Bronchiec­ta­sis fosters lung in­fec­tions

Cape Breton Post - - SPORTS -

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.

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