Pulmonologist versus Infectious Disease Dr

Posted by bbeers @bbeers, Dec 2, 2023

I was diagnosed with MAC in August. Pulmonary Dr. wanted me to start Big 3 even though I have no symptoms. I asked if I could take one at a time rather than all three at once. He said no. I just wanted to space them out so I could determine which one, if any, was causing side effects. I decided to see an Infectious Disease Dr. and her approach is different. Do you have a preference over one type of Dr. to another. I feel like the ID Dr. might be better equipped to handle this disease. Thank you

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@bbeers My pulmonologist and ID doctor were a team when I was being treated for MAC. The ID doc managed the meds - dosage, frequency, etc, and the pulmo managed my bronchiectasis & asthma.

The most important thing is to be sure both of them are up-to-date on the protocols for treating MAC and managing bronchiectasis.
Sue

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@sueinmn

@bbeers My pulmonologist and ID doctor were a team when I was being treated for MAC. The ID doc managed the meds - dosage, frequency, etc, and the pulmo managed my bronchiectasis & asthma.

The most important thing is to be sure both of them are up-to-date on the protocols for treating MAC and managing bronchiectasis.
Sue

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In my case because I have kidney disease, the kidney doctor and the infectious disease doctor were a team and often told the pulmonary doctor "no". re. Tobi for example. It was an interesting war experience! (this was for pseudomonas not MAC)

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@liz440

In my case because I have kidney disease, the kidney doctor and the infectious disease doctor were a team and often told the pulmonary doctor "no". re. Tobi for example. It was an interesting war experience! (this was for pseudomonas not MAC)

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Interesting. When my husband had pseudomonas we had to monitor the drugs the pulmo wanted to use. His kidney doc was in a different clinical system. As his CKD progresses we will try to find someone in the same network, but when you're seeking the best available sometimes that isn't an option.
Sue

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@sueinmn

@bbeers My pulmonologist and ID doctor were a team when I was being treated for MAC. The ID doc managed the meds - dosage, frequency, etc, and the pulmo managed my bronchiectasis & asthma.

The most important thing is to be sure both of them are up-to-date on the protocols for treating MAC and managing bronchiectasis.
Sue

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I agree with sue. Both my pulmonologist and infectious diseases doctor worked together. Same as sue.

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@sueinmn

@bbeers My pulmonologist and ID doctor were a team when I was being treated for MAC. The ID doc managed the meds - dosage, frequency, etc, and the pulmo managed my bronchiectasis & asthma.

The most important thing is to be sure both of them are up-to-date on the protocols for treating MAC and managing bronchiectasis.
Sue

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Hi Sue, how do you determine if both of them are up to date on those protocols. I have an appt. with the ID Dr. and I can ask her if she treats bronchiectasis and my mild copd. I don't think my Pulmonologist will take kindly to me seeking out an ID Dr. but I could be wrong. Thank you

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In my case, the pulmonologist called in ID immediately when he saw the results of the culture.

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I'm newly confirmed for MAC and will start big three after Christmas. Do most people take all three at once? Or can you take one at breakfast, one at lunch, and one at dinner? I was hoping to isolate side effects by taking separately. I need to go back to my ID to confirm before I start.

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Each person can be different but I found this schedule worked best for me. Ethambutol with breakfast, rifampin at 10am, Azithromycin with big dinner, rifampin at 9pm. AZ & ethambutol can be taken with food. Rifampin cannot and requires a 2 hour window if no food.

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@rstel7272

Each person can be different but I found this schedule worked best for me. Ethambutol with breakfast, rifampin at 10am, Azithromycin with big dinner, rifampin at 9pm. AZ & ethambutol can be taken with food. Rifampin cannot and requires a 2 hour window if no food.

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Thank you for your response. Initially he wanted me to take all 3 at once 3 days a week. Now that I am seeing an ID Dr. she isn't starting me on any meds right now because I have no symptoms. It's kinda like living with a bomb inside of you just waiting to go off and not knowing when that might happen. I believe I got this disease from volunteering to take care of the 4H Gardens. Oh well, it is what it is. Best wishes for good health for you.

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@rstel7272

Each person can be different but I found this schedule worked best for me. Ethambutol with breakfast, rifampin at 10am, Azithromycin with big dinner, rifampin at 9pm. AZ & ethambutol can be taken with food. Rifampin cannot and requires a 2 hour window if no food.

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Thanks for the feedback. I am reading the following on the Mayo clinic website:

Take the capsule on an empty stomach, 1 hour before or 2 hours after a meal, with a full of glass water. It is important to take this medicine on a regular schedule. If this medicine upsets your stomach, take it with food.

Seems kind of contradictory.

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