enormous sputum clearance all the time

Posted by dispatchpat @dispatchpat, Jul 12, 2023

I’m finally seeing an ID doc end of this month. I have slight bronchiectasis and MAC. I have endless white/clear sputum. it gurgles in my chest and easily comes past my esophagus all the time. I barely need to start my autogenic drainage, it’s just always ready to be expelled. I do saline nebulizing after a quick albuterol dose every day just in the hopes that the saline is killing some bacteria. This has been my story since November diagnosis. I am 65 and very athletic, my oxygen saturation is excellent. I have two lines of thought. I wonder if you can help me work through. 1) I am leaning towards diving into the big three protocol with fingers crossed, and a hopeful attitude that I will be a lucky one and sail through without terrible side effects. this decision is being prompted by my understanding that chronic inflammation is a terrible enemy in this fight. do you think I am balancing my considerations intelligently? And, 2) when I do my airway clearance, at the end of the saline dose, I’ll extend my expelling time with autogenic drainage and push this whole process close to an hour. This easily produces a half a cup! Then, I just get bored, distracted, fed up and walk away. I’m good for the day, as far as not needing to cough, which has been a godsend. But I am constantly producing all day long, and either subtly or not so subtly expelling it. I’m starting to think I should have a marathon session and just keep going with the autogenic drainage… Is that crazy? To sit for hours and just expel expel expel? Thanks as always for your collective insight!

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@rebecross

It's helpful to read that no only do others cough up stuff all day, but they also get sick and tired of it!
What I would really like is to believe is that I will ever get to a point where I am not coughing constantly AND spitting into a cup. NO amount of airway clearing "finishes", and so I do wind up walking away..but then I just keep spontaneously producing. I am exhausted. My Pulom is trying me on Azithro, no change after one month, so perhaps she'll up the dose to 500mg 3x a week.
My sputum tests were negative, so I guess that means I do NOT have MAC??
What next I wonder???

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When you say, "...My sputum tests were negative..." did they just do a typical slide in the local lab, or did they grow out the sputum culture for 6-8 weeks to see what would develop?
Also, did they test for other organisms like Pseudomonas?
Sue

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@sueinmn

When you say, "...My sputum tests were negative..." did they just do a typical slide in the local lab, or did they grow out the sputum culture for 6-8 weeks to see what would develop?
Also, did they test for other organisms like Pseudomonas?
Sue

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It took 8 weeks to get the results. I just looked up the results on Kaisers site, negative for AFBs after 8week. No systemic fungus or WBCs, whatever they are. I will.ask about the
Pseudomonas.

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Same here. Some days I have to miss work because I can’t stop. Only thing is there is almost daily black elements in it.

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@rebecross

It took 8 weeks to get the results. I just looked up the results on Kaisers site, negative for AFBs after 8week. No systemic fungus or WBCs, whatever they are. I will.ask about the
Pseudomonas.

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@healthybon

Hi Irene……do you do postural drainage every day also? If so, did you have lessons from a respiratory therapist?
Bon

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No out patient respitory therapists available in st Augustine or Jacksonville area.

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@squire123

No out patient respitory therapists available in st Augustine or Jacksonville area.

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In some circumstances, this would be referred to as Pulmonary Rehabilitation - there are at least 3 facilities mentioned in the Jacksonville area...maybe that is worth a try?

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@lizotteba12

Yes bit wants me to take ethambutol 400mg,azithromycin tab 500 mg,Rifadin 309 MG, I started Friday, sick all day lack of energy upset stomach today I took Rifadin got sick vomit don't know what to do

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Rifampin made me very sick, I had aggressive, endless diarrhea, stomach cramps, and zero appetite. At the time, I had no idea which drug was causing this, and I just sucked it up. But I read a lot about Rifampin and how it made other people sick. I was going away and I could not have the diarrhea on the flight, so I decided to stop taking the drug for the duration of my vacation. The diarrhea was soon gone and I regained my appetite. I told my pulmo, and begged her to take me off rifampin.

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What exactly does all this horror do to HELP QUALITY of life?
I'm only on Azithro, my pulmonary says I do NOT have MAC.
If my day to day life doesn't change why on earth would I risk my liver, hearing, and so forth?

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