Bronchiectasis fosters lung infections
EAR DR. DONOHUE: Tell me something about bronchiectasis. I have had it for more than six months. Is it treatable? I use albuterol in a nebulizer. I am tired all the time and have no appetite. I have a cough with phlegm. Some nights I sweat. My doctor has me on ethambutol, clarithromycin and rifampin. — D.M.
ANSWER: The bronchi are the airways, the breathing tubes. Bronchiectasis (BRONG-key-EKtuh-siss) is a condition where the airways are stretched way out of shape. They become the perfect place for collection of thick, pusfilled secretions that promote coughing of yellow sputum, sometimes containing blood. The airway problem often results from previous infections and it fosters recurrent infections.
Antibiotics are frequently called upon to clear the airways of infecting germs. Medicines that open up the airways so that their thick secretions can drain are prescribed. Your albuterol nebulizer is such a medicine.
If bronchiectasis is limited to one specific lung location, that section can be surgically removed, or removed through artery embolization. That’s a procedure in which the artery serving the involved lung part is injected with material that forms a clot. Cut off from its blood sup-
Dply, that section of lung dies and is absorbed. I believe, however, that you suffer from the more-widespread variety of bronchiectasis, where much of the lung is involved.
You are getting treatment. You are on three antibiotics: ethambutol, clarithromycin and rifampin. This combination of antibiotics is used for a germ called mycobacterium, a germ often associated with bronchiectasis. It’s a distant relative of the TB germ. Let me emphasize that you do not have TB, and you won’t spread the mycobacterium germ to others.
It takes a long time to eliminate mycobacterium. If the germ succumbs to treatment, as it often does, you should be feeling much better. Your energy returns. You stop coughing. You don’t have further night sweats.
Bronchiectasis is somewhat like chronic obstructive pulmonary disease (COPD), the two illnesses of emphysema and chronic bronchitis. This is a very common condition. The booklet on COPD explains it and its treat- ment. To obtain a copy, write: Dr. Donohue — No. 601, Box 536475, Orlando, FL 32853-6475. Enclose a cheque or money order (no cash) for $6 Cdn with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I would like to know the following: If a frying chicken has 10 per cent saturated fat and 30 per cent cholesterol with its skin, how much fat and cholesterol does it have without its skin? — R.B.
ANSWER: Does the label list fat and cholesterol as percentages or as grams? Let me do this in grams.
A fried chicken breast with skin (about three or so ounces) has 8.7 grams of fat, 2.4 grams of which is saturated fat, the bad kind of fat. It has 87 mg of cholesterol. (The daily total of cholesterol should be kept under 300 mg.)
A fried chicken breast without skin has 4.1 grams of fat, of which only 1.1 grams is saturated fat. It contains 78 mg of cholesterol.
You can see that there is a big difference in the amount of fat between the two. The same decrease in fat occurs with other parts of the chicken when the skin is removed — wings, drumsticks, etc.
DEAR DR. DONOHUE: What can you tell me about sniffing or smoking incense? The teenagers are into this. Are there side effects? — F.C.
ANSWER: The only information I can find on this topic is a study that took place in Singapore on a large number of Chinese there. They lived in cramped quarters where incense was burning constantly. Those people had an increased incidence of cancers of the tongue, mouth, nasal passages and larynx (voice box).
I have to admit, I was unaware of this fad. I thought it was my age, but I talked to many teens, and they had no knowledge of it. Maybe it’s a regional thing.