bronchiectasis

[mikeholder]

Thanks for the previous help. You were correct that I did not have IPF. The Hi Res Cat scan of my lungs stated the following:
There is abnormality within the left upper lobe anteriorly.  There are prominent parallel linear densities, several of these, which have the appearance of dilated bronchi, which project more peripherally than normal.  This is at least suspicious for bronchiectasis.  This is accompanied by some mild interstitial scarring (coarsened linear densities), which involve actually both upper lobes.No definite dilated bronchi on the right are demonstrated. No definite findings of interstitial lung disease are noted.  No pulmonary masses or nodules are There  are no pleural effusions or pneumothoraces.
IMPRESSION: 1. Findings within the anterior left upper lobe are very suggestive of fusiform bronchiectasis. 2. There are additional regions of interstitial scarring involving both upper lobes.3. No definite CT evidence of interstitial lung disease otherwise. My Pulmonologists gave the diag. of bronchiectasis. He said is was mild and gave me advair. I quit smoking 6 weeks ago and he said this was the best thing for it. Should I go with his diag. or seek 2nd Opionion. I have no symptoms of this disease and am still running 2-3 miles a day. He want to monitor this by having repeat PFT and CT in 6 months for at least the next 1.5 yrs. What would be your recommendations? Is it possible to live a normal life with this disease or is it shortened? (Current age is 41) Thanks!

[National Jewish]

Inflammation causes damage to the airways of the lungs.  When the airways become dilated this is called bronchiolectasis.  When the airways become distorted with areas where mucus can collect this is called bronchiectasis.  It can be difficult to clear this mucus because of damage to the normal methods that the lungs use to clear mucus.  This can lead to episodes of infection.  Traditionally an ongoing infection can lead to the inflammation.  So it is important that lung infections are treated.  Pulmonary hygiene is very important in preventing and controlling lung infections.  Using an inhaled bronchodilator may help to loosen the mucus.  Many people find the routine use of a mucus clearance device to be very helpful in clearing the mucus from their lungs.  This is a small device that you exhale into causing a vibration in your lungs that loosen mucus so that you can cough it up easier.  The names of 2 types of devices are Flutter Valve and Acapella.  Bronchiectasis can result from airway blockage along with infection, so it may effect only one area of your lung.  If your lung infections are always in the same area of the lung, surgery to remove that portion of your lung may provide a cure.

During the 6 months that you are waiting for your repeat PFTs and CT scan, further testing should be done.  Culture testing for tuberculosis mycobacterium, non-tuberculosis mycobacterium, fungi especially Aspergillosis, and bacteria would identify if you have an infection that needs to be treated.  Blood testing to check for low alpha 1-antitrypsin, low immunoglobulins, or cystic fibrosis would identify if you have other problems that need to be treated.

At this time quitting smoking is the most important thing that you can do for yourself!  Congratulations, you have made a wise decision to stop smoking!  You may want to look at our Quit Smoking Topic Center at http://www.nationaljewish.org/topic/smoking_cessation.html for ways to help you stick with your wise decision to smoke no more.  Also check with your doctor for other quit smoking resources in your area.