Very mild exercises causing exacerbations?

[HMBS]

Short Version:

Has anyone got exacerbations (from bronchiectasis) after even very mild exercising? (meaning that during the exercise I had no or little breathlessness) (e.g. running for a few minutes or swimming for less than 200 meters) I observe that I had these and wonder if this is common. I feel like that I now have a dilemma between exercising (maintaining muscle strength) and avoiding exacerbations (preventing further damage to my lung)

Long Version:

Hi, I am new to this community but I have had bronchiectasis for 29+ years (I was first diagnosed in 1991 when I was 26, and now I am 54). I think my case is a relatively mild one. Other than having frequent infections, I have a pretty normal and active life. I never needed to be hospitalized and for each exacerbation typically a course of oral antibiotic treatment was what I needed (either Amoxicillin (in the US and UK), Cefdinir (in the US), or Co-trimoxazole (in the UK) ). I have been keeping records of these treatments and I observe that every year I ended up needing about 3-10 such treatments.

I have a question on exercising. All the literature I have read recommends exercising. However, I noticed that some of my exacerbations seemed to have been triggered by exercising -- even very mild exercising. For example, jogging for a few minutes, or swimming for less than 200 meters. I said the level of my exercising was mild because I did NOT feel overstressed (or breathlessness) during, or immediately after, these mild exercises -- I even felt pretty good (effect of endorphins) but then in some occasions after a day or two I would have an exacerbation. This pattern has happened quite a few times that I am 90% sure about the causal relationship between my mild exercising and exaberations.

There were also periods in my life when I was really busy with other things that I did not do any exercises for several months (or even a year) and interestingly in those periods I have less exacerbations.

I have tried cutting down the strenuousness of my workout and then set out on a course to “building it up slowly”, but this strategy has not been very successful for me. By that I mean that in a lot of these courses, after one or two weeks of building up I had another exacerbation. That forced me to stop exercising for a while (until my infection is over), and after that I had to restart from the very low level again.

I used to be able to swim 600 meters without much troubles but now I dare not to swim more than 200 meters. I used to be able to run 20 minutes or so but now I have had incidents where I seemed to have an exacerbation after just a few minutes of running. My latest exacerbation seemed to be triggered by just a long day of walking (about 17,000 steps (8 miles or 13 km)

I wonder if anyone here has a similar experience?

I have discussed these with my doctors and they just gave me very general advice of “not stressing yourself too much”. I feel like this topic has not been researched in depth so they can only give out common-sense advices.

As I said I had 4-10 exacerbations each year (the numbers have got higher in recent years). I want to keep exercising to maintain my muscle strength, but doing so risks more exacerbations. I feel like that I now have a dilemma between exercising (maintaining muscle strength) and avoiding exacerbations (prevent further damage to my lung)

Another question: What are the typical frequencies (or ranges) of bronchiectasis exacerbations? I tried googling some statistics on this but I could not find any.

Thanks and regards,

-- HM