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Bronchiectasis - advice on treating symptoms while waiting for sputum test results

SalvadorBA profile image
31 Replies

Hello, I introduced myself recently after having my first bronchiectasis flare-up a few weeks ago. I have an urgent question that I'd be grateful for any advice on please. After I rang the doctor at the outset about my symptoms, I was first put on the AB Clarithromycin for a week which seemed to work initially, but 10 days or so ago I realised my symptoms were coming back (mainly breathlessness and coughing). I was advised by kind contributors to this Forum to take a sputum sample, which I did on 2 days running because I was only able to bring up minimal amounts. While waiting for the results, I was prescribed 1 week's Amoxicillin, which will run out today. 4 days ago the test results came up as 'normal' because I hadn't brought up anything relevant for a diagnosis. I have since been able to get a "Flutter" device but am still unable to bring up any sputum, except for a minimal amount which was sent for analysis yesterday. My GP understandably is now saying I should wait for the result of the new sputum sample, which could take another week - in the meantime though I have strong heartburn and bouts of relatively mild breathlessness, and from tomorrow will not be having any treatment, except using the Flutter. Fortunately I have been referred to the Royal Brompton but will have to wait till I'm sent an appointment. I'm now quite apprehensive as I dread having another flare-up, though for all I know, maybe I'm still in the flare-up that started a month ago. As my GP is unable to help, my question to the Forum is: can anyone advise me please if there anything I can be doing in the meantime to reduce the breathlessness and heartburn, and to bring up the sputum which I can feel is definitely there? Thanks in advance.

31 Replies
Bevvy profile image
Bevvy

Heartburn/reflux can make you breathless and often people with lung issues, have reflux. There are many different prescription medications that can help prevent reflux. Your gp really should prescribe something whilst you are waiting for test results and hospital appointments.

SalvadorBA profile image
SalvadorBA in reply to Bevvy

Thanks Bevvy. I'm not sure if I have reflux as there is no unpleasant taste in my mouth, though maybe that's what is causing the heartburn. I have been reading a lot about foods I should and shouldn't eat, so I'm focussing a lot on this now.

Bevvy profile image
Bevvy in reply to SalvadorBA

You can have silent reflux where get minimum symptoms but causes breathlessness. Also not all reflux results in unpleasant taste in mouth but causes pain. Reflux is just a medical name for heartburn so the fact you say you have heartburn…….

SalvadorBA profile image
SalvadorBA in reply to Bevvy

Thanks again Bevvy, this is all new to me so thanks very much for your comments!

SalvadorBA profile image
SalvadorBA in reply to SalvadorBA

Incidentally another symptom over the last 24 hours has been light wheezing.

Lapis5 profile image
Lapis5 in reply to SalvadorBA

Also gluten free diet and no dairy will you a lot.

SalvadorBA profile image
SalvadorBA

Bevvy, my GP has prescribed me the antacid Lansoprazole so thanks again for your advice.

Patk1 profile image
Patk1 in reply to SalvadorBA

Lanzaprazole shld help heartburn if taken as prescribed.Bronchiectasis infections should be treat with 14days antibiotics.if you've not had training in how to expectorate,there r videos to help until u r under the specialist.look up " lung clearance techniques " eg " active cycle of breathing/ postural drainage"

I hope the sample detects any bacteria.

SalvadorBA profile image
SalvadorBA in reply to Patk1

Dear Patk1, thanks for your answer. I've not had training in anything as the last 2 years have taught me that our GP surgery, with its many part-time, overstretched resident and locum doctors, is only capable of adopting a 'sticking plaster' approach at best. Now that I've been referred to the Brompton in London I'm hopeful the approach there will be different. I'll look up the techniques you mentioned, for which I'm grateful, thank-you!

Patk1 profile image
Patk1 in reply to SalvadorBA

Yr welcome x

gingermusic profile image
gingermusic

Do you have a nebuliser as I fond that using a nebuliser with saline in it three times a time is a great help in getting my mucus up as for the reflux take Gaviscon after meals and before bed.

SalvadorBA profile image
SalvadorBA in reply to gingermusic

Thanks Ginger music, my sister has bought me a nebuliser and I'll use that. I've just started on the Lansaprazole but if that doesn't work I'll research Gaviscon, thank-you.

gingermusic profile image
gingermusic in reply to SalvadorBA

I wish you well, Ruth

stones93 profile image
stones93

you should have been prescribed a minimum of 2 weeks antibiotics for a flare-up of bronchiectasis and your GP should be made aware of this. Two different antibiotics for one week each could easily have made the situation worse.The standard regimen is to have stand-by antibiotics.....usually doxycycline 100mg twice a day for two weeks. These can be taken for longer if the symptoms are not entirely gone. Some people have co-amoxiclav.

Sputum samples often don't produce a result...like you I hardly cough anything up most of the time and find it hard to produce a sample.

As others have said omeprazole for the heartburn is helpful.

But really you need a proper plan from your chest consultant that your GP adheres to.

SalvadorBA profile image
SalvadorBA in reply to stones93

Good morning Stones93 and thank-you. The first time they prescribed AB a couple of weeks ago, nobody even mentioned I need a sputum sample first, which I only learned about on this Forum, while the second time last week it was because they said my sputum sample wasn't useable. It a relief to see I'm not the only one who can't produce a sample, thank-you! I'll never ever get a "proper plan" for my condition from my GP, but I hopefully will whenever I'm seen at the Brompton. As the Germans might say in this case, my GP surgery is "over-asked" in this case (= they don't seem to have a clue!).

Lutontown profile image
Lutontown

Gaviscon for your heartburn, which is probably Oesophagitis. I got this when on a two week course of Doxycicline. Best to wait for the result of your sputum test to get you on the right AB to sort the bug. Some bugs may need an IV AB. Trouble with AB's is that kill the good guys as well as the bad.

SalvadorBA profile image
SalvadorBA in reply to Lutontown

Thanks for your reply Lutontown. I've now been put on a one week course of Doxycicline after the results of a sputum test - as I already have heartburn, I hope the AB don't make it worse like yours did! Not sure whether to be relieved or apprehensive that the doctor has only prescribed me the AB for a week.

davannh profile image
davannh

I hope you are seen at the Royal Brompton quickly. You do really need to take all the advice about lung clearance. Saline nebulisers, flutter, Active Breathing Cycle. Make sure you don’t lie flat if you have acid reflux, I ingested some acid into my lungs and ended up with E-coli in my sputum. I have had Bronchiectasis for my whole life, the care I have now is brilliant, but I make sure I follow all advice to the letter. Do you have any sinus issues?

SalvadorBA profile image
SalvadorBA in reply to davannh

Hello Davannh, your having had bronciectasis all your whole life makes me feel very lucky to have only developed it now. Yes I'm anxious to see someone who understands the condition at the Brompton, so I hope I get an appointment soon. I don't have any sinus issues (touchwood!), just nasty heartburn so I'm learning all about my new diet. I assume the brochietasis and heartburn are related, but I trust the Brompton will enlighten me. I am indeed trying different methods to clear my lungs but as near as nothing is forthcoming. On a positive note, I was surprised to get 2 calls today, one from my GP surgery saying they've found traces of Beta Haemolytic Strep in my miniscule sample and I should start a week's course of Doxycycline, and a second call from my local hospital, asking me to go tomorrow for a chest x-ray, which I wasn't expecting. So hopefully this is a sign things are starting to move, slowly but surely. When you say the care you have is brilliant, is that because you have direct access to a specialist and are seen for regularly by that person (without your having a flare-up) or is that because your GP now understands the condition and can help you without your seeing a specialist each time?

davannh profile image
davannh in reply to SalvadorBA

No I do not use my GP. I have direct access to a Lung Defence Support Service at Royal Papworth. They are amazing and normally reply on the same day.

stones93 profile image
stones93

Some GPs don't seem to have a clue about bronchiectasis sadly. I spent at least a year with my old GP trying to get a definitive diagnosis while he gave me short courses of antibiotics, one after the other, and seemed to try to obstruct all my attempts to get to see a specialist.

However, a new GP, and now under the bronchiectasis specialist here, and all seems to run smoothly.

Hope it does for you too.

SalvadorBA profile image
SalvadorBA in reply to stones93

Thanks Stones93. What you describe sounds familiar to me and I'm very pleased you're now pleased with how you're being treated. I wanted to change my GP but none are marked highly and apparently I live outside the catchment area of the better one. My brother thinks GPs often don't send their patients to see a specialist as they risk getting their knuckles rapped if they make a mistake.

SalvadorBA profile image
SalvadorBA in reply to stones93

Thanks for your good wishes!

Mooka profile image
Mooka

I hope your referral is to a respiratory consultant who specialises in Bronchiectasis. Hopefully they will refer you to a physio to help with bringing up mucus. Co-amiclav is my weapon of choice and I always have a supply of two weeks at home for my rescue antibiotics. Your consultant should write to your GP (ask to be copied in) advising them to supply you with two weeks of rescue antibiotics and that a sputum sample should be sent off before you start the antibiotics. Take the copy of the letter to the receptionist who will probably question who requested it. I rarely produce positive samples. In fact even my respiratory doctor couldn’t get one from a bronchoscope. I hope you get sorted soon.

Lapis5 profile image
Lapis5 in reply to Mooka

Also, drink Pinapple juice and eat it. Take Ginger as well, and drink a cup of warm/hot water w lemon and honey in it first thing inthe am and that will loosen the mucas. u need correct nasal spays too.

SalvadorBA profile image
SalvadorBA in reply to Lapis5

Thanks for those tips Lapis5. I'm afraid I have now also developed heartburn so I'm not allowed pineapple or lemons, though I'm pining (excuse pun) for both as I write!

SalvadorBA profile image
SalvadorBA in reply to Mooka

Many thanks Mooka. Yes I will definitely ask the Brompton specialist if I could see a physio too. Quite a few people on the forum like yourself write that they have a 2 week supply of AB in reserve. Does this mean that the type of AB you need to take will never change, ie. you only need to give in a sputum sample once, because the results will always be the same?

Mooka profile image
Mooka in reply to SalvadorBA

No not at all. It’s the antibiotics that have worked best for me in the past except when it was the dreaded pseudomonas causing the infections. The idea of a sputum sample is different antibiotics work for different bugs but of course they would have identify the bug to tailor the antibiotic. Both my respiratory doctor and immunologist advise my GP that I should have a sputum sample tested and take two weeks antibiotics. That way GP can’t argue. If there’s one that’s worked best for you in the past let your doctor know. You need a supply at home as it’s always a weekend/bank holiday when you need them!

SalvadorBA profile image
SalvadorBA in reply to Mooka

Thanks Mooka. I'm probably being dense so I have to ask, what is the point of having an emergency supply of AB if you should only take them after your sputum has been analysed with every new flare-up? If that is the case, what's the point of keeping AB in reserve, as presumably they may be the wrong ones?

Mooka profile image
Mooka in reply to SalvadorBA

You’re not being dense we were all new to this once. It’s so that you can take the antibiotics as soon as you think you need them. It’s more important to start treatment than to worry about results of a test. In an ideal world you will get a sample, start the antibiotics and then get it to your surgery. It doesn’t always happen like that. In time you will get to know when something is not right and if you should take them. If your test comes back with a bug and you’re not on the right antibiotics your GP should let you know. I’m immune suppressed so if I delay I can and have in the past ended up being admitted and none of us want that. My Bronchiectasis is well controlled now and I haven’t had an infection for a few years. TBH I rarely bothered my GP when I was having them frequently, I would take the sample in and take the antibiotics but that’s because my GPs didn’t understand Bronchiectasis or my rare autoimmune disease. I think BLF have a good leaflet on Bronchiectasis. Learn as much as you can and you will soon be in control. Of course there’s plenty of people here to help too.

Lapis5 profile image
Lapis5

I TAKE A HOT/WARM SHOWER AND C OUGH AND SPIT IT OUT, TWICE A DAY. ALSO A NEBULIZER W 3% SALINE WILL HELP AND AN OSCILLATING VEST TWICE A DAY. MUCINEX OVER THE COUNTER ALSO WILL HELP.

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