A career with bronchiectasis in the U.S

[cashewcat]

Hello,

I have had bronchiectasis since I was 7 years old. It was mild until recently. I lived and worked in New York City for 10+ years until COVID and I relocated to Florida during COVID. In New York City, I was working as a leasing manager in the residential property management field. I left New York City because I was worried about my bronchiectasis and getting COVID. I moved to South Florida where I switched to real estate sales from property management. Unfortunately, the leasing manager role I had in New York wasn't paying much in Florida. I couldn't afford a 50% pay cut so I went to real estate sales. I have been a real agent for the past 2.5 years. My health recently declined as my bronchiectasis worsened and I was thinking of changing my career to something more remote with good insurance. Any ideas of what type of remote work I could do? I have a Bachelor of Arts in International Relations and only worked in the real estate field after graduating from college. I am in my mid-30s. I would appreciate some ideas.

Thank you,

Alison

[Alberta56]

Welcome to this forum. Sorry I can't help with US job opportunities, but good luck in your search.

[Patk1]

Welcome to the forum.i can't help with Yr career change but I'm sure suggestions will b forthcoming.Could a cold/cough/flu/ covid have caused Yr bronchiectasis exacerbation?

Whatever u do,I'd take measures to avoid viral infections frm others - handwashing,handgel,masks,antiviral nose& throat sprays

[cashewcat in reply to Patk1]

Thank you. I thought I am very careful, but you never know. At my job, I am with people all the time. I use hand sanitizer and wash my hands when I can. I am going to take it easy and try to get in better shape.

[bwp91]

I’m sorry you’re struggling and a career change might well help. But I think I’d first concentrate on getting on top of your bronchiectasis. Unless you’ve got it very badly, I’m thinking that it shouldn’t hinder you too much in your 30s. I’ve had bronch since I was three (now 80) and in some ways am better than ever with better treatments (e.g. azithromycin 3 times a week and a Fostair inhaler) and the updated knowledge that e.g. exercise rather than rest is best. Looking after small children was tough and I knew that some jobs were out of the question but generally I’ve done what I wanted. Do you have a good attending who concentrates on bronch? Check you’re doing everything you can to improve your health before you rush to a career change, though that might well help in the end. Good luck!

[cashewcat in reply to bwp91]

Thank you. You are right, I should take care of my health first. I am happy you are doing well in your 80’s. God Bless. There is hope. 😀

[watergazer]

hi and welcome from the UK. Good luck in your search x

[lvn0619]

Are you doing your airway clearance following nebulizer with albuterol then 3 or 7% saline at least twice daily. I would encourage you to find a pulmonologist who specializes in bronchietasis and recommended treatements. Mayo clinic may be of help if your close to Jacksonville and or can travel. Also look into additional BC sites which can be helpful in finding BC specialists in FL. Two of the sites are Mayo Connect and Lung Matters.

[cashewcat in reply to lvn0619]

Thank you. I have been treated at NYU Langone in New York City and I still go there twice a year to see bronchiectasis specialist. In Florida I have good pulmonologist and he was highly recommended by my doctor from New York. I am doing my airway clearance 4x a day now and when I am in remission 1-2x a day. I use Albuterol, saline and steroid Breo. I also have aerobika device for nebulizer to exercise my lungs and smart vest. I only use smart vest when is really bad for 30 minutes 2x a day. I am going to look into Mayo Clinic in Jacksonville. Thank you for the recommendation.

[lvn0619]

Glad to hear. Just curious, are you on the steroid inhaler due to another lung condition? Much of Lung Matters protocols are evidence based as is Mayo Connect . I follow all 3 sites to see what's new or different in treatment modalities. Your doing everything necessary and hopefully your Tx .plan will resolve your exacerbation. Have you given a sputum sample for analysis? I don't know about the amount of exposure you have in real estate but certainly less that say a teacher with multiple students. Handwashing and masking offer the most protection when working with the public. Hopefully your research will find a work opportunity from home that meets your needs. Take care.

[cashewcat in reply to lvn0619]

A pulmonologist gave me a steroid last year for bronchiectasis. I don't have another lung condition. He said is better to take it and prevent future infections.

Also, I avoid dairy, gluten, and anything that triggers inflammation in my body. I take turmeric and ashwagandha supplements.

[lvn0619]

There is information on steroid use with bronchiectasis. There are times when they may be indicated for a flare up but according to the literature they lower are immunity and open us up to drug resistant bacteria. You may already be aware of this. I’ve had to learn so much about BX and what is beneficial in treatment and what is not. Take care.

[cashewcat in reply to lvn0619]

I was told that when I take oral steroid it could lower my natural immunity over time. I took the oral steroid such as Dexamethasone. My doctor gave me that steroid twice last year in addition to antibiotic. I don’t think worked well because I am still sick. Probably lower my immunity. I was told that inhaler steroids such as Breo are safe and I can use the low dosage everyday.

[lvn0619 in reply to cashewcat]

Usually inhalers containing steroids are prescribed for people with CODD and other pulmonary diseases. Unfortunately some pulmonologist treat us as though we have COPD and prescribe these medications. Since your still feeling unwell, consider being tested for flu, Covid and RSV. A comparison CT of chest would be helpful to rule out worsening BE, pneumonia or other pathology. I’m not a physician but I do follow the BE recommendation to maintain stability or having a flare up of symptoms. I hope you can be seen soon by your specialist.

[cashewcat in reply to lvn0619]

Thank you. When I am in New York, I will go over that with my doctor who specialize in bronchiectasis. I also have a question for you. Did you try oxygen therapy? I was wondering if that could help too. Sometimes I feel like I don’t have enough air. I get tired by 3 pm.

[lvn0619 in reply to cashewcat]

No I haven’t. Those times when I had a flare up and was overly fatigued and short of breath were due to Infection. I was treated for pseudomonas last January through June. I was on inhaled tobramycin 28 days on and 28 days off. I am on the big three for MAC which is slow growing and was diagnosed a couple of years ago. I started these meds this January and so far am tolerating them. My exertional shortness of breath improved greatly after pseudomonas treatment. I boil my equipment for 10 minutes after use. My water heater is at 140 but it’s documented that 130 degrees will kill MAC. I removed my shower head to prevent steam as MAC is in our water pipes, water, soil etc. MAC causes, fatigue, sob, weight loss over time. Some people have eliminated it with airway clearance. I’m looking into a 0.2 micron filter for showerheads which is the only filter effective against MAC. Have you had a sputum sample for culture, AFB and Fungus done lately? I think I mentioned before that it’s really important to submit a specimen and have a chest CT. Your Dr could send you scrips to get this done prior to appointment. Many of these recommendations come from National Jewish Health in Colorado. As a reminder you can read these guidelines and pose questions about your health on the Lung Matter website. This website has a wealth of information from clients with BE as does the Mayo Connect website.