ARDS

[caiochick]

I am improving with breathing treatments and oxygen. I have returned to work, but really struggle with any exertion including talking for any length of time, which is a vital part of my job. With bronchiectasis does one continue to manufacture mucus or will I eventually get it all up? I still cough a lot and suffer with pain in the midriff area on my sides which my doctor says is chest wall pain. Is this going to be ongoing or will the cough and secretions subside eventually?

[Davy9]

By definition bronchiectasis is a chronic or long term circumstance. Again, by definition, it means that there have been permanent changes made in that airways have become dialated rendering them prone to chronic secondary infections.

Of course every case is individual and to what degree your situation will pose you an ongoing problem is not easy to say. The chest pain could be a consequence of a number of things and it will hopefully dissipate.

Secretions are part of every smokers life almost as soon as the take up the habit. You will see even young smokers suffer from that morning ritual of coughing up a nights accumulation of secretions. One of the 1st consequences of smoking is that the ciliary escalator in the lungs becomes compromised. That is comprised of a dual layer of mucous pushed up the airways by small little hairs called cilia. When it functions normally it moves debris that get into the lungs to the upper airways where it can be easily expelled. Once compromised that debris and the mucous must be coughed out from deep inside the lungs. Add to that an increase in thick mucous from the irritation of the cigarette smoke and you have more mucous and the need to cough it all out. It collects at night and makes for the lovely morning hack and even teenaged smokers have it.

Certainly ending smoking helps with that problem, but not over night. Since you have additional changes in your airways you can plan on secretions and secretion management for the foreseeable future. In fact you want to become an expert at managing your secretions. You will want to have a daily routine that insures that all of your secretions are eliminated (ideally coughed out, not swallowed). You will want to understand the early signs of lung infections which will involve understanding how that impacts the volume, tenacity, color and odor of your secretions. You will want to inspect your secretions for these changes (sounds gross, it is, but it is important). You do not want to start having chronic lung infections as they will damage your lungs more. Understanding secretions and secretion management is one of your best tools to help you accomplish that.

[caiochick]

Interesting, but does it make a difference that I am not a smoker? I smoked over 30 years ago for less than 10 years, but never had any lung problems until this bout started in June. So, is my prognosis any better? Do the secretions occur absent cigarette smoke?

[Davy9]

Secretions are a regular part of normal lung function. The airways are lined with glands that secrete mucous. They can produce small amounts of mucous or copious amounts of mucous. When healthy the lungs do not produce a noticeably large amount of mucous. Given a simple chest cold and otherwise healthy lungs will produce lots of mucous. Mucous is a cleansing and defense mechanism for the lungs.

Long term exposure to irritants (such as daily smoking) does alter the makeup of the mucous glands. They become greater in number and they produce more of the thick type of mucous. Remove the irritant and in time the lungs can get better. There can be residual or permanent damage done to the lungs and certain processes might have been initiated that proceed to worsen even in the absence of the irritant. A long term smoker who quits after the lungs have suffered serious damage will not stop the progress of emphysema. Long term smoking actually causes the lining of the airways to become less like normal airway tissue and more like the skin we have on the outside of our bodies and those changes do not heal. Obviously the more and the longer a person smokes the worse their potential for serious lung disease.

Bronchiectasis can be caused by a number of things. Smoking merely opens the door for a wide variety of lung problems. When the no-smoking pundits tell people that smoking can harm your health they are exquisitely correct and very serious. That you stopped the habit long ago is in your favor for a number of reasons. How much or how little this will impact the course of your bronchiectasis I cannot say. Your secretion problem and the need to manage and understand it is not changed because you quit smoking. Your secretion situation is a consequence of the bronchiectasis and it will need to be handled regardless of whether you ever smoked.