Pulmonologist versus Infectious Disease Dr

That is the instructions for rifampin, not the other two.

What I have learned is that none of the specialists are good at kidney disease so you always need your kidney doctor to weigh in on the meds including dosage. Also do your own research. Little things like pepcid for example need 1/2 dose not full dose, etc etc. My kidney doctor would not allow a port for 2 week antibiotic treatment because 1. infection 2. may need veins or whatever for dialysis in the future - so I had to stay in hospital 2 full weeks for merem IV.

https://www.mayoclinic.org/drugs-supplements/ethambutol-oral-route/proper-use/drg-20063728

Hi,
I’ve been living with the “ticking time bomb” for 6 yrs. I also have minimal symptoms & have never taken the “big 3”. My pulmonologist referred me to an ID Dr. several years ago, but he did not feel my condition warranted treatment (at the time I was regularly coughing up blood). I started nebulizing sodium chloride (3% initially, then 7%) & I really believe that has helped me stay healthy (no colds, flu, or Covid-fingers crossed). I would speak with the ID Dr. about what she would recommend. Regular exercise, a healthy diet, & 7-8 hrs of sleep are all part of my treatment plan! Take care, Linda

I'm shocked that your doctor wanted you to take them all at once! Normally, they tell you to start with one; a week later then next, and a week later the third one. But...if you have no symptoms; please do NOT take the meds!! Too many side effects. I lost some hearing; my eyes got bad, and my balance off and nausea and lost weight...I was already 95 pounds. After 14 months, I just stopped taking them.

Hi, I started the big 3 in October. I take the azithromycin on empty stomach two hours before breakfast. Around noon I take the ethambutol with lunch. Two hours before or after dinner (empty stomach) I take the rifampin. So far so good. I only take on MWF. Best of luck! I also eat yogurt and take probiotics on the days I don’t take the meds.

Or you could be right...my first pulmonologist "fired" me when I consulted the ID doc after a year of not getting any better. He connected my to a different pulmo with whom he works well. Interesting note - they are all part of the same large clinical practice group that includes all my other docs as well. I guess it all comes down to personalities. But you need to do what is best for you and your health.
Sue

I have both ID Doctor and Pulmonologist. Both suggest to have each involved. If any doctor is offended by second opinions or having the desire to have another specialist involved, find another doctor

As sue said,a team, working together! My 1st pulmonologist dr.whom was rated as a Mac Dr. Had missed the disease on my chart! I had to make him turn his computer back on and read further!! Then he seemed unhappy I went to an i.d. Dr. ! My id dr.was the one that stressed the importance of checking vision/hearing/liver.ect. so thankful for this site and Sue's input! Good luck and good health.

Hi!
In my case I was given Azith and Ethmbutol as a pair because the Rifampin interacted with my chemo treatments. Once Chemo was over, I started all 3 together which I take at night with no major side effects. Fatigue and a weakness in my legs at times but nothing that prevents me from living my life.
However, I had to drop out of playing competitive sports.
After 6 months (MAC) was still positive and I was approved for Arikayce and continued with the same regimen Big 3 three times p/w. After 2 months on Arikayce, I' had a negative sputum culture so I'm on the right path and once I have had 3 or more negative cultures, I will be weaned off the drugs.