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BRONCHIECTASIS

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The following are the questions I asked the doctors treating my 78 year old father who suffers from bronchiectasis.  I am sharing the questions in the hope that they will be useful to others confronting any medical condition.  The answers are obviously specific to my father’s state of health and the ailment: bronchiectasis.  The following relates UK treatment and medications; practices may differ in other countries.

 

I have simplified and embellished the answers with my own deductions (most notably in answer 4).

 

Q: what exactly is the problem?  E.g. bacterial infection, both lungs, bottom/middle/top, etc.

A: unrecoverable lung damage (bronchiectasis) in lower part of both lungs.  Bronchi have been damaged by previous infections (not smoking).  Affected bronchi have lost flexibility, meaning poor lung action/reduced volume and poor circulation of mucous, leading to stagnation of mucous in lower lungs and thus increased risk of recurrent infections.

 

Q: what exactly has been done?  E.g. IV spectrum anti-bac (name/dose), x-ray, bloods, etc.

A: x-ray; blood tests; mucous tests; intra-venous (IV) broad spectrum anti-bacterial course finishes today, to be followed by anti-bac pills.

 

Q: what exactly will be done over next 4/8/12 weeks?

A: change ACE inhibitor blood-pressure pill (known to cause dry-cough in some people) to medication with no similar side-effects; appointment with pulmonary rehab (lung physio) to be taught exercises designed to keep lungs clear (these to be done regularly for life); outpatient appointment in 4-6 weeks to check recovery.  All other medication fine:

  1. Blood pressure: pill (as above)
  2. Blood sugar: pill
  3. Breathing: preventer inhaler (steroid (red)); reactive inhaler (blue); water-on-lung pill; mucous loosening pill.
  4. Bones: calcium and VitD pills.
  5. Laxative: pill; as needed.
  6. Pain: pills; as needed.

 

Q: will this recur?

A: yes.  Likely to be annual or more often, depending on exercise and aging.  Each infection causes more damage which, in turn, increases the risk of repeat infection thus creating a deteriorating and self-perpetuating cycle (until death).

 

Q: what can be done/avoided to reduce the risk of recurrence?

A: regular lung exercises (as above), good hygiene, physical activity, quarterly GP check-up, regular flu jab, reduce weight.  The doctor described one easy exercise: use a straw to blow bubbles into a half-full 750cl water bottle.

 

Q: what should be done in the event of a recurrence?

A: take medicine, inform GP/come to hospital.

 

Q: what are the key terms to use when describing this condition to a GP/medic?

A: bronchiectasis.

 

Q: if he was a private patient/the Queen, what would have been done differently?  E.g. timing, tests, treatment, etc?

A: medical response/treatment would have been the same but the speed and environment would have been better.

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