Tuesday, 8 September 2015

My Crappy Lungs

I can't remember the exact date, but some time during the 1990s I was diagnosed with Bronchiectasis. No, not Bronchitis - look at the word again. It's pronounced bronk-ee-ecktassis. Here is a brief explanation:


"Bronchiectasis is a long-term condition that affects
the lungs. It is defined by inflamed, permanently and
irreversibly damaged airways. Common symptoms
of bronchiectasis include a chronic cough, producing
sputum (phlegm), recurrent chest infections, fatigue
and breathlessness. Bronchiectasis is not to be 
confused with bronchitis and, unlike chronic 
obstructive pulmonary disease (COPD), it is not related
to smoking. However, it is not advisable to smoke."

Now for the technical stuff:

Bronchiectasis is a long-term condition which affects your lungs. It is defined by inflamed, permanently and irreversibly damaged airways. Common symptoms of bronchiectasis include a chronic cough, coughing up sputum (phlegm), recurrent respiratory tract (chest) infections, fatigue and breathlessness.

In bronchiectasis two things happen:

Damage to an airway – making it unable to clear mucus
Infection of the mucus in the blocked airway
Process of damage to airways
Process of damage to airways
Process of damage to airways
In bronchiectasis parts of some airways become damaged and widen.
The areas are permanently / irreversibly damaged by inflammation and produce excessive mucus.
The airways lose some or all of their ability to clear mucus. Mucus gathers in the damaged airways, creating an environment where bacteria can grow. This can lead to repeated chest infections and as a result your airways become scarred and more inflamed and produce even more mucus.
Sometimes the airway becomes blocked or ‘plugged’, affecting airflow. Surrounding lung tissues and airways can also become affected.
The damage to the airways can be thought of as a ‘vicious circle’. In order to manage bronchiectasis the circle has to be broken.


Causes of bronchiectasis
In bronchiectasis the damage to the airways is usually caused by infection such as:

Previous pneumonia
Whooping cough
Measles
Tuberculosis (TB)
Other causes can include:

Obstruction or blockage in the airways: this can be due to a growth / tumour or something that has been inhaled, e.g. a peanut
Autoimmune diseases (e.g. rheumatoid arthritis (RA), systemic lupus erythematosus (SLE))
Inflammatory bowel disease (e.g. crohn’s disease, ulcerative colitis)
Cystic fibrosis
Disorders that affect the function of the cilia
Immune deficiencies
Chronic asthma
Alpha 1 / antitrypsin deficiency
Allergic bronchopulmonary aspergillosis (ABPA): this is an allergic reaction to a fungus called aspergillus (usually in people with asthma or cystic fibrosis)
In about 50% of people with bronchiectasis no cause is identified.

Common symptoms include:

Chronic productive cough
Coughing up sputum: this can vary in colour and quantity
Recurrent chest infections: this is due to bacteria growing in the damaged airways
Fatigue: this is often a result of coughing frequently during day and / or night as well as fighting off infections
Breathlessness / wheezing: this is due to the inflammation / blockage of the airways
Symptoms may vary from day to day and will depend on the severity of your disease. It is likely that you will have ‘good’ periods (when you feel well) and periods when your condition deteriorates and your symptoms increase. This is known as an ‘exacerbation’.

An exacerbation is when your condition deteriorates and your symptoms increase. When this happens you need to access medical advice as soon as possible as you may need antibiotics and / or further treatment.

Changes to look out for include:

Increased coughing
Increased amount / consistency of sputum
Darker colour sputum
Fever or chills
Aches and pains
Breathlessness
Blood in sputum (haemoptysis)

Sounds nice, doesn't it. I have had Pneumonia, and I've had Pseudomonas. I've also had Pneumonia and Pseudomonas together. Friendly little souls these bugs. I just wish they weren't so friendly with me. So, I usually end up with a temperature of about 39-40 degrees 'c' and blood pressure right off the scale. Unable to function, or understand what is happening to me, struggling to breathe. The only treatment is 14 days on intravenous antibiotics. I usually have Tazocin, or Meropenem. Stop me if I'm boring you - oh you can't, not unless you stop reading. 

Normal treatment is inhalers. Here are the ones I use:



Spiriva

You put one of the capsules in the device, press the button to crush the capsule, then take one puff as the lovely lady in the next photo is doing. I take this once, in the morning.




Fostair Inhaler


Ventolin Inhaler

Due to treatments for various other condition, my veins are shot! Cannulas have to be replaced every 36 hours, so they gave me a PICC Line, or Peripherally inserted central catheter. A PICC line is a long, thin, flexible tube known as a catheter. It is inserted into one of the large veins of the arm near the bend of the elbow. It is then threaded into the vein until the tip sits in a large vein just above the heart. 



Where it fits




In situ

As my oxygen levels were lower than 88% I also needed oxygen for 10 days. 



To make it easier to eat, drink and speak, I used nasal Cannulae most of the time

Four times a day, I also used a nebulizer for saline. I still used this once a day at home.


And I also use a salt pipe now. This performs the same thing as the nebulizer, but is portable, quiet, and rather pleasant.


I also take tablets. Two Carbocysteine every morning and two every evening. These are to keep my sputum runny. Then on Monday, Wednesday and Friday I take one Azithromycin. This is a prophylactic antibiotic, to try and prevent any chest infections.


Now for my room. It was lovely being on my own, because I didn't feel as though I had to join in anybody elses conversation, and my phone calls were also more private.


All the comforts of home


And the view from my garden


One of my chemotherapy group, Yvonne, sent me this lovely balloon as a get well gift.

This was my third visit to the hospital for treatment. The second time, I was trained how to do my own antibiotics, which meant I could go home after five days and do the treatment there. This last time though, I was far too ill, and on oxygen therapy too, so I had to stay in for 15 days in total. Not looking forward to that again!!


2 comments:

  1. It's like reading a medical journal, and a bloody big one at that if all your conditions were on it. I'm not sure but I'm detecting a slight difference in the look of the models demonstrating the equipment and you, it might be my eyes though. Xxx

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  2. You know what they say, variety is the spice of life, so I keep several different models in my medicine cupboard. All they require is to be fed ice cream and peanuts, so not very demanding at all.

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