First bronchiectasis flare up!

[ManishaPM]

I had my first bronchiectasis flare up last week. I was given antibiotics which I finish on Saturday but I'm still coughing a lot, coughing up phlegm throughout the day and vomiting whilst coughing. I'm not sleeping and just feel drained. The only self management advice I've been given are breathing exercises. I've bought myself an Acapella device and a salt pipe which do help temporarily but I really need some advice on dealing with this condition long term. I'm struggling to live my normal life, like go to work and have a social life. Any help would be much appreciated, thanks!

[Bella395]

Did you send a sputum sample to the laboratory for analysis? If not, now that you have finished the antibiotics you can do this but will need to ask the surgery staff for a sterile pot. Obtain an early morning specimen before you eat or drink and take it in to the surgery ASAP.

Bronchiectasis protocol is two weeks of antibiotics - see British Thoracic Guidelines on the Management of Bronchiectasis. You can refer your doctor to this document.

If your sputum is thick and hard to cough up, ask for a mucolytic. Carbocysteine is one such drug and the dose is usually two capsules three times a day. Nebulised sodium chloride 0.9% can work well but you might need to purchase a nebulizer. Before doing so, check with your GP because he or she will need to add the nebules to your repeat prescription list.

Schedule your active cycle breathing and use of the Acapella at least twice a day, preferably before food or at least an hour afterwards.

Long term antibiotics are recommended in people who have more than three exacerbations in one year (BTS Guidelines).

[ManishaPM in reply to Bella395]

Thank you for your reply.

The Dr didn't ask for a sputum sample. I was just given a 5 day course of antibiotics and when I went back a week later I was only able to see a nurse and she was very unhelpful. I explained I was vomiting up my medication including my thyroid meds and feeling very light headed but still no help. I will call the surgery again and demand to see a Dr.

I don't have a problem with thick sputum, I actually have the opposite problem and end up coughing up over myself because I don't feel it coming.

Thank you for you advice.

[Ade29 in reply to ManishaPM]

Sorry I have just seen this. Even-through it’s on my notes often I have to say should I do a sample now I have emergency antibiotics and a spare sample pot. Also unless you go to a GP who understands bronchiectasis they will say they can hear your chest but they would anyway. You have to become expert yourself I have found often I understand more than them

[Izb1]

Hi ManishaPM, you really need 2 weeks antibiotics with bronchiectasis and your doctor should know this, you may also need steroids. I have had one major flare up and my sinus's got infected, it lasted months so make sure you get back to your doctor asap. I now take a daily vit d3, vit k2 mk7, magnesium and have a healthy diet, look back on previous posts, ghere is alot of information there. I wish you all the best x

[ManishaPM in reply to Izb1]

Thank you very much for your advice. I will call my Dr ASAP!

[Izb1 in reply to ManishaPM]

Littlepom has given you the best advise below. I will just add that I also use Sterimar which is a nasal wash and I use this everyday to clear out the germs in my nose x

[Hidden]

Right. First of all. Bella's advice is very good so I won't be repeating it.

However, it is obvious that your GP is trying and failing woefully to treat and manage your bronchiectasis. One week of abs for a bronch exacerbation. is as useless as taking smarties. They have obviously not read the guidelines which were co written by my consultant.

GPs are not trained in bronchiectasis. They treat it like a well person's chest infection or copd. It us neither. It is complex, debilitating if not treated and managed appropriately and requires specialised treatment.

You need a bronchiectasis specialist consultant. Not a general respiratory consultant as they do not have the training or experience.

The bronch specialist will decide the form of antibiotic treatment that you need and will advise the GP of that. They will also have a physio to help you get control of your bronch. Personal management is as important as drug treatment. Like several on here, I have had extensive bronch for 66 years. I have had a full and very active life and continue to do so. My relationship is with my consultant through her secretary. My GP only writes the prescriptions for my rescue pack as instructed by my con.

Bronch experts are usually at big teaching hospitals. Find the name of the one closest to you. Take it to your GP and Insist on a referral. This is the difference between living your life with bronchiectasis and having bronch ruin your life because it is not controlled properly. We bronchs have to be very pro active in our own interests and vociferous in sourcing the right treatment. Good luck. We are here for you.

[ManishaPM in reply to Hidden]

Thank you so much for your advice. As it's my first flare up I put my trust in my GP but I can't leave the house right now as I feel so poorly. I am determined not to let this be my life now so I will address this with my GP ASAP. Really appreciate all your help.

[Hidden in reply to ManishaPM]

Please do keep asking. We are here to support you.

[LizPat30]

Hi I am very new to bronchiectasis and really just wanted to send my support. I cannot add to what has been written but would endorse that my consultant has directed my GP ie two weeks of antibiotics ready to be used at the sign of a flare up plus the sputum pot ready to be sent. I have my appointment with the respiratory therapist in two weeks. I do hope you feel much better soon xxx

[ManishaPM in reply to LizPat30]

Thank you for your advice. I will be get in touch with my GP ASAP and demanding a consultant.

[Response]

Along with the other information below, ask (push) to be referred to a bronch physiotherapist. The one my mum had was by the nhs but a private company, but she was excellent. You'll need to wait a long time though for an appointment.

[ManishaPM]

Thank you, I will definitely be pushing now.

[Redrum46]

Wen I’m like that it’s only steroids with antibiotics that sort me out my doctor for past couple of years has sed steroids are only for asmatic s and I have bronctiactasis

[ManishaPM in reply to Redrum46]

I have asthma and bronchiectasis. I normally have a 5 day course of steroids every month for my asthma and they do really help me. This was my first bronchiectasis flare up and the 5 day course of antibiotics hasn't helped at all.

[Bella395 in reply to ManishaPM]

Assuming you mean a five day course of oral steroids each month, this indicates that the asthma is not well controlled, especially if the dose is high. Uncontrolled asthma and bronchiectasis is a complex situation to deal with. As has been said, you need to find a consultant who specializes in these conditions and ask for a referral asap.

The five day course of steroids has not helped because you probably still have an infection. Also, it is too short a course. My OH has the same problems as you and has 30mg x 7 days then reduce by 5mg every three days until back down to his maintenance dose of 10mg Prednisolone.

[ManishaPM in reply to Bella395]

Yes my asthma is a big problem, unfortunately my triggers are things that cannot always be controlled e.g. weather, smells, dust. I normally have a 5 day course of 40mg and I suffer badly from the side effects but they do help my chest so it's worth it. I'm calling my GP first thing tomorrow morning regarding my bronchiectasis treatment plan. Thank you for your help.

[Neville33]

Sputum sample...

[ssafa]

I agree with everyone's comments and the need for a min 2 weeks antibiotics. You need to ensure that you have bronchiectasis I believe the only way its identified is by CT scan and if you haven't had a sputum sample tested how on earth can you treat it as it depends on what you have.

[ManishaPM in reply to ssafa]

Hi, I have been diagnosed with bronchiectasis after having a CT scan.

[ssafa in reply to ManishaPM]

so you should have had a sputum sample done as there are so many infections you can get that there is one antibiotic cures all. In the last few months I have had 4 differing infections that required 4 different treatments. My nemesis is Pseudomonas which is so difficult to deal with.

HOPE THIS HELPS

[Durcot]

Salt is a big problem, I got a salt pipe and had problems . I told my doctor and he told me not to use it as it creates the flem that makes you cough. That also means salt additives in your diet. Told me to drink alot of water. Since then I've been good. But I have sever COPD and sever ASTHMA. I tell my doc everything and I ask alot of questions. I read all I can get about my illness so I can ask the questions.

[ManishaPM in reply to Durcot]

I find that my salt pipe helps to settle my coughing.

[Durcot in reply to ManishaPM]

I thought so to but it keeps me coughing is all it did. It was temporary at best.