Bronchitis is a common respiratory condition characterized by inflammation of the bronchial tubes, which are the air passages that connect the windpipe (trachea) to the lungs. It can be caused by viral or bacterial infections, as well as exposure to irritants like cigarette smoke, air pollution, or dust. My case followed a severe infection caused by a bacterium, Mycoplasma Pneumoniae. The inflammation in the bronchial tubes results in increased mucus production, leading to symptoms such as a persistent cough, chest discomfort, and difficulty breathing.
There are two main types of bronchitis: acute bronchitis and chronic bronchitis. Acute bronchitis is often short-lived and typically caused by viral infections, like the common cold or the flu. It can resolve on its own or with supportive care. On the other hand, chronic bronchitis is a more long-term condition usually associated with smoking or prolonged exposure to irritants, or following pulmonary infections, bacterial, viral and/or fungal.
Treatment for bronchitis depends on the underlying cause. In cases of acute bronchitis, treatment typically focuses on managing symptoms and includes rest, hydration, and over-the-counter medications to alleviate cough and fever. For chronic bronchitis, the primary approach is to quit smoking if applicable, and healthcare providers may prescribe medications to open the airways and reduce inflammation. In either case, it's essential to consult a healthcare professional for a proper diagnosis and guidance on managing the condition effectively. Antibiotics may be indicated, selection is guided by sputum culture, but more precisely with Respiratory PCR testing.
What is sputum?
Sputum is a term used to describe the mucus or phlegm that is coughed up from the respiratory tract, including the bronchial tubes, and expelled from the mouth. In the context of bronchitis, sputum plays a significant role as it is one of the hallmark symptoms of the condition. When a person develops bronchitis, the bronchial tubes become inflamed, and the body responds by producing excess mucus as a protective mechanism. This mucus can be clear, white, yellow, green, or even blood-tinged, depending on the severity and the underlying cause of the bronchitis.
The color and consistency of sputum can provide valuable information to healthcare providers when diagnosing bronchitis. For example, yellow or green sputum is often associated with bacterial infections, while clear or white sputum may indicate a viral cause. Blood-tinged sputum could be a sign of more severe irritation or inflammation in the airways. Monitoring changes in sputum can help healthcare professionals determine the progression of the condition and guide treatment decisions. Sputum analysis, along with other clinical assessments, aids in tailoring the most appropriate treatment plan, whether it involves antibiotics for bacterial bronchitis, antiviral medications for viral bronchitis, or bronchodilators and anti-inflammatory drugs to relieve symptoms and reduce inflammation.
Clearing that pesky mucus from the lungs. First things first, get the junk out!
The Flutter Valve for Mucous Clearance
What is an asthmatic without the obligatory 'inhaler.' Used by physicians for many decades, these portable devices have delivered life-saving medications at the moment that the medication is needed. Sprayed directly into the mouth, timed precisely with inspiration, and after significant practice, the asthmatic might get it right.
The Incentive Spirometer for Increasing Depth of Breathing
There is a simple device, remarkably inexpensive, that takes much of the worry out of timing the 'squeeze.' Teaching a child to do it right is very difficult, expensive if you consider the waste of medicine that is involved in 'practicing.'
The Philips Respironics Optichamber makes it very easy to administer the bronchodilator and increases the amount of medication delivered to the lungs by around 60%. I have patients that are able to get by with one puff instead of two on their Ventolin, saving more than a few dollars by reducing the frequency of inhaler refill.Sel
The 'Spacer' for an Inhaler to Increase Efficiency of Asthmatic Inhalers
I found that you can get these with a detachable mask, something that might be worth having around, but it works very well if you place the mouthpiece directly in your mouth.
The Inhaler, mine is Ventolin (albuterol, Ventolin is the better of the generics)
attaches on the opposite side of the chamber.
Attach your inhaler mouthpiece to the opening in the spacer.
Shake the inhaler, before each use.
Exhale and just as you begin to inhale slowly, you actuate the inhaler into the chamber.
Precise timing is not essential as it is without the Spacer. This device is equipped with a high volume whistle that fires if you inhale 'too fast.' Perfect feedback, actually.
The need for self help became obvious after my first hospitalization for pneumonia: My First Impression
I was admitted in January 2023 with asthmatic respiratory failure after a two week long bout of pneumonia (Mycoplasma Pneumoniae.) I had been doing well, I thought, working full time in the clinic. One Thursday afternoon, however, I was escorted out of the office and ended up in the hospital.
Antibiotics, oral steroids and 3 days later, I had a discussion with the respiratory therapist who was giving me my nebulizer treatments. He looked at my inhalers and asked: "Hey, Doc, where are your spacers?" Well, it is not my field of expertise, but I know better now. The spacer makes the inhaler work like a champ.
The Test
Being a bit skeptical, I needed to be convinced. The RT suggested that I try two puffs without the spacer, and see how well I'm breathing. He was withholding the nebulizer, I might add.
Then, he told me to take one 'hit' on with the spacer. I did as I was told, and moments later, the effect was unlike any I had previously experienced with the albuterol. I did not take a second inhalation, as it was entirely unnecessary.
The principal advantage to the spacer is efficiency. The principal disadvantage is bulk. It does not fit neatly in my trouser pocket. It is the Essential Accessory for the Asthmatic.
The spacer increases the efficiency of the inhaler by 40 to 60%
The device is probably a reasonable device to carry in a purse, folio or whatever the garment that men are seen carrying through the airports.
I bought three of them, leaving one at the office, one in my bathroom and one in my car.
I have been a physician for 42 years, and I rarely pick up pearls of wisdom as I did from that Respiratory Therapist.
It is now a frequently used piece of armamentarium in the treatment of my patients with asthma and chronic bronchitis.
I provided a link to an Amazon page where you can see the instructions for use.
I chose not to use the spacer-facemask, for my own situation.
David S. Klein, MD, FACA, FACPM
Stages of Life Medical Institute
1917 Boothe Circle
Longwood, Florida 32750
