking anything with dye in it or other added ingrediants that aren't necessary for your health, or bad for one's health, condition etc.....as added sugar for taste.
Your post gives me hope to be able to avoid all that.
I called the local compounding pharmacy to inquire, they indicated I need the doctor to write a specific prescription of what to put in it or not put in it. Any information you can share regarding, how and what, of your compounded guaifensein will be greatly appreciated. I am in OKC not NYC or Rochester etc. etc., so more limited in medical resources etc. Barbara

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Hi Barbara,
Yes, agree on your concerns re additives.
Sue has a good suggestion for your hunt for a compounding facility/ shop.
Hope this is OK to name my pharmacy that compounds and ships the 'Guai' to me.
It is my old pharmacy in Victoria, B.C. Canada. Estevan Pharmacy, 2517 Estevan road.
Since this is not a narcotic, cross border shipping is OK, unless new regulations.
They also require doctors prescription.
But, I would encourage you if possible to find a place nearer to you, if more convenient.
Such a simple thing yet has proven so effective!
Hope that helps!

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