Topics

inhalative cortisone therapy
Dear expert-team, In the course of a change of the care-center 6 months ago and an actual quite prologned infection I have a question about a demand-oriented inhalative cortisone therapy: For about 5 years I have been attuned to 2 puffs/day budesonid 400 at my "old" care center. At the new care center the sense of this inhalative therapy could not be seen (I do not have asthmatical symptoms or allergies, FEV1 at 65%) and we decided to quit the budenosid, which worked out well (no worsening of the lung function, no subjective worsening either). Since the beginning of december I suffer however from a bacterial infection (Staph. A), which leads in combination with the acutal very cold weather in my eyes to an extremely sensitive bronchial system. I am interested in the question now if there is any experience in giving budesonid for example for some weeks "around an infection", in order to "calm down" the attacked bronchial system a bit. Or would one rather recommend bronchial-dilating drugs, probably also fast-acting ones, which I do not have in my drug repertoire (I inhale formoterol as a long-acting dilating drung)? Many thanks
18.01.2010
Pseudmonas in the snow - snow cannons
Dear Dr. Kahl, in snow cannons Pseudomonas germs are added in order to snow the ski-runs. How is the danger for CF patients? Many thanks for your answer
18.01.2010
Pseudmonas in the snow?
Can Pseudomonas survive in the snow or can spread? Or does one not have to assume that they are there? Thanks
18.01.2010
Growth and lung function
Dear experts, with our daughter (7, CF), there could be seen some "changed areas" in the HRCT (high resolution CT). Is it possible, that due to the growth of the lung the relative part of these areas decreases, so that the lung can "grow healthy" in part? Or can one assume that "healthy" and "changed" parts grow equally? Best regards,
18.01.2010
Mould detection under the floor cover
How dangerous are the following germs that have been detected at a mould-investigation of the dry floor insulating layer (under the floor cover): Actinomycetes, Aspergillus restrictus, Aspergillus versicolor, Wallemia sebi, Acremonium spp., Penicillium spp., Cladosporium, Absidia sp, Blastobotrys, Engyodontium album, Scopulariopsis sp., Mucor sp., Fusarium sp. in the room-air. Thanks
18.01.2010
Mouth spray
Hello, after I have read about diverse product recalls of nose sprays I ask myself, if the by me used mouth spray could probably also be contaminated (I change the type according to the offer). I like to have it with me to be fresh when on travel - might it be harmful? Regards,
18.01.2010
Pancreas 2
Dear Dr. d'Alquen, my daughter has the mutation R1048G and R1162G; in our CF center, as well as in your forum we have been told, that that kind of mutation probably speaks for a mild course, whereby one has never a guarantee. In the last winter my daughter had finally 7 infections of the lung, better said bronchitis, but she never had a colonization with Pseudomonas. In most cases the influenza virus had been detected, as well as other bacteria in the upper airways. At the routine check in may we have been told by the CF-center, that one has to find out, why she has had so many infections. Therefore we have had a stay in hospital in june for some days, the aerosol-therapy had been shown to us (two times a day beclomethasone and salbutamole with saline) and she takes since may every second day 250mg Azithromycin. In September we had another check and we have been advised to go on with the therapy that my girl will be well-off. To our question, if the dosage is not a bit too high, they said that this would be better than again having infections. Unfortunately the doctors do not know how it will go on, and my concern, that now also the pancreas could be involved, is present. In any case we will tell them about our observations in january - we can wait until then, or not? My daughter is doing really well at the moment, nearly no mucus at inhalation and her apetite is according to her age. The only striking thing is a rather soft stool, not to say mild diarrhoe from time to time. Best regards and many thanks
17.01.2010
Pseudomonas
Dear expert team, my daughter has had a positive finding of Pseudmonas at the age of 14 months for the first time, which turned to be negative after 2 weeks of iv-therapy. 4 years later, at the age of 5 and a half years, Pseudmonas has again been in the swab and had been treated with 4 weeks Ciprofloxacin orally as well as 2 times a day inhalation of colistin. The first control swabs with and without antibiotic treatment were negative, 5 weeks ago unfortunately the result was positive again. Now she is told to take Ciprofloxacin and Colistin for 3 months. Unfortunately the last swab was positive in spite of the antibiotic treatment and I want to know, if one should change the therapy now and which alternatives there are for the current therapy?
17.01.2010
Coughing due to inhalation?
Hello, our son is 2 years old now. In August, CF has been diagnosed. Since september we inhale regularly. Even after the first inhalation he started coughing at night. Since then he coughs several times a day really hard. He gets N-acetyl-cysteine regularly and since one week also antibiotics. That has not changed anything however. Before the antibiotic therapy a swab had been done, this was negative for Pseudmonas. Is there the possibility that he does not tolerate the inhalation (only with saline) ? Does something like this exist? Or do you have an advice what can be done here! Thank you very much,
17.01.2010
Pseudomonas / home IV for a child (nearly 5 years) yes or no?
Hello, our dauhter is going to get her first IV because of Pseudmonas. We have inhaled antibiotics until now for about 2 months and took antibiotic suspension. Unfortunately the germ is still present in a moderate number. Now our doctor proposed and IV. We would be interested in the advantages / disadvantages and if it makes sense according to your opinion to support a home IV. Regards,
17.01.2010
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