Bronchiectasis
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I was recently diagnosed with Bronchiectasis (right lung) based on CT scan with contrast. Pulmonary doc prescribed steroid inhaler and antibiotic (to clear the mucus infection). Infection is gone and steroid has had some impact. Will do follow up CT scan next week. I am 75.
I did not play trumpet during December. I have resumed by playing long tones, scales, and easy tunes. I still find breath control to be a challenge. I start my practice with breathing exercises.
Prior to all of this my range was up to E flat above the staff. Currently, it is barely up to C above the staff after warm ups.
My understanding is that Bronch does not go away, it is merely treated. Any suggestion for practice routine and additional physical exercise is appreciated. Thanks.
Schilke x3
Bach Strad 37
Courtois Flugel -
@fels Antibiotics are the staple in treating Acute exacerbations of Bronchiectasis. Pulmonary function test where FEV1, FVC, TLC and DLCO may also be helpful in detailing cofounding measures of level of obstructive or restrictive disease. These values may best predict and follow response to prolonged medications (such as steroids). With that said, the HRCT scan is very helpful in determining the diagnosis and disease course as well. Depending on the underlying cause there may be more specific treatments in managing, so the remaining advice I give is more for general therapy or idiopathic causes of bronchiectasis.
Pulmonary Rehab Therapy is very beneficial for ongoing management and improved outcomes in bronchiectasis, so hopefully, your physician has scheduled you for such a program.
Flutter valve therapy on a daily basis is additionally helpful. Actually, playing the trumpet (especially if you can get in some time at circular breathing) can enhance this. They are simple devices and fairly inexpensive (the flutter valves not necessarily the trumpet).
Daily inhalation of saline by a nebulizer has been found to enhance pulmonary function in bronchiectasis.
Finally, chronic therapy using the antibiotic azithromycin at 500 mg on Monday, Wednesday and Fridays are helpful in systematic reviews. This works more as thinning secretions (called a biofilm) as opposed to the traditional of high dose, daily short term antibiotic courses. So in this way, azithromycin acts more as an anti-inflammatory agent than as an antibiotic.
Run these ideas by with your pulmonary physician and see if he would consider this. Let him know you received this advice from a physician that ran an Adult Cystic Fibrosis clinic for 27 years, and was on the accreditation committee for the Cystic Fibrosis Foundation. Dr. GO
PS: Here is a link to an article that may be of help to you: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478409/
Allora Pocket Trumpet 2014
Harrelson Summit 2017
Kanstul 1526 2012
Getzen Power Bore 1961
Getzen Eterna 4-Valve Fulgelhorn 1974
Martin Committee 1946
Olds Super Recording 1940
Olds Recording (LA) 1953
Olds Recording (Fullerton) 1967
Olds Ambassador 1965 -
@Dr-GO Thanks for the detailed and timely response. I am scheduled for a follow up CT scan next week and review with the Pulmonary doc later in March. In the meantime I will further investigate your suggestions and add them to my current routines. Thanks again
Fels
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Another option to consider is High Frequency Chest Wall Oscillation, which is done with a device attached to a wearable vest. This can loosen otherwise adherent mucous secretions, allowing them to be expelled by coughing.
A summary of results is attached. A discussion with your pulmonologist should determine whether it would be a useful treatment modality for you. The downside is that it is more expensive than the average trumpet (maybe even as expensive as a high end boutique model), but the upside is that insurance often covers it, unlike the boutique trumpet.
