l want to avoid a fallout between myself and a GP for whom l have huge respect. when clinics are shut,in these troubled times the responsibility for maintaining the health of the Bronch community has fallen to primary care During a routine phone call with the GP recently,as no current information was available a chest Xray was recommended. The result was the apparent prescience of an infection in the upper chamber of the right lung.
At the time l had no symptoms and clear sputum and was very fit for 92. In other words the diagnosis had to be flawed based on my current health status. Over the years l have found a variety of opinions regarding the accuracy of X-rays in the context of testing for exacerbations,My firmly held belief is that the colour or otherwise of sputum is the slam dunk diagnosis for the presence of unwanted bacteria and the X-ray or indeed a scanner produces result that are at the very least questionable.
Your experiences would be invaluable in tackling this sensitive subject with my GP,
Many thanks.
Written by
locheil
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29 Replies
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Oh dear, GPs! An xray of bronch lungs is always going to look like an infection! You are right, an exacerbation involves darker, thicker and greatly increased volumes of sputum and usually, feeling lousy! The GP could also send some sputum off to find out what is in there. Unfortunately most bronchs have bugs hiding down there which show up on lab plates but are not in sufficient numbers to cause trouble but people get fixated on this, leading in my opinion to taking too many antibiotics.As you must know, the only true diagnosis of bronch is by ct scan.
However
If you feel lousy, have a fever, have chest pain and can't cough anything up it could indicate pneumonia which my GP missed on 2 xrays in 2015!
Maybe it is time that you got yourself a bronch expert consultant to help your GP with your management.
Don't be afraid of stepping on your GP's ego by giving them more accurate information. My GPs know that I am more knowlegable about my condition that they could ever be.
l cannot say how delighted l am to have your response.During the early days after my diagnosis 10 years ago with no information and real fear it was your hand on my shoulder that gave me courage to face the unknown.
I agree with Littlepom that using X-ray alone to diagnose infection isn’t necessarily helpful in bronch. You could suggest he tests the level of C-reactive protein (CRP) in your blood instead. It should only take 2-3 days to get the result. It’s a very reliable indicator of inflammation (and therefore infection). A normal level of CRP would be less than 10, but when you have an acute infection it can be in the hundreds.
Thank you so much for your reply the CRP investigation has never been considered before. Unfortunately the specific interest in Bronch in my region has been deminished by the transfer to research of our lead respitatory consultant.
Hi lovheil, you say that your sputem was clear, I had a sample sent off, felt fine clear sputem and had a very nasty bug which took weeks to clear. Can you ask to be seen by a specialist at a hospital near you? Good luck, take care.
Thank you so much for your reply.Somewhere in the distant passed I do recall learning about the bug to which you refer. I think my first step must be to present a sputum sample that has not so far been requested. The labs are very busy so I will get the GP to urge it on. I should point out that I have just completed a full (2 week course of Amoxicillin 500 - I might as well have used Smarties for all the effect it had. I will leave the choice of treatment to those with the knowledge but its beginning to sound like IV antibioticsnot anything that either I or the dear old NHS will be looking forward too!
IF you have anymore information regarding your particular bug that would bea great help.
Sorry can't remember the name, it was long lol. My consultant has changed me from amoxacilin to co-amoxiclave for 14 days to clear bugs. Amoxacilin was not doing the job lol. I also take 2 puffs of Fostair, twice a day and saline nebs then my AerobiKA to help clear the muck. Good luck, take care and stay safe.
Just used a short course of co-amoxiclav 500/125. ,what a star,the acid burns through the defence layer of the bug and the amoxicillin kills it,pretty strong stuff.
I'm glad you've been put on co-amoxiclav. Amoxi on its own is not strong enough to deal with the wickedest bugs. But you really need a fortnight's worth of treatment, so look out for signs that the bug is coming back.
I can’t understand why GPs still give amoxyl to bronchs. It is useless. Also, anything less than 14 days antibiotic is not going to hit the bug on the head and runs contrary to the guidelines for bronch treatment. You really do need a bronch specialist to put your GP right.
Thank goodness for this site, it helps us deal with these queries and gives us the confidence to tackle our gp's. Find yourself a bronch specialist and get your gp to send in a mucus sample x
Last Sunday night I was sat watching tv feeling fine. Within minutes I didn’t know where I was or what I was doing. I actually climbed into bed fully clothed. My husband eventually insisted I went to a & e where I was diagnosed with pneumonia via x Ray. I had no cough, no cold and no green sputum. This was followed up by an ultrasound. My crp and white blood cells were raised. I have no idea what my temperature was but must have been off the scale as I was taken straight through when I got to the hospital. I’m immune deficient so probably am slightly different to others. I think this is what the second part of Littlepom’s post is referring to. I was happy to read her post as this has never happened like this before to me. I’m sorry if this confuses you more.
what a horrible experience! That is exactly what happened to me. I went to the GP four times. I could not cough anything, terrible pain under my ribs temp over 39. I knew it wasn’t the bronch. She wouldn’t believe me even after 2 xrays. In the end I had a friend take me to A&E at the QE where my consultant is. They tried to send me away as being out of their area. I just slid down the wall. Finally sent to resp ward. My con came, took one look at me and nearly fainted. I also had an empyema which had been missed on the xray. Result, litre and a half taken from the space outside my lung, six weeks IV in hospital and at home and months to get my strength back. And people wonder why I have no trust in GPs!
You make me feel like I got away lightly. I had no prior warning it was so quick. My husband says I was talking gibberish- first time he’s listened to me in a long time! The hospital was going to admit me but said I would be safer at home. I suspect this is more due to bed shortages but happy not to be admitted. They followed me up by telephone and gave me a number to ring is needed. They also talked about virtual wards where you have a wearable that monitors you remotely. I was given 7 days of clarithromycin and co- amiclav taken together. Not sure if this equates to 15 days or not 🤷🏻♀️. Your post was reassuring as I’ve never had this happen to suddenly. Thank you for your help.
if you have bronch seven days of an antibiotic is not enough, so keep an eye on it coming back. It’s a good thing that they gave you two different abs to cover different bugs. I hope that it does the job.
Get a sputum test jar; get some of your sputum into and have it analysed. That way you will know for sure. I frankly cannot see what an X-ray (which pass straight through matter like infected sputum) has any value in identifying an infection. But the GP may have something else in mind of course.
For the record a sputum test jar is part of my emergency exacerbation kit. And like you I start by judging the colour - is it worth the effort yet!?
I'd just Have a word with gp.most r very open to suggestions. Contrary to some statements,it's radiographers who report on xrays,not gp.why were u sent for x-ray x
Hi. Massachusetts/USA. Patient at Brigham in Boston. Dx Bronch in 1966 age of 20 . Came very close to left lower lobe resection. Have dealt with flares and infections since then. Pulmonary function now at 26 . Not much left. Also have diaphragm paralysis bi lat, all playing second fiddle to FSHD. MD. Severe pain ,mobility and breathing difficulties. Pulmonary doc has told me several times I can have infections with clear mucus or phlegm . On permanent antibiotic nightly. In October in hospital with pneumonia despite no fever or coloured phlegm. Tight painful chest , dry raspy non productive cough .We all know when something is wrong . My pulm doc had me through the hoops and admitted. The good docs listen when you find yourself in front of a new GP or ER doc. Try to speak in clinical, rational and almost flat aspect. Answer ?s straight . Don’t BS. Whether UK or U S you have to navigate the system : both clinically and financially. Good luck with this nasty and insidious disease.
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