being treated for bronchiectasis

[mibli]

Dear Dr D Tinkelman last post was 31/5/10 regarding recurrent lung infections and constant antibiotics . I have been off work 5 mnths now as each time i steat to get better i have another bout of lung infections .Four yrs ago i had my first bad lung infection at the time i had my appendics out and was off work 4 mnths . Since last year i have been on  antibiotics and predisidone have been off work 5mnths  and not getting better for any more than 4weeks at a time due to lungs being infected as the time between bouts of infection are getting closer and have constant wheeze on exhalation.  I was referred to pulmunary Dr at hospital in May pft was within normal also challenge test in June was showing nothing significate to asthma being present.  Back last week Pulmn Dr plan is to do Ct scan in 2-3 weeks , has said what i have based on all symptoms e.tc. that i have bronchiectasis has given me letter for my GP to prescribe long term antibiotics and inhaler and also physiotherapy. I am concerned he also asked about my childhood history i told him i was healthy and that the only thing i remember was having sunray treatment as i was supposedly thin. He said that ; sunray was given as treatment for lungs in those days because  TB was widely around  i said my parents were not told that  and he explained that it people were not told the reasons for sunray they were just sent if you were underweight .P Dr  asked if wee in contact with anyone with TB i said as a care a client had i.At secondary school my best freind had TB and was off school for a year At college my freind had TB and had to give up course till later date,.  Would i may have had any underlying problems i didnt know about .   Dr T could you enlighten me in bronchiectasisdiagnosis with or without scan being done yet. if you need more detail chech my post 31/510

I have had swallowing  left side of throat is not gulping properly and mucus sits there.  Have reflux and on lansoprazole

[David Tinkelman, M.D.]

Thank you for this follow-up.  I am sorry to hear that you continue to have problems.  As I mentioned in my prior response, Bronchiectasis should be high on the list of possibilities, to account for your repetitive lung infections.  The diagnosis of standard tuberculosis, related to your exposures years ago, could well be the correct diagnosis.  The following is from my previous response:
"In the meantime, however you should also ask the  lung specialist (Pulmonologist)  in the respiratory to determine if you have any other lung disease that has developed independently of reflux induced lung disease. One you specifically might ask about is mycobacterial infection; specifically MAC disease, with or without bronchiectasis. Obtaining the CT scan of your lungs should be a priority, as it could well establish a diagnosis with reasonable certainty."
You will note my reference to MAC.  That is an infectious disease caused by bacteria related to the common form of Tuberculosis, called Atypical Mycobacteria.  I did not explain this the first time, as I knew your pulmonary doctor would know what I was referring to.  I still believe this is a reasonable diagnosis to consider.
A CT scan will definitely establish the diagnosis of bronchiectasis if present.  As I suggested, bronchiectasis, a disease in which “pockets” of infection develop in the lungs in areas of the lung where the normal small bronchial tubes are badly damaged or destroyed.  This can occur with a variety of bacteria, including the MAC.  It can occur with diseases present at birth, such as Cystic Fibrosis (CF) or develop in later years in previously normal lungs, secondary to chronic lung disease.  You should have testing performed, for CF
Given the chronicity of your illness, a wait of two weeks to do a CT Scan is not unreasonable but you might ask your lung specialist if there is a way it might be scheduled sooner.  In the meantime, what should not be delayed is sending samples of your sputum to the Microbiology Lab, at the nearest large hospital, these specimens to be cultured for TB, fungi and all “routine” bacteria.  The specimens should also be stained and examined under a microscope, on arrival at the laboratory.
Do not delay.
Good luck

[hava]

August 30th,2010
This pranayam will get extra oxygen into the lungs, and help to heal.The effect is gradual so allow time to notice benefits.
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day. Children under 15 years – do 5 to 10 minutes twice a day.
Not for pregnant women. Seriously ill people do it gently.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.