Mucoid impactions-clearing?

Posted by pacathy @pacathy, Mar 15 10:20am

I had my CT and MD appointment this week. Doc was pleased the CT was no worse. There were waxing/waning trees in bud and ground glass, but the 3 areas with mucoid impactions distal to my areas of (mild) bronchiectasis are still present after >1 year. Is it possible to clear those since they’re distal to bronchiectatic areas? The report wasn’t available before my appointment.

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Good question. I have no suggestions but also would really like to hear whether others have experience/advice to share on this.

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@kathyhg

Good question. I have no suggestions but also would really like to hear whether others have experience/advice to share on this.

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I'd be interested to know that also.

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@pacathy My computer was "doing its own thing" yesterday, and along with some photo edits, some of my posts didn't!
Mucoid impactions would concern me because the mucus is such a great breeding ground. The only recommendation I found on line was NAC or guaifenesin to thin the mucus, but not sure how well it works on impactions.
Did your pulmonologist have any comment? Are you MAC-free at this point?
Sue

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Thank you, Sue. Their capacity for breeding bacteria is my concern also. The radiologist commented on those areas of mild bronchiectasis and mucoid impactions and said unchanged from CT in Jan 2023 (pre Mayo visit). The report wasn’t available prior to my appointment with Penn pulmonologist and he didn’t comment on those. He was pleased that CT was stable.

I haven’t had MAC, but thought I did for 8 months. While I waited for culture done at Mayo, they had me doing quite aggressive airway clearance including postural drainage 2x/day. Since I didn’t clear the areas at that point, I wonder if it’s possible. Mayo doc decreased AC frequency to daily when cultures came back negative and postural drainage was stopped due to reflux. I’m just doing neb, Aerobika and huffing. I’m doing quite well except when g-kids bring viruses home..

I think when I get back from an upcoming trip, I might try NAC (will be new) and do airway clearance 2x/day for a month again. Can’t hurt, right?

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@pacathy

Thank you, Sue. Their capacity for breeding bacteria is my concern also. The radiologist commented on those areas of mild bronchiectasis and mucoid impactions and said unchanged from CT in Jan 2023 (pre Mayo visit). The report wasn’t available prior to my appointment with Penn pulmonologist and he didn’t comment on those. He was pleased that CT was stable.

I haven’t had MAC, but thought I did for 8 months. While I waited for culture done at Mayo, they had me doing quite aggressive airway clearance including postural drainage 2x/day. Since I didn’t clear the areas at that point, I wonder if it’s possible. Mayo doc decreased AC frequency to daily when cultures came back negative and postural drainage was stopped due to reflux. I’m just doing neb, Aerobika and huffing. I’m doing quite well except when g-kids bring viruses home..

I think when I get back from an upcoming trip, I might try NAC (will be new) and do airway clearance 2x/day for a month again. Can’t hurt, right?

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@pacathy Mucoid impaction is the same as mucus plugging. It seems that we all have some degree of mucus plugging. My understanding of the disease process is that mucus plugging/mucoid impaction can lead to bronchiectasis. Airway clearance as you suggested cannot hurt and it can only help with the mucus plugging/mucoid impaction.

Regarding NAC, Mucinex, I've read research articles that show benefit, and research articles that show no benefit. My take: NAC, mucinex break apart the mucus in our lungs and seemingly make it easier to expel. In that breaking apart process does it leave behind some of the broken apart mucus (phlegm) leading to further mucus plugging? Without NAC Mucinex the phlegm globs remain in tact and in theory can be huffed out all in one piece. Still, I would like a pulmonologist with knowledge, training and experience to explain it all to me. Until then do what you feel works for you!

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@scoop

@pacathy Mucoid impaction is the same as mucus plugging. It seems that we all have some degree of mucus plugging. My understanding of the disease process is that mucus plugging/mucoid impaction can lead to bronchiectasis. Airway clearance as you suggested cannot hurt and it can only help with the mucus plugging/mucoid impaction.

Regarding NAC, Mucinex, I've read research articles that show benefit, and research articles that show no benefit. My take: NAC, mucinex break apart the mucus in our lungs and seemingly make it easier to expel. In that breaking apart process does it leave behind some of the broken apart mucus (phlegm) leading to further mucus plugging? Without NAC Mucinex the phlegm globs remain in tact and in theory can be huffed out all in one piece. Still, I would like a pulmonologist with knowledge, training and experience to explain it all to me. Until then do what you feel works for you!

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Thanks, Scoop. I wasn’t sure how common persistent mucoid impactions/plugs are on CT’s in community patients.

I see my pulmonologist again in 6 months and if my list isn’t too long, I’ll ask him.

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We can all hope that the new AI technology that is being developed will be used to develop new antibiotics to treat bacteria & NTMs. More research is needed to understand how Bronchiectasis develops. I’m seeing more recent scholarly articles indicating that repeated infections can cause Bronchiectasis. All the more reason Physicians should pay more attention to colour and viscosity or the consistency of phlegm and order sputum tests for patients before referring to pulmonologist or respiratory specialists.

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@jnmy

We can all hope that the new AI technology that is being developed will be used to develop new antibiotics to treat bacteria & NTMs. More research is needed to understand how Bronchiectasis develops. I’m seeing more recent scholarly articles indicating that repeated infections can cause Bronchiectasis. All the more reason Physicians should pay more attention to colour and viscosity or the consistency of phlegm and order sputum tests for patients before referring to pulmonologist or respiratory specialists.

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You may be on the right track regarding AI - I think that using it for modelling various scenarios, based on patient records and would be an ideal application.
Another thing I think needs serious research is targeted delivery of antibiotics. When infection settles deep in the lungs or other tissue, we need some kind of nano-tech to deliver the antibiotic directly to the affected tissue.
If I was younger, I might go back to school - but I enjoy retirement too much. 😉

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@jnmy

We can all hope that the new AI technology that is being developed will be used to develop new antibiotics to treat bacteria & NTMs. More research is needed to understand how Bronchiectasis develops. I’m seeing more recent scholarly articles indicating that repeated infections can cause Bronchiectasis. All the more reason Physicians should pay more attention to colour and viscosity or the consistency of phlegm and order sputum tests for patients before referring to pulmonologist or respiratory specialists.

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Physicians need to pay more attention to patients complaints of persistent cough and fevers. Basic stuff. 😀
If I hadn’t had an x-ray for back pain that noted nodules, I’d probably still be coughing my lungs out. It was ordered by Urgent Care, not primary doc.

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@sueinmn

You may be on the right track regarding AI - I think that using it for modelling various scenarios, based on patient records and would be an ideal application.
Another thing I think needs serious research is targeted delivery of antibiotics. When infection settles deep in the lungs or other tissue, we need some kind of nano-tech to deliver the antibiotic directly to the affected tissue.
If I was younger, I might go back to school - but I enjoy retirement too much. 😉

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Really quite interesting @sueinmn I’m hoping there are researchers who can leverage AI and work with teams of people, including patients perhaps, to develop new antibiotics, new methods to target antibiotics to specific areas of a patient’s lung. Secondly, help educate doctors, pulmonologists, respiratory experts
- the medical field - and general public about a chronic lung condition that can occur in people with previous lung issues, but also in an otherwise healthy person, with previously healthy lungs. I’m reading more about how multiple infections / pneumonia that is not treated adequately can cause Bronchiectasis and definitely make it worse. Time is of the essence with providing CT scans, sputum tests, antibiotics, and airway clearance for many people. The goal must be limiting the damage that inevitably happens. Sadly, more people are being diagnosed with this condition. Awareness may bring more changes and research focus. I’m hopeful.

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