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How do you handle a flare up or exacerbation?

Posted by Sue, Volunteer Mentor @sueinmn, Oct 25, 2023

It's that time of year when the "bugs" come out - colds, flu, bronchitis -too many to mention. With lungs damaged by MAC and/or Bronchiectasis, getting sick is always scary because of the danger of all our symptoms flaring, or getting a new infection.

What precautions do you take as the "sick season" approaches?

What do you do when you feel a cold or other illness coming on? Do you make any changes in your airway clearances, diet or activities?

What do you do when you actually become ill? Do you have a routine or plan with your doc as to when to "wait it out" and when to call them?

Let's hear how everyone manages, please?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

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cholash | @cholash | Mar 10 12:57pm
In reply to @scoop "@cholash" + (show)

@scoop you’re awesome . Thanks so much !

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ursala7 | @ursala7 | Mar 11 12:00pm
In reply to @scoop "@cholash Jumping in here to say that often BE exacerbations begin as viruses, which can turn..." + (show)
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@cholash Jumping in here to say that often BE exacerbations begin as viruses, which can turn into bacterial exacerbations. If you listen to the various BE updates from MD experts they discuss when to treat. They run through a list of approximately 7 symptoms and if there are 3 of those symptoms they treat as long as there has been a sputum sample dropped off before beginning abx.

Most of us are colonized and these colonies get out of control (often spawned by viruses) and start causing symptoms (increased phlegm, increased cough, aches, malaise etc). To ignore these symptoms invites worse outcomes. I agree with @sueinmn that efforts to clear lungs should be stepped up in these situations. For example, instead of clearance 2x, go up to 3-4 times a day. If you do not feel better after a couple of days of increased routine, doctor should be contacted for possible treatment. It's best to avoid abx if possible but not at the cost of decreasing lung health.

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@scoop i agree with the your explanation of viruses spawning colonized bacteria into motion. For me the body's response (symptoms) to a flu virus can come on so fast and furious that I equate it to a "cytokine storm". This doesn't happen very often, but it has, every few years, when I've caught seasonal flu or COVID. I definitely seek help as soon as i feel that specific hyperactive immune response (high fever, headache, prolific mucus, malaise) because I can literally feel my lungs filling up with fluid that i can't expel quickly enough. I call this type of incident an exacerbation, and it's rare; have only had it about 4 times since my bronchiectasis was diagnosed 12 years ago. But in every day life, when my system kicks up an annoying, heightened immune response, (aka bronchiectasis symptoms, the cause of which I can't explain) I self manage to try to avoid antibiotics, adding extra airway clearance, more fluids and mucus thinners, and sometimes saline. I call these ordinary incidents flares. I don't get too concerned as long as within 24-36 hours things are improving, and they normally are. There's a huge difference between what I call a flare and an exacerbation (in my definition of the terms). I don't have asthma to complicate things.

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