NRAS
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Are lung diseases related to RA.

Is there a chance for a rheumatoid arthritis patient to be affected with lung diseases like Bronchiectasis when the disease is chronic,I mean when the patient is suffering from RA more than 25 yrs.

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Sadly, yes. There are a range of things that can affect people with RA more than those who don't have it, including bronchiectstasis. I believe with modern treatments things are improving as the lung complications that are a result of years of uncontrolled inflammation are not as common now. However, if you have RA and symptoms of any lung problem do go and get it checked out.

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Yes is the simple answer. Bronchiectstasis or nodule on the lung are sometimes things that can be associated with RA. I have bronchiectstasis and though you may get bad days a bit like RA ....with the right treatment it is managable

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l suffer copd, and was told by my chest special,the RA weakens your defences, making you more prone to chest infections and the like, when l told my RA doctor she was happy , but when you think about,all the drugs your body as taken over the years trying to combat RA,must weaken your body, but no time l was told this ,if l was l may have taken time to think, bout whats next....

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ops she wasnt happy meant to

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Hi j

I have had bronchiectasis for 64 years from babyhood and for the last 10 years or so inflam arth, although I do not have RA. My last rheumy told me he it is thought the two often go together, that or crohns. We are unlucky to get both bronch and arth, but a person would be very unlucky indeed to have all three.

If you are dx with bronchiectasis it is very important that you see a respiratory consultnant with a special interest in cystic fibrosis/bronchiectasis. Cons should refer you to a resp physio who will teach various techniques and gadgets to aid with mucus clearance, which you would have to do on a daily basis to prevent the mucus pooling and becoming infected. Cons would also discuss inhaler and/or nebulising and medication regime.

It would be interesting for me to know what medication those with lung condidtions take. I cannot take DMARDS, nor can I take NSAIDs and the last steroid injection I had has not really touched the pain. I go to a centre of excellence for rheumy and she really has said there is nothing else and she does not really like the morphine patches the gp thought might help. Sorry not meaning to highjack your thread - just keen to know how the rheumy's have helped others with chronic lung disease.

I really hope you don't have bronchiectasis - RA is quite enough to deal with.

Love C xxx

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If you haven't discussed anti-tnfs with your rheumatologist, then I wouldn't say there was nothing else that could be done.

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Hi

thank you for your reply.My pulmonologist says as my two lungs are affected,the only thing we can do is postural drianage by which we drain the mucus.I am doing it daily and she gave only one tablet daily at bed time and a inhaler..Even I do that posural drianage still I get cough and phlegm when.Almost every 3 months I am using antibiotics as mucus is getting infected and I get fever.Recently I heard about manuka honey.It seems it is very helpful in killing bacteria and infections. I am thinking to use it. My rheumy says it is a different (bronchiectasis) disease and asked me to follow pulmonologist advise.I am continuing with my Dmards.I am suffering from RA from my age of 26,now I am 53.

Now I am feeling that I managed RA more easily than bronchiectasis.

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Thank you - I get your point, but surely it should have been cons who should have brought up tnfs, and the fact that she didn't would make me think she has taken into account any effect it may have on my lung condition. Colonised with haem inf and so had constant infections the whole of last year. Will ask next time though thanks. Wish I was as proactgive re arth as I am re bronchiectasis - just floundering really and can't see anything changing.

XXX

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Hi jhansiranishurineni

Sorry you have bronch as well as RA.

I don't understand your rheumy's statement 'it is a different (bronchiectasis).' Bronchiectasis is bronchiectasis. There are 3 types cylinrical, cystic and varicose, but basically it is an abnormal widening of the airways where mucus can pool and become infected. There are different causes and maybe this is what he/she means.

All my life I have done and still do postural drainage with percussion and shaking. I also use an acapella at the same time. Before doing my drainage I nebulise a bronchodilator and either 0.7 saline or the stronger hypertonic saline 7% (this helps to loosen the gunk). Some folks are prescribed a mucolytic which also loosens up the gunk.

My bronch is also scattered in both lungs and I had a lobectomy on one lung when I was 15, they would not do this now unless bronch was localised.

You might want to check you resp cons has a special interest in cystic fibrosis and or bronchiectasis - you can do this online.

You pulmo is correct that we must clear the gunk from our lungs, but he is not right that postural drainage is the only way nowadays. As you say pulmonologist can I assume you are from the states. Lots of folks I know in the states use the Vest if insurance allows. All bronchs are different and prefer different methods of mucus clearance. Your pulmo should really refer you to a respiratory physio to teach you different methods and you can then find a technique which works best for you.

I am really interested to know do you have to withdraw your RA medication whilst you have a lung infection?

You might want to ask you pulmo if nebbing saline would benefit you. Also does he feel prophylactic antibiotics would help. (abs you take low dose of Mon, Wed and Friday) or sometimes 1 daily.

I am so pleased for you you manage your RA pretty well - I guess you know quite a lot about managing as you have had it for such a long time. Bronch management needs constant hard work. It is the other way round with me and I find my arth affects my life usally much more than bronch, because the pain is just not controlled at all. I don't get the excercise I used to, which is much needed for my lungs. I find the arth very life restricting. Bronch would be too, but I have a very proactive cf/bronch specialist and I work hard keeping my lungs at their optimum best - sometimes, especially last year failing because of haemophilus especially with all the bugs going about.

Re manukia honey - One of our lovely members on Bronchiectasis R Us from NZ nebulises manuka honey and swares by it. However I have asked my consultant and he had not heard of this and was concerned because our samples are cultured in a sugar base. He was going to look into it and I will ask him. It is supposed to be good for the stomach and our kiwi friends use it on cuts and grazes. They only use the medical quality of 18+ and usually get it from Comvita.

Here in UK you can mostly get an acapella from the hopital physio if you have bronchiectasis but it does seem a bit of a post code lottery. The one they give you is called the Acapella Choice. My second one has just broken and so I thought I should really buy my next one. I bought it from Amazon and the price is good. I will put up a link because I feel you may find it will help to loosen up the gunk.

amazon.co.uk/Acapella-Choic...

I would really appreciate knowing what medication you are taking for your arthritis and indeed from anyone else who has bronchiectasis and/or asthma.

Best wishes to you

Love C xxx

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Hi

I thank you for your advice.I am really wondering how you are managing with bronchiectasis from many years. If possible can you try to give more information about manuka honey. One of my family friend is coming from Australia next week and he is bring for me manuka honey,as I asked him to bring.I live in Hyderabad,Andhra Pradesh,India. But I dont understand the dosage etc.

Even I didn't under stand why my doctor told that these two are not related.(diseases)

At present For RA I am using-

weekly once(friday) 10mg folic acid,weekly once (on Sunday ) 15mg Methotrexate

daily one BP tablet,b.complex,vitamin d.Thats it.

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Hi jhansiranisurineni

Unfortunatey, as the others have mentioned, yes RA can affect the lungs. It may be worth speaking to the British Lung Foundation helpline to see if they can offer any further advice on managing your bronchiectasis and would perhaps have some more information on the use of manuka honey as a treatment for this. You can contact them on 03000 030 555 (Mon to Fri 10 am to 6 pm).

Kind regards

Sarah Kate

NRAS

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hi

Thank you for giving me your advise. You gave the contact number of British Lung Foundation Helpline. But I from India.I live in Hyderabad,Andhra Pradesh.How can I contact them,please let me know.

Thank you

jhansi rani

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Oh sorry about that Jhansi. You could email the British Lung Foundation helpline on: helpline@blf.org.uk

Or perhaps it would be more useful to contact an organisation based in India. They may also be aware of other good organisations to help you. One that we are aware of is the Arthritis Foundation of India Trust: arthfound.org/

Kind regards

Sarah Kate

NRAS

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hi

Thank you very much for your valuable reply.

bye

jhansi rani

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Hi jhansiranisurineni

I was wrong, you are not from the states but from India. Nice to meet you.

You wonder how I manage bronchiectasis for all this time, and the answer really is because I have had to, and more recently asthma, arth and oesteoporosis.

I am 64 and so for many years there was nothing else but postural draining and penicillin. Now things have improved and the tests and treatments are more effective, and there seems to be more trials now specifically for bronchiectasis, which has been quite neglected in the past. We have a lot to thank our brothers and sisters with cystic fibrosis for.

I am not sure how your health system works in India - if you have to pay for treatment using insurance or if you have a free at the time you need to use, as we have here.

The most important things are to get a pulmo who specialises in bronch and to do mucus clearance every day.

With regard to manuka honey - it is not recognised in the UK as a treatment and I have no personal experience of using it medicinally. I have had it on toast, but that is the honey you buy in the supermarket. I only mentioned it as you asked about it.

I would just say Jhansi there are lots of rubbish sites re bronchiectasis and you would be wise to only stick to the reputable ones. The site Sarah Kate mentioned British Lung Foundation is excellent and I am a member myself. The other site I have belonged to for a long time now is Bronchiectasis R Us. This is also a very supportive and informative site. It was started by a wonderful young lady from the UK who has bronch and it has members from all over the world. All members have or care for folks with bronchiectasis. There is one lady on there who uses manuka who is from NZ.

For arthritis I have tried hydroxi and sulphasalazine. The sulphasalazine effected my lungs and so my rheumy didn't want to give me methotrexate. Gastro enterology don't want me to take anymore non steroid anti imflammatory drugs, so I feel completely at a loss regarding my arthritis. Thank you so much for listing the drugs you take for your arthritis.

I hope you soon feel more confident about managing your bronchiectasis. As well as British Lung Foundation and Bronchiectasis R Us, please feel free to pm for a chat anytime.

Love C xxx

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i was on 15mg methotrexate weds with 5mg folic acid Fridays for my RA for about 9-10 months, but they stopped it all as i Had a cough - which cleared up after 2 weeks steroid nose drops!. But they had me in the sstem to get x-rays, breathing tests an d then CT scan and tell me i bave v mild brochiectstasis, prob from RAH OR the drug?? BUT they didn't xray me before starting the mxt !!!! so have no base line to compare against. As a child i had bronchial asthma , lost it at age 4, then bronchitis each inter until adult, then occasionally. Without my RA drugs i am in a wheelchair now and screaming about it and with pains. Before they took me off it i was doing 20 lengths daily in local pool and walking, but not far, feet up at aother times. Waititng for Nov. apptment to learn my fate.... Any advice anyone - tkin g 200 mg iuprofen and 2.5 mg prednisolone x3 daily to survive just. ps am 73 only diagnose abt 20 months ago with RA o have been lucky - so far. Wd cross fingrs if i could lol xx

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funny you should say about methotrexate and coughing I have only been taking it for 3 weeks but got a cough with it went to docs Friday and he sent me away with an inhaler I think it must be down to mxt seeing consultant in a couple of days so going to tell him about it

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i had a cough after abt 6 monthson mtx but gp gave me nasal steroid drops which cleared up the cough in 2 weeks,tho she also startedc the xray etc processes which suggested bronchiecstasis so am gonna have2 fight from my w/chair to try 2get mtx back - was doing 20 lengths daily and walking ok till they stopped it. take care x

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Yes, vet common with RA, I have lung issues , recently had pleurisy and needed round of steroids. This has gone on for yrs. See a pulmonoligst soon.

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