<![CDATA[BE CLEAR with Bronchiectasis - Blog]]>Mon, 13 Apr 2026 03:48:08 -0700Weebly<![CDATA[Brensocatib (BRINSUPRI) and Verducatib: What Patients Need to Know About These Emerging Bronchiectasis Treatments]]>Mon, 30 Mar 2026 10:40:48 GMThttps://www.letsbecleartoday.com/be-clear-blog/new-bronchiectasis-treatments-brensocatib-brinsupri-verducatibThere is growing excitement in the bronchiectasis community around new medications that may help reduce inflammation and slow disease progression.
Collage with photo of Prof Chalmers, Brinsupri bottle, Airtivity trial
Two of the most talked about therapies right now are brensocatib (BRINSUPRI®) and verducatib.

These medications represent a new class of treatment known as DPP1 inhibitors, designed to target inflammation at its source.
At the same time, it is important to understand how these medications work, who they may help, and what options exist if they are not accessible.

How Brensocatib Works and What to Expect

During a recent patient webinar, Prof. James Chalmers from the University of Oxford shared important insights about brensocatib.

It Does Not Work Instantly

One key takeaway is that brensocatib does not provide immediate results. It typically takes about four weeks to begin having an effect.
This is because the medication works at the level of the bone marrow. It influences inflammatory cells before they enter the bloodstream. Those cells then travel to the lungs, which takes time.

​Understanding this timeline can help set realistic expectations when starting the medication.
​
Early Patient Experience

Some early patient reports have been encouraging.

One individual shared:

“I’ve been on it for almost two months. I feel like a normal person for the first time in four years. No side effects. I’ve been on 25 milligrams since September. No wheezing or chest congestion anymore. I still cough, but there is less in my lungs.”
​
Of course, not every experience has been entirely positive. Some individuals have reported side effects, including skin changes.
As with any new medication, responses can vary from person to person.
​
What We Still Do Not Know

Even with FDA approval of brensocatib for non-cystic fibrosis bronchiectasis, several important questions remain.
​
  • How effective is it for people without frequent exacerbations?
  • What about individuals with nontuberculous mycobacterial infections, who were excluded from trials?
  • Could earlier use help slow lung function decline?
    ​
While early feedback is promising, we still need real-world data to better understand long-term outcomes.
Verducatib and the AIRTIVITY™ Clinical Trial

If brensocatib is not available or affordable, another option to explore is the AIRTIVITY™ clinical trial studying verducatib.
​
Verducatib is a similar DPP1 inhibitor and is currently being studied worldwide.

Clinical trials like this are essential for:
​
  • Expanding treatment options
  • Understanding how these medications perform in different populations
  • Improving access in the future

If you are interested, speak with your doctor to see if participation may be appropriate for you.

An Established Option: Azithromycin Prophylaxis

While new therapies are emerging, existing treatments remain an important part of care.

During a recent support group discussion, Dr. Ed Chan a researcher at National Jewish Health, in Denver, Colorado, emphasized the continued role of azithromycin.

​Why Azithromycin Is Used

Azithromycin is often prescribed on a regular basis, such as weekly or several times per week, to:

  • Reduce inflammation
  • Decrease exacerbations
  • Help stabilize symptoms

This approach is supported by international bronchiectasis guidelines and has helped many patients.

Important Safety Consideration: NTM Monitoring

Long-term azithromycin use requires careful monitoring.
Patients should be regularly tested for nontuberculous mycobacterial infections.
​
Why This Matters

If an NTM infection develops:
​
  • Azithromycin is typically discontinued
  • This helps prevent antibiotic resistance
  • It preserves azithromycin as an effective treatment

Azithromycin is a key medication for treating NTM infections. Using it when an infection is present could reduce its effectiveness when it is truly needed.
​
Balancing Hope with Reality

​There is real momentum in bronchiectasis research, and that brings hope. At the same time, not everyone has access to newer therapies yet.
​
It is important to:
​
  • Stay informed about emerging treatments
  • Explore clinical trials when appropriate
  • Continue optimizing current therapies

Every person’s situation is different, and treatment decisions should always be made in partnership with your care team.
​
Looking Ahead

Medications like brensocatib and verducatib represent an exciting step forward in bronchiectasis care. At the same time, established therapies such as azithromycin remain valuable tools.

The future of bronchiectasis treatment will likely involve a combination of:

  • New targeted therapies
  • Proven existing treatments
  • Personalized care approaches

While also recognizing that access and unanswered questions remain, there is hope for those of us living with bronchiectasis!!
]]><![CDATA[Reflux and Bronchiectasis: Why It Persists and What You May Be Missing]]>Wed, 25 Mar 2026 19:01:26 GMThttps://www.letsbecleartoday.com/be-clear-blog/reflux-bronchiectasis-overlooked-triggersHave you tried everything to get rid of reflux and still no luck?
I think I may be able to help.
Person in blue shirt holding chest with fireball to suggest heartburnPicture
It can be incredibly frustrating when you’ve done all the right things. You’ve seen specialists, had testing, adjusted your diet, and maybe even elevated the head of your bed. And yet, the symptoms remain.

A drippy nose, hoarseness, sore throat, or that persistent feeling that something is stuck in your throat.

And it’s not just about the reflux.
For those of us living with bronchiectasis, there is also the concern about how reflux, both acid and non-acid, may be contributing to disease progression. That uncertainty can create real anxiety.

Let’s walk through a few commonly overlooked factors that may be playing a role:

The Connection Between Reflux and Bronchiectasis

Reflux is not always straightforward. While many people think only about acid reflux, non-acid reflux can also contribute to symptoms and may be harder to detect.
In bronchiectasis, reflux can potentially:
  • Irritate the airways
  • Contribute to inflammation
  • Increase the risk of aspiration

This is why managing reflux is not just about comfort. It may also help protect lung health.
Overlooked Triggers That May Be Worsening Your Reflux
​
1. Are You Using Albuterol Before Airway Clearance?

Albuterol can be very helpful for opening the airways. For some people, it is an essential part of their routine. However, it is not always necessary for everyone. Because it relaxes smooth muscle, it may also relax the lower esophageal sphincter. This can allow stomach contents to move upward, contributing to reflux symptoms.

You might consider asking during your next pulmonary function test if your breathing can be evaluated with and without albuterol. If it does not make a meaningful difference, it may be worth discussing whether you need it.
2. Are You Staying in Tight Clothing After Exercise?

This is easy to overlook. Tight clothing, including workout wear, can increase pressure between the abdomen and chest. That pressure can contribute to reflux. A simple change into looser clothing after exercise may help reduce symptoms.
3. Are You Bending at the Waist Throughout the Day?

Even if you avoid eating late and elevate your bed, daytime habits matter.
Activities like:
  • Making the bed
  • Loading the dishwasher
    ​Picking things up
  • Certain types of exercise

All involve bending at the waist, which can trigger reflux.
Try bending at the knees or hinging at the hips instead.

4. Could Your Supplements Be Contributing?

This is a big one that is often missed. Some supplements, especially those with acidic components such as ascorbic acid (vitamin C), can trigger reflux symptoms in certain individuals.

In addition, it may not be just one supplement. It could be:
  • The combination of multiple supplements
  • The timing of when you take them
  • Taking them on an empty stomach

If you are taking several supplements, it may be worth reviewing them with your medical team to see if adjustments could help reduce symptoms.
5. Are You Drinking Carbonated Beverages?

Carbonated drinks, including sparkling waters like LaCroix, Pellegrino, and Topo Chico, can increase stomach pressure.
As much as many of us enjoy them, they may worsen reflux symptoms and are worth limiting.
6. How Is Your Stress Level?

A certain amount of stress is part of life. In fact, it helps motivate us.
But chronic stress can impact gut function and worsen reflux symptoms. Incorporating stress management practices, even small ones, can make a meaningful difference over time.
Why Reflux Can Feel So Hard to Control

One of the most challenging aspects of reflux is that it is often not caused by just one factor.
It is usually a combination of:
  • Medications
  • Daily habits
  • Body mechanics
  • Supplements
  • Diet
  • Stress

This is why you may feel like you are doing everything right and still not seeing improvement.
A Gentle Reminder

If you are dealing with ongoing reflux, you are not alone.
Sometimes it is not about finding one perfect solution. It is about identifying several small factors that, when adjusted, can collectively make a difference.



And as always, any changes should be discussed with your medical team.
]]><![CDATA[M. abscessus Biobank Study | Personalized Phage Therapy Research Opportunity]]>Wed, 25 Mar 2026 10:22:29 GMThttps://www.letsbecleartoday.com/be-clear-blog/m-abscessus-phage-biobankResearch Opportunity - Mab Biobank for Phage Therapy Development
M abscessus scientist looking into microscope Picture
Tolka AI Therapeutics is building a biobank specifically for Mycobacterium abscessus to advance personalized bacteriophage therapy research. This IRB-approved study (BRANY#25-08-468-1945) aims to collect Mab isolates that could lead to personalized treatment options.

What We're Doing: We're collecting sputum samples from Mab patients to isolate bacteria for phage discovery. If we find active phages against your specific Mab strain, you could potentially access personalized phage therapy through future clinical trials or expanded access programs.

Participation Details:
● Two sputum samples collected at home
● All materials and shipping provided (no cost)
● Brief medical history questionnaire
● Optional monthly QOL-B surveys

You're Eligible If:
● 18+ years old
● Live in the US
● Have Mab documented from respiratory specimens
● Can safely produce sputum

This is a unique opportunity to contribute to research that could directly benefit you and the broader M abscessus community.

Sign up or learn more: tolka.ai/biobank

Questions: questions@tolka.ai

]]><![CDATA[Bronchiectasis Patient Conference 2026 | International Event With Translation]]>Mon, 16 Mar 2026 11:42:45 GMThttps://www.letsbecleartoday.com/be-clear-blog/bronchiectasis-patient-conference-2026-international-event-with-translationIf you live outside the United States, this bronchiectasis conference hosted by the European Lung Foundation was made for you.
collage of top bronchiectasis and MAC experts
To our dear overseas Bronchi-family… get ready for one of the best conferences of the year!

I know there have been several bronchiectasis webinars held in the United States that were not always convenient for those of you living in other parts of the world.

This upcoming conference, on March 21, 10:00-16:00 CET, however, is one you will definitely want to sign up for. One thing I absolutely love about it is that translation services will be available, so hopefully you will be able to listen in your own language.

Agenda for bronchiectasis conference
Second page of agenda for bronchiectasis conference
Click to SIGN UP NOW!!!
]]><![CDATA[Bronchiectasis Care Centers Accepted into Network]]>Sun, 15 Mar 2026 22:48:29 GMThttps://www.letsbecleartoday.com/be-clear-blog/bronchiectasis-care-centers-accepted-into-networkThe Bronchiectasis and NTM Association has accepted 25 new Care Centers into the Bronchiectasis and NTM Care Center Network (CCN). These eight Care Centers and 17 Clinical Associate Center sites in 14 states, added to the previously approved 33 Centers, bring the current total to 58 centers across the United States.  
doctor arms outreached to on another
The CCN aims to facilitate access to specialized care and support for the hundreds of thousands of people with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease.   

“The prevalence of bronchiectasis and NTM lung disease continues to increase. Patients deserve access to high-quality, specialized care and resources,” said Doreen Addrizzo-Harris, M.D., Chair of the CCN Steering Committee. “The CCN’s innovative, nation-wide network will help us enhance care and improve quality of life for those living with these conditions, as well as accelerate progress toward a cure.” 

Centers accepted into the CCN receive a designation of either a Bronchiectasis and NTM Care Center or a Bronchiectasis and NTM Clinical Associate Center, based on institutional resources and infrastructure. The requirements are established by the CCN’s Steering Committee, comprised of leading experts in the field. 

The new Bronchiectasis and NTM Care Center sites are:  The new Bronchiectasis and NTM Clinical Associate Center sites are: 
Why This Expansion Is Encouraging

For many people living with bronchiectasis, finding knowledgeable clinicians can be challenging. The expansion of the Care Center Network means that more patients across the United States may gain access to specialized care and coordinated treatment teams.
​
These centers bring together pulmonologists, infectious disease specialists, respiratory therapists, dietitians, and other professionals experienced in managing bronchiectasis and NTM lung disease. As the network continues to grow, will help improve diagnosis, treatment, and quality of life for the hundreds of thousands of people living with these conditions.

Interested in the thirty-three previously approved bronchiectasis and NTM Centers?
​
Or, go to the Bronchiectasis and NTM Association’s Care Center Network page to find a center by location and zip code.
]]><![CDATA[Bronchiectasis Care Centers: Why Team-Based Care Improves Diagnosis and Treatment]]>Sat, 14 Mar 2026 19:24:06 GMThttps://www.letsbecleartoday.com/be-clear-blog/bronchiectasis-care-centers-why-team-based-care-improves-diagnosis-and-treatmentWhen I was first diagnosed with bronchiectasis, one of the most confusing parts of the journey was figuring out who should be managing my care. 

Should I see a pulmonologist?
An infectious disease specialist?
A respiratory therapist?
Bronchiectasis physicians working together to improve patients' lives

Over time, I realized something important: bronchiectasis is a complex condition that often requires a team of experts working together.

Fortunately, in the U.S., this type of coordinated care is becoming more common. The Bronchiectasis & NTM Association has created a Care Center Network designed specifically to support people living with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease.

These specialized centers bring together clinicians with expertise in diagnosing and managing these conditions. The goal is simple but important: reduce the time to diagnosis and provide comprehensive, high-quality care.

What Is a Bronchiectasis Care Center?
A bronchiectasis care center is a specialized medical program where multiple healthcare professionals collaborate to diagnose and manage bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. These centers typically include pulmonologists, infectious disease specialists, respiratory therapists, dietitians, pharmacists, and mental health professionals who work together to provide coordinated, comprehensive care for patients.

Why Specialized Bronchiectasis Care Is Important
Bronchiectasis and NTM infections are being diagnosed more frequently worldwide. Yet many patients still experience long delays before receiving an accurate diagnosis or appropriate treatment. Patient surveys have shown that many individuals feel their care is fragmented and that support services are limited.

Other complex medical conditions have demonstrated that multidisciplinary care improves outcomes. Diseases such as cystic fibrosis, HIV, and cancer are often treated in specialized centers where multiple experts collaborate to manage all aspects of the disease.

Bronchiectasis care centers are built on a similar model.

What Patients Should Expect From a Bronchiectasis Care Center
A bronchiectasis care center focuses on coordinated, patient-centered care. While each center may operate differently, most share several key features.

Patients can generally expect:
  • A team approach to care
  • Multiple specialists collaborating to manage different aspects of the disease.
  • Expertise in bronchiectasis and NTM infections
  • Clinicians familiar with the latest research, diagnostic tools, and treatment strategies

More specific services will include:

Education and ongoing monitoring
Care centers often provide follow-up appointments and patient education between visits.

Access to additional specialists when needed
Patients may be referred to experts such as dietitians, mental health professionals, or pulmonary rehabilitation programs.

The Bronchiectasis Care Team
Because bronchiectasis affects many aspects of health, care centers rely on a multidisciplinary team of specialists.

Pulmonologists and Infectious Disease Specialists
Pulmonologists focus on lung structure and airway disease, while infectious disease physicians evaluate bacteria identified in sputum cultures and determine whether treatment is necessary.
Collaboration between these specialists is often essential when managing bronchiectasis and NTM infections.

Program Coordinator
Many care centers include a program coordinator, often a nurse, who serves as the main point of contact for patients.
This person may help coordinate testing, obtain medical records, communicate with providers, and assist patients with navigating their care.

Respiratory Therapy and Airway Clearance
Airway clearance is a cornerstone of bronchiectasis treatment.
Respiratory therapists teach techniques to help patients clear mucus from their lungs and guide them in using airway clearance devices such as nebulizers, positive expiratory pressure devices, and chest oscillation vests.

Nutrition Support
Bronchiectasis can sometimes affect appetite and digestion. Some patients experience reflux, reduced appetite, or unintended weight loss. Maintaining adequate nutrition is important for lung health, and dietitians can help patients develop individualized nutrition plans.

Mental Health and Social Support
Living with a chronic lung disease can affect emotional well-being. Anxiety and depression are common among patients with bronchiectasis. Mental health professionals and social workers
can help patients address emotional challenges, navigate healthcare systems, and connect with supportive resources.

Additional Specialists Involved in Bronchiectasis Care
Because bronchiectasis can be associated with other conditions, additional specialists may become involved in care.

These may include:
• gastroenterologists for reflux and digestive issues
• ear, nose, and throat specialists
• allergists and immunologists
• genetic counselors
• thoracic surgeons

For example, gastroesophageal reflux disease (GERD) is common in bronchiectasis and may worsen lung symptoms.

How to Find a Bronchiectasis Care Center
If you are interested in receiving care at a specialized center, the Bronchiectasis & NTM Association maintains a Care Center Network across the United States. Even if most of your care is provided locally, many patients benefit from periodic consultations with specialists at these centers, who can help guide treatment decisions.

Frequently Asked Questions

Do I need to go to a bronchiectasis care center?
Not everyone needs to receive all of their care at a specialized center. However, many patients benefit from at least one consultation with clinicians who have expertise in bronchiectasis and NTM lung disease.

Can I still see my local doctor?
Yes. Many patients continue to work with their local pulmonologist or primary care physician while also consulting with a specialized center. This collaborative approach helps ensure continuity of care.

What specialists treat bronchiectasis?
Bronchiectasis care often involves a team that may include pulmonologists, infectious disease specialists, respiratory therapists, dietitians, pharmacists, mental health professionals, and social workers.

Why is airway clearance important?
Airway clearance helps remove mucus from the lungs, reducing infections and improving breathing. Respiratory therapists often teach patients how to perform these techniques and use airway clearance devices effectively.

These are encouraging times
Bronchiectasis and NTM lung disease are complex conditions, but patients should not have to manage them alone. Specialized bronchiectasis care centers represent an important step toward improving diagnosis, treatment, and long-term outcomes.

By bringing together pulmonologists, infectious disease specialists, respiratory therapists, dietitians, and other professionals, these centers provide comprehensive, patient-centered care that can make a meaningful difference for people living with bronchiectasis.
]]><![CDATA[Clearing a MAC Infection: My Personal Journey]]>Fri, 06 Mar 2026 19:24:41 GMThttps://www.letsbecleartoday.com/be-clear-blog/clearing-a-mac-infection-my-personal-journeyAfter several years, I finally cleared a Mycobacterium avium complex (MAC) infection. It was a long journey that required patience, consistency, and a deep commitment to my health.
Linda Esposito smiling because she cleared her mac infection

What Is Mycobacterium Avium Complex (MAC)?

MAC is a type of nontuberculous mycobacterial (NTM) lung infection. It often occurs in people with bronchiectasis. Bronchiectasis (BE) can cause mucus to build up in the airways, creating an environment where bacteria are more likely to grow and persist.

However, it is not always clear which came first. Did the bronchiectasis create the conditions for the infection, or did the infection contribute to airway damage and cause the BE? In some cases, it truly can be a “chicken or the egg” situation.

Symptoms Can Vary Widely

People experience MAC very differently. Some individuals struggle with symptoms such as night sweats, debilitating fatigue, chronic cough, and daily sputum production. Others may have very few symptoms and feel relatively well even while the infection is present. Because symptoms and disease severity can vary widely, treatment decisions are often individualized and difficult to make.

When Antibiotics Are Recommended for MAC

When my infection was first diagnosed, my doctor recommended antibiotic therapy. Standard treatment for MAC often involves several antibiotics taken for a long time — often over a year.

Choosing a Different Initial Approach

In my case, after careful discussion with my physician, I initially chose a different approach. As an experienced health coach, I decided to focus on myself as my only client and see whether I could clear the infection without starting antibiotics right away.
​
I committed to what I called building a brick house. Rather than relying on one single intervention, I focused on laying one brick at a time through consistent airway clearance, regular exercise and movement, and healthy lifestyle practices, including stress management and reflux control.

At the same time, I continued to monitor my condition closely with my medical team and understood that antibiotics remained an option if my condition worsened.

A Long but Meaningful Journey

It was not a quick or easy process. But after several years, my cultures finally cleared.

My experience is not meant to suggest that everyone can or should follow the same path. Many people with MAC absolutely require antibiotic treatment, particularly those with cavitary disease or who are very symptomatic. This decision should always be made with a physician who is well-trained in bronchiectasis and Non-tuberculous Mycobacteria lung diseases, such as MAC. ​

But my journey is a reminder that there can sometimes be more than one path forward. Steady, consistent care of our lungs and overall health can make a meaningful difference over time.
​
For me, the process of building that brick house, one daily habit at a time, became the foundation for protecting my lungs and supporting my long-term health.

*Common Questions About MAC Lung Disease*

How long does it take to clear a MAC infection?
MAC infections can take a long time to treat or resolve. When antibiotics are used, treatment often lasts at least 12 months after cultures become negative. If cultures are not converting by six months, the protocol is often changed to daily medication rather than three times a week, and an inhaled antibiotic might be added.  
Do all people with MAC infection need antibiotics?
Not always. Some people with mild symptoms and no cavitary disease may opt for "watchful waiting" and be monitored closely before starting treatment. Others, particularly those with more severe disease or significant symptoms, may benefit from antibiotic therapy. Decisions about treatment should always be made with a pulmologist and/or infectious disease doctor who specializes in bronchiectasis and MAC lung disease.
Can lifestyle habits help support lung health with MAC or bronchiectasis?
Absolutely! While lifestyle practices are not a cure for bronchiectasis and chronic lung infections, consistent habits such as airway clearance, exercise, stress reduction, reflux management, and good sleep can play an important role in supporting lung health and overall well-being. 

My story and the practices I used to build a stronger and more resilient body are discussed in my book, The BE CLEAR Method to Living with Bronchectasis, available on Amazon.

​This post is for educational purposes only. It reflects my personal experience and should not be considered medical advice. Never change your treatment plan without discussing it with your medical team.
]]><![CDATA[Neutrophils, Apoptosis, and Why This Matters in Bronchiectasis]]>Tue, 20 Jan 2026 19:09:59 GMThttps://www.letsbecleartoday.com/be-clear-blog/inflammation-bronchiectasis-neutrophils“Recent research has revealed that… neutrophils are not normal in bronchiectasis. I mean, they are fundamentally different. They have delayed apoptosis compared to the normal host…”
​
Dr. Pamela McShane
Picture
A pop-a-what?Let’s talk about apoptosis.
Yes, it is one of those words that sounds like what it actually is. But before we get there, we need to talk about those ever-discussed immune cells called neutrophils.
​
What are neutrophils supposed to do? Neutrophils are white blood cells that act as the body’s first responders. Their role is to rush to infection sites and kill bacteria quickly and aggressively.
Just as importantly, once their job is done, neutrophils are supposed to die off promptly through a tightly regulated, natural process called apoptosis. This allows inflammation to resolve and tissues to heal.
​
In a healthy immune system, this entire cycle is fast and well-controlled, typically completed within a few days.
Neutrophils themselves are not harmful. In fact, they are essential for fighting infection. The problem arises when their activity is not properly regulated.

What goes wrong in bronchiectasis?

In bronchiectasis, neutrophils are fundamentally altered. They do not behave the way they should.
Instead:
  • They release excessive and destructive enzymes
  • They delay apoptosis, meaning they do not die when they should
When neutrophils remain active for too long, they continue releasing proteases such as neutrophil elastase, along with inflammatory signaling molecules. This ongoing activity damages airway walls and interferes with normal mucus clearance.
​
Neutrophils are meant to be short-term emergency responders. Their weapons are powerful by design, but they are intended to be used briefly. In bronchiectasis, however, these cells linger and continue firing within already vulnerable airways.

Why delayed apoptosis causes harm

When neutrophils fail to undergo apoptosis:
  • Airway tissue is repeatedly injured
  • Chronic inflammation persists
  • Cilia, the tiny hair-like structures that help clear mucus, are damaged
  • The airways become more vulnerable to infection

Neutrophil enzymes do not distinguish between bacteria and lung tissue. They attack whatever is in front of them. When these cells do not shut down as they should, the result is a prolonged inflammatory assault that drives airway damage.
​
The degree of delayed apoptosis and neutrophil-driven inflammation can vary from person to person, which helps explain why bronchiectasis severity and progression differ so widely among individuals.

A newer approach: calming neutrophils, not eliminating them

It has been about five months since some people started Brinsupri™, and early feedback is beginning to emerge. Many who choose to share their experiences publicly report benefits such as less breathlessness and more energy. Everyone’s experience is different, but these early observations are encouraging.

So how does Brinsupri (brensocatib) work?

Brinsupri does not stop the body from making neutrophils. The immune system still sends these cells into the lungs as usual.
What Brinsupri appears to do is make neutrophils less damaging. This reflects a reduction in harmful neutrophil-driven inflammation rather than elimination of neutrophils or suppression of the immune system.

With Brinsupri, neutrophils remain present but tend to be less aggressive, cause less irritation and injury, and trigger less ongoing inflammation.

In simple terms, Brinsupri helps calm neutrophils down.
​
It does not kill them.
It does not force them to die sooner.
It helps reduce the ongoing lung tissue damage they can cause once they reach the lungs.

These therapies are intended to limit inflammatory injury and may help slow disease progression, but they do not reverse existing structural airway damage.
​

Deciding when or whether to consider treatment

Some people are choosing to wait to see how others respond to the new medication. This can be a reasonable and thoughtful approach.

However, if your lung function is declining or you are experiencing frequent exacerbations, the ongoing damage also needs to be considered. Each exacerbation can leave lasting effects on the airways and influence long-term outcomes.

At your next medical visit, consider asking your clinician about Brinsupri and whether it might be an option for you. There are also similar therapies currently in clinical trials that may become available where you live.

Understanding the biology behind bronchiectasis empowers patients to have more informed, collaborative conversations with their care teams.
​
Educate. Self-advocate. Share information with others.
]]><![CDATA[Strength Training With Bronchiectasis & MAC: Why Staying Strong Matters]]>Sun, 18 Jan 2026 19:37:36 GMThttps://www.letsbecleartoday.com/be-clear-blog/strength-training-with-bronchiectasis-mac-why-staying-strong-mattersAs a personal trainer, I have always enjoyed lifting weights. Now, with bronchiectasis and a history of MAC, I have an extra reason to stay strong.
Linda Esposito showing her strong arm muscles
I am at the gym most days and often write social media posts or work with clients in between 30-minute workout sessions. Some days I complete one session, other days two, and occasionally I add a shorter half-session depending on how my body feels.

Fueling Before and After Workouts

Before heading to the gym, I always eat. That might include peanut butter on toast, Greek yogurt, eggs, a banana, or berries, along with my must-have coffee. After my workout, I eat again, making sure to include both protein and carbohydrates.
​
This consistent fueling is the only way I have enough energy to train and the ability to build and maintain muscle. Without adequate nutrition, strength gains are limited, especially for those of us managing chronic lung conditions.

Training With Breathing in Mind

Lately, I have been separating my upper- and lower-body workouts, but there is no single right approach. What matters most is paying attention to balance. I focus on strengthening my chest and neck muscles to support airway clearance, while also stretching them to prevent tightness and neck pain.

As I discuss in my book, The BE CLEAR Method to Living with Bronchiectasis, it is equally important to strengthen and stretch the back muscles. People with bronchiectasis often round forward during coughing and while using airway clearance devices. Addressing both the front and back of the body helps counteract this pattern.

A Functional, Whole-Body Approach

This front-and-back approach supports posture, breathing, overall strength, and endurance. It also builds confidence. Strong muscles help make daily activities easier and breathing more efficient.
Start slowly. The exercises in my book are well-suited for beginners and also helpful for more experienced exercisers who want to identify imbalances and build full-body strength.

A Few Important Reminders

Always nourish your body before and after exercise. Without proper fueling, it is difficult to achieve meaningful results. If you have GERD, you may need to wait a bit after eating before exercising.

As discussed in a previous post, including a carbohydrate can help absorb stomach fluid and reduce reflux.

Before starting, stopping, or changing any exercise program, be sure to get medical clearance from your physician.

You can find my book on Amazon!
]]><![CDATA[Living and Breathing with Art: Finding Calm and Strength with Bronchiectasis]]>Sun, 18 Jan 2026 10:21:41 GMThttps://www.letsbecleartoday.com/be-clear-blog/personal-story-living-with-bronchiectasisIn the inspiring video Living and Breathing with Art, Maggie Hart shares her personal journey with bronchiectasis and chronic lung disease, a condition she has lived with since age 28.
Picture
Despite facing significant medical challenges, including two lobectomies, Maggie reflects on how art has become a powerful source of calm, grounding, and peace in her life.

As a former licensed independent clinical social worker, Maggie brings a deep understanding of the emotional and mental toll of chronic illness. She speaks openly about anxiety, uncertainty, and fear, and how creative expression has helped her navigate these challenges.

Through painting, Maggie finds a space where she can be fully present, momentarily setting aside illness and worry to immerse herself in the creative process. Her artwork often tells a story of strength and resilience.

One particularly meaningful piece, Breath and Flowers, was created before her second lobectomy and helped Maggie reframe her lungs as something beautiful and life giving rather than something to fear. She also shares her old doors series, which symbolizes the doors that close and open throughout life, mirroring the emotional journey so many people experience while living with chronic illness.

The video includes a gentle, guided art exercise using only a pen and paper. It is designed to help viewers slow down, relax, and tap into their imagination. Maggie emphasizes that artistic ability is not required, reminding us that we are all wired for art and self-expression.

She also offers a thoughtful reminder to be mindful of art supplies that may be harsh on the lungs, reinforcing the importance of creativity that supports both emotional and physical well-being.
Maggie’s message is a beautiful reminder that art can be more than a hobby. It can be a tool for healing, reflection, and connection, especially for those navigating life with chronic illness.

Thank you, Maggie, for sharing your story. You are the soul of our bronchiectasis community.

Maggie's Video


​Maggie's Art Website

Check out Maggie's art!! Do you also paint to help deal with the anxiety of living with bronchiectasis?
]]><![CDATA[Humidifiers and Lung Health: Benefits, Risks, and Safer Options]]>Fri, 02 Jan 2026 20:31:38 GMThttps://www.letsbecleartoday.com/be-clear-blog/humidifiers-and-lung-health-benefits-risks-and-safer-optionsWhile humidifiers can be helpful for dry air, inadequate cleaning and sterilizing may allow bacteria and other microorganisms in the water to become airborne.
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In some cases, these particles can be inhaled into the lungs, posing a risk to individuals with vulnerable airways.

Joseph Falkinham, a leading microbiologist who studies lung pathogens, has explained that humidifiers can disperse organisms such as nontuberculous mycobacteria (NTM) into indoor air. These bacteria are known for forming persistent biofilms in the lungs and can pose particular risks for individuals with bronchiectasis or other conditions that increase airway susceptibility to infection.

Why ultrasonic humidifiers raise concern

Dr. Falkinham is especially concerned about ultrasonic humidifiers, and the reason comes down to how they work. Ultrasonic humidifiers use high-frequency vibrations to break water into a very fine mist. Everything in the water gets aerosolized, including minerals, bacteria, and fragments of biofilm that may be growing inside the device.
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Because the particles created are extremely small, they can remain suspended in the air longer and be inhaled deep into the lungs. This increases the potential for waterborne organisms, such as NTM and Pseudomonas, to reach the inflamed airways.

Why evaporative humidifiers are considered safer

Evaporative humidifiers work differently. They use a wick or filter and a fan, allowing only water molecules to evaporate into the air. Most bacteria, minerals, and heavier particles are left behind in the reservoir or trapped in the filter rather than becoming airborne.
For this reason, if a humidifier must be used, evaporative models are generally considered safer than ultrasonic models.

Lower-risk ways to add moisture to the air

Lower-tech approaches reduce risk by relying on evaporation rather than aerosolization. Examples include boiling water on the stove or using ceramic containers on radiators. When possible, using sterile or well-filtered water can further minimize exposure.

What works for me


What works for me may not be right for everyone, but adding moisture to the air without a traditional humidifier works well in my home. On occasion, I use an electric teapot filled with sterile water and leave the lid open as it boils to add moisture to the air. The kettle turns off automatically, and I unplug it when it is finished.

For those interested in learning more, the Bronchiectasis and NTM Info & Research Connect Forum offers thoughtful discussions about environmental precautions. This patient-only forum frequently includes input from Dr. Falkinham, including conversations about humidifiers and why evaporative approaches may be safer than ultrasonic devices.


Medical disclaimer

This content is for educational purposes only and reflects personal experience and general information. Always consult your physician or care team before making changes to your health or home care practices.
]]><![CDATA[Bronchiectasis and Coffee: Do You Really Have to Give It Up?]]>Wed, 31 Dec 2025 09:59:43 GMThttps://www.letsbecleartoday.com/be-clear-blog/drinking-coffeeA common search phrase I see related to bronchiectasis is “bronchiectasis and coffee.” And honestly, I understand why.
coffee and cookies
When you’re first diagnosed with bronchiectasis, the learning curve can feel overwhelming. Suddenly, you’re told this is a chronic condition, and along with that comes a long list of new ways to take care of yourself.

You may be advised to perform daily airway clearance, prioritize adequate protein and nutrition, work toward or maintain a healthy weight, exercise regularly, protect yourself from infections, and, on top of all that, somehow manage stress.

That’s a lot.

So it makes perfect sense that one of the first questions people ask is whether they’ll have to give up coffee.

For many of us, coffee isn’t just a beverage. It’s comfort. It’s routine. It’s a small moment of normalcy in a life that may suddenly feel very medicalized.
​
The short answer is this: most people with bronchiectasis do not need to automatically give up coffee. But, as with many things related to bronchiectasis, the details matter.

Why Coffee Comes Up So Often in Bronchiectasis Conversations

Coffee raises questions for a few main reasons.

Caffeine is a stimulant, and people worry it might worsen coughing, increase anxiety, or interfere with sleep, all of which can affect respiratory health.

Coffee is also frequently discussed in relation to acid reflux and GERD, which are common in people with bronchiectasis. Reflux can worsen cough, increase aspiration risk, and contribute to airway irritation. In addition, hydration matters for mucus clearance, and some people worry coffee may be dehydrating.
Because of all this, coffee often shows up on informal lists of “things to avoid.”

But here’s the key point: bronchiectasis care is highly individualized. There is no single bronchiectasis diet, and there is no universal rule about coffee that applies to everyone.

Coffee, Caffeine, and the Airways

Interestingly, caffeine has mild bronchodilator properties, and related compounds were historically used in respiratory treatments. For some people, coffee feels comforting, supports morning alertness, and fits naturally into a routine that includes movement and airway clearance.

For others, it may increase jitteriness, worsen anxiety-related shortness of breath, or aggravate reflux symptoms.
​
Neither response is right or wrong. It’s simply information.
A helpful question to ask yourself is not how you think you should feel after coffee, but how you actually feel.

The Reflux Connection (Often the Real Issue)

When coffee causes problems for people with bronchiectasis, it’s often not the lungs directly, but the digestive system.

Coffee can relax the lower esophageal sphincter in some individuals, thereby increasing the likelihood of gastroesophageal reflux. If stomach contents travel upward, especially at night or when lying down, they can irritate the airways through micro-aspiration.

Signs that coffee may be contributing to reflux include heartburn, chest discomfort, frequent throat clearing, hoarseness, or a cough that worsens after drinking coffee, particularly on an empty stomach.

If this sounds familiar, the solution isn’t always eliminating coffee completely. Often, it’s about timing, quantity, and awareness.

Ways Some People Continue to Enjoy Coffee

Many people with bronchiectasis find they can keep coffee in their lives by making small, thoughtful adjustments.

Drinking coffee after food rather than on an empty stomach can help. Some people tolerate lower-acid coffee or cold brew better than traditional coffee. Others find that reducing portion size, switching to half-caffeinated coffee, or avoiding coffee later in the day makes a meaningful difference, especially for sleep and reflux control.
​
This isn’t about rigid rules. It’s about noticing patterns and responding to them.

Stress, Enjoyment, and the Bigger Picture

Stress management is an important part of living well with bronchiectasis. That doesn’t only mean breathing exercises or meditation. It also means preserving small rituals that bring comfort and pleasure.

If coffee is something you truly enjoy and it doesn’t clearly worsen your symptoms, removing it “just in case” may increase stress rather than reduce it.
​
Quality of life matters. Sometimes the most supportive choice isn’t more restriction, but more awareness.

The Bottom Line on Bronchiectasis and Coffee

Coffee is not automatically off-limits if you have bronchiectasis. Your personal response matters more than generalized advice. Reflux, rather than caffeine itself, is often the deciding factor. Small adjustments can go a long way. And preserving enjoyment and routine is part of holistic care.

Living well with bronchiectasis isn’t about giving up everything you love. It’s about learning how your body responds and making informed, compassionate choices.
​
For many people, that still includes a cup of coffee.

]]><![CDATA[NTM Talk Podcast: Bronchiectasis & NTM Lung Disease Conversations]]>Fri, 26 Dec 2025 11:34:33 GMThttps://www.letsbecleartoday.com/be-clear-blog/ntmtalk-podcast-bronchiectasis-ntm-lung-disease-conversationsNTMTalk.com is a podcast dedicated to nontuberculous mycobacterial lung disease and bronchiectasis. ​
Dr Colin Swenson and Dr Wendi Drummond
NTMTalk.com is a podcast dedicated to nontuberculous mycobacterial lung disease and bronchiectasis. Dr. Wendi Drummond, an infectious disease expert, and Dr. Colin Swenson, a pulmonologist, host it. Together, they aim to share accurate, practical, and approachable information for patients, loved ones, and healthcare providers.

What makes it especially enjoyable is their chemistry. A pulmonologist and an infectious disease doctor having thoughtful, honest conversations about bronchiectasis and NTM lung disease. Relatable and reassuring all at the same time.

If you’re looking for something meaningful to listen to while walking, resting, or just taking a breath, this is it!!

Let’s support this podcast program by sharing it with others. NTMTalk.com
​
What is Bronchiectasis?
Airway Clearance, an Interview with a Respiratory Therapist
What is NTM?
Diagnosis of NTM Lung Disease
Treatment of MAC Lung Disease
Arikayce, Clofazimine, and More
Vest Therapy in Airway Clearance, an RT Interview
Exacerbations of Bronchiectasis
Mycobacterium abscessus
The One About Sputum
Dancing in the Rain (mental health)
Reflux & Aspiration
Hemoptysis, or the Bloody Cough

Plus interviews with many of our favorite people and LOTS of questions answered!!

Now a new season is underway. Here is Episode 1 of Season 3.

Happy Listening‼️‼️

Linda Esposito

]]><![CDATA[Why Testing Your Travel Plan at Home Matters | BE CLEAR with Bronchiectasis]]>Tue, 23 Dec 2025 11:34:18 GMThttps://www.letsbecleartoday.com/be-clear-blog/why-testing-your-travel-plan-at-home-matters-be-clear-with-bronchiectasis​When you live in a one-bedroom apartment, you quickly learn that planning ahead and working as a team is essential.
toaster, coffee pot, fruit on a table

I had an early-morning doctor’s appointment, and, as we often do, my husband offered to sleep on the pullout sofa. I gratefully accepted because it meant I could take my time showering and getting dressed in the bathroom off the bedroom.

And then I had what felt, at the time, like a brilliant idea.

Instead of tiptoeing around the apartment trying to quietly make coffee and toast while he slept, why not have a bedroom picnic? I’d bring the coffee pot into the bedroom, plug in the hot plate, and while I was at it… the toaster too.

So we packed everything up. I even grabbed a cooler with ice packs and proudly hauled it all into the bedroom, laughing and feeling like a true team player.

Morning comes. I put my coffee up to brew, and then I realize—no coffee cup. I tiptoe out, grab a mug, sneak back in, and drop the bread into the toaster.

Just as I was congratulating myself—beep, beep, beep. The smoke detector had other plans.

Of course, Tony woke up.

Fortunately, he was able to fall back asleep, and once he was fully up later, we had a good laugh about the whole thing.

But it also drove home an important point.

Anytime you try something new, there are bound to be glitches. And that absolutely applies to travel.

That’s why when my clients and I talk about upcoming trips, I always recommend testing anything new ahead of time—whether it’s a device, a system, or a routine.

The last thing you want is to discover on the road that you forgot something essential or that your plan just isn’t going to work.

A little trial run at home can save a lot of stress once you’re traveling.

For a limited time, I am offering a New Year's gift: 10% off an initial consultation and $50 off a coaching package.

​Let's go!!!

Visit www.letsbecleartoday.com/consultations

A little trial run at home can save a lot of stress once you’re traveling.

​
]]><![CDATA[Natural Ways to Reduce Nausea Using Scent-Based Therapies]]>Mon, 15 Dec 2025 10:59:39 GMThttps://www.letsbecleartoday.com/be-clear-blog/natural-ways-to-reduce-nausea-using-scent-based-therapiesFeeling nauseous can stop your day in its tracks. Whether you are experiencing nausea from illness, travel, medication, or post-procedure recovery, you want relief that is fast, safe, and simple.
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In a recent Instagram post, Wendi LeBrett, MD (@socalgastrodoc), discusses how certain smells can reduce nausea. These scent-based therapies do not replace medical care, but they can be a helpful tool while you wait for medication to work or when you need gentle support at home.

In this blog, I highlight four scents supported by scientific evidence. These include isopropyl alcohol pads, peppermint oil, ginger oil, and lemon oil. All have been tested in various clinical settings and show promise in reducing nausea.
​

Is Smelling an Alcohol Pad Effective for Nausea?

The short answer is yes. Smelling an isopropyl alcohol pad is one of the best studied non-medication approaches for nausea. In emergency departments and post-surgical recovery rooms, patients who inhaled the vapor from an alcohol pad reported a noticeable decrease in nausea within one to three minutes. The effect is rapid, and nurses widely use the approach because it is safe, inexpensive, and readily accessible.

Researchers believe the strong scent stimulates sensory pathways inside the nose that interrupt the nausea reflex. This type of sensory interruption is what makes alcohol pads especially helpful when nausea comes on quickly.

Peppermint Oil for Nausea Relief

Peppermint oil is one of the most studied essential oils for nausea. Multiple randomized trials show that inhaling peppermint oil can reduce nausea in postoperative patients and in people with general medical nausea. Relief is often felt within about five minutes.

The cooling and calming effect of menthol appears to influence the vagus nerve, which plays an important role in nausea. Peppermint oil can be used by placing a drop on a cotton pad and inhaling it gently or by using a small personal inhaler. This is a popular option because the fragrance is familiar and well-tolerated.

Ginger Aromatherapy and Its Benefits

Ginger has a long history as a natural remedy for nausea. Modern clinical trials support its use, especially for pregnancy-related nausea and mild postoperative nausea. In randomized studies, patients who inhaled ginger oil experienced reduced nausea intensity compared with placebo.
​
Ginger contains compounds called gingerols and shogaols that interact with serotonin receptors involved in the nausea pathway. You can use ginger oil in the same way as peppermint: place one or two drops on a cotton pad and inhale slowly.
​

Lemon Oil for Morning and Mild Nausea

Lemon oil has been tested in pregnancy-related nausea and has shown benefit in several clinical trials. It provides a bright, clean scent that many people describe as uplifting. Some find it helpful first thing in the morning when nausea can be intense. Lemon oil does not work as quickly as alcohol pads or peppermint oil, but it can help settle the stomach gently.

How These Scents Compare

Isopropyl alcohol provides the fastest relief based on current studies. Peppermint oil comes next and has strong evidence in postoperative care. Ginger oil is especially helpful in pregnancy-related nausea and can be used throughout the day. Lemon oil is a gentle option that provides a pleasant sensory distraction.

All of these options are generally safe for most people, although individuals with asthma or scent sensitivities may wish to use them cautiously. If your nausea is persistent, severe, or accompanied by other concerning symptoms, it is important to speak with your clinician.
]]><![CDATA[Identifying Underlying Causes of Bronchiectasis]]>Mon, 15 Dec 2025 10:21:25 GMThttps://www.letsbecleartoday.com/be-clear-blog/identifying-underlying-causes-of-bronchiectasisYour physician needs to send cultures not only for routine respiratory bacteria but also for nontuberculous mycobacteria (NTM) and fungi. ​
Aspergillus organis that can cause an allergic reaction in the body called ABPA
Routine cultures alone may overlook significant contributors to ongoing inflammation, airway damage, and recurrent infections.

​Many people assume that a “negative sputum” means everything has been checked, when in fact only standard bacteria were tested. Without additional orders, the lab will not automatically screen for NTM or fungi.

One important example is allergic bronchopulmonary aspergillosis (ABPA). ABPA is a known cause of bronchiectasis and can worsen existing disease by driving chronic airway inflammation. It is more commonly recognized in countries such as India and in certain parts of Europe, yet many patients in the United States go undiagnosed for years. This often happens simply because the appropriate tests are not being ordered. Unless a clinician specifically requests Aspergillus-related testing, neither blood work nor fungal sputum cultures will be performed.

A thorough evaluation for ABPA and other fungal-related contributors should include several key components:

• Blood tests for Aspergillus-specific IgE and IgG, which indicate whether the immune system is reacting strongly to Aspergillus.

• Total IgE levels, which are often significantly elevated in ABPA.

• A complete blood count to assess eosinophils, a type of immune cell that rises in allergic or inflammatory airway conditions.

• Sputum cultures for fungal organisms, including Aspergillus species, to determine whether fungi are present in the airways.

• Chest imaging, especially high-resolution CT scans, which can show patterns characteristic of ABPA such as central bronchiectasis or mucus impaction.

Taken together, these steps provide a much clearer picture of the underlying causes of a person’s bronchiectasis. Identifying ABPA, NTM, or fungal infections early can prevent worsening airway damage and allow for more targeted treatment. For many patients, this broader testing is the missing piece in understanding why their symptoms persist despite standard treatments.

​
]]><![CDATA[Why I Spent Black Friday Creating New BE CLEAR with Bronchiectasis Videos]]>Sat, 29 Nov 2025 12:17:58 GMThttps://www.letsbecleartoday.com/be-clear-blog/why-i-spent-black-friday-creating-new-be-clear-with-bronchiectasis-videosSome people spent yesterday, Black Friday, shopping for good deals. I spent the day making new videos for my BE CLEAR with Bronchiectasis YouTube Channel.
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I have a meeting with my technical consultant this week to post fresh content. If you’re a subscriber, you know I usually upload a long-form video every Sunday, plus a YouTube Short midweek.
​
If I’m being honest, this content creation would be a lot harder without that standing appointment. Knowing I’m going to meet with Tania keeps me accountable, and it pushes me to get the work done before we sit down together.

How Accountability Helps My Clients Too

I like to think that’s exactly what I provide for my private coaching clients. Help them stay on their chosen path to feeling better with BE.
​
When they know we’re going to meet, maybe they start paying closer attention to: ​
It is never about perfection. It is about momentum.

Your Invitation: Watch the BE CLEAR YouTube Channel

I’ve been posting for almost 2.5 years, and there are now more than 160 videos available.
​
Go to youtube.com/@BECLEARwithBronchiectasis to see what might interest you!
​

A Helpful YouTube Tip


If you scroll to the middle of the BE CLEAR YouTube channel, you will see playlists.
​
These playlists are groups of videos organized just like my book chapters, following the BE CLEAR Method: ​​

Your Invitation: Watch the BE CLEAR YouTube Channel

I’ve been posting for almost 2.5 years, and there are now more than 160 videos available. What I am most proud of is that this is an excellent resource for those in our bronchiectasis community who do not speak English, thanks to YouTube's translation feature!
​
Go to my BE CLEAR with Bronchiectasis YouTube Channel today!!

​

Start Now—Not After the New Year

Small, realistic steps support our health.
​
Don’t wait until after the New Year. Start NOW!



]]><![CDATA[Do Perfumes and Scented Candles Make You Cough?]]>Fri, 28 Nov 2025 21:17:39 GMThttps://www.letsbecleartoday.com/be-clear-blog/do-perfumes-and-scented-candles-make-you-coughNavigating holiday gatherings can be joyful, heartwarming, and at times a bit challenging if you are sensitive to fragrance. Most people never think twice about perfume or scented candles. ​
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Navigating holiday gatherings can be joyful, heartwarming, and at times a bit challenging if you are sensitive to fragrance. Most people never think twice about perfume or scented candles. But for those of us with asthma, bronchiectasis, or other chronic lung conditions and hypersensitive airways, strong scents can turn a celebration into an uncomfortable experience. 
​
Fragrance exposure can trigger coughing, chest tightness, or even an exacerbation. With a bit of preparation and open communication, you can enjoy the season while protecting your breathing and staying well.

How to Communicate With Your Host

If you are sensitive to scent, you can gently let your host know before the gathering. Share that you are hypersensitive to scented candles and perfume and that these products can make you feel unwell. Most hosts appreciate clear communication and want their guests to be comfortable.
​
Your host can then mention the scent sensitivity to invited guests or simply avoid using strongly fragranced items during the gathering. This is not being overly demanding. It is a small request that protects your health.

What to Do If You Arrive and Scents Are Already Present

If you walk in and notice a scented candle burning, it is appropriate to ask if it can be removed. A considerate host would far rather put out a candle than watch a guest feel miserable during dinner. A simple and warm request is all that is needed.

Is Bringing Your Own Air Purifier Appropriate

For some people, a portable air purifier is not optional. It is a tool that prevents symptoms and helps them breathe comfortably. If this describes your situation, bringing an air purifier to Thanksgiving is entirely acceptable.
​
The key is to let your host know in advance. A brief explanation, such as, I have a lung condition, and bringing a small air purifier helps me stay well, is usually enough. Hosts are often grateful for the clarity.

You Are Not a Killjoy for Protecting Your Health

People sometimes worry that asking for fragrance-free accommodations makes them appear difficult. The truth is that you are advocating for your well-being. You are not taking anything away from the celebration. You are ensuring that you can participate fully and comfortably.
​
A caring host wants you to feel well. They would never want a guest to become ill because of fragrance exposure.

​A Holiday Should Be Enjoyed, Not Endured

The holidays are meant to bring connection, comfort, and shared joy. If avoiding fragrances or bringing your own air purifier helps you remain comfortable and well, you are doing the right thing—your health matters. Communicating openly makes it easier for your host to support you.
​
Protecting your breathing is never rude. It is responsible and thoughtful. When you take care of yourself, you can enjoy the holiday with more energy, more calm, and more presence.
]]><![CDATA[Water and Ice Safety with Bronchiectasis]]>Wed, 26 Nov 2025 18:56:27 GMThttps://www.letsbecleartoday.com/be-clear-blog/water-and-ice-safety-with-bronchiectasisDo you ever laugh at yourself for not seeing the whole picture? I sure do. I remember hearing that some people with bronchiectasis and NTM are told not to drink tap water. 
Linda Esposito holding an ice tray and talking about taking precautions with water
I thought the issue was simply the bacteria in the water itself.

I had no idea that the real concern was how those bacteria could be aspirated into the lungs through reflux. That was a true deer-in-the-headlights moment for me.

At first, I handled the issue by boiling pot after pot of water. Then I moved on to buying jugs of bottled water, which took up precious real estate in our one-bedroom apartment. Eventually, I settled on the LifeStraw pitcher, which felt like a better long-term fit.

But what never crossed my mind was that the same concerns applied to ice. Ice trays, built-in refrigerator ice makers, and even refrigerator filters can harbor bacteria and biofilm.

Once I learned that, things clicked. Now I am much more cautious with ice, and when I visit my daughters, I skip the built-in ice and water dispensers. In restaurants, I rarely order drinks that come from taps, and I avoid water coolers because they can develop internal biofilm.

Looking back, I realize I probably was not ready to understand everything all at once. I needed the information to build slowly over time. And that is perfectly okay.
​
Sometimes it really can feel like too much until we baby-step our way into new habits.

]]><![CDATA[Maggie: Living with Bronchiectasis for over 30 years]]>Wed, 26 Nov 2025 17:09:41 GMThttps://www.letsbecleartoday.com/be-clear-blog/maggie-living-with-bronchiectasis-for-over-30-years“I am strong, I am resilient, I embrace gratitude for each breath I take.”

This is my daily meditation mantra, and it reflects the way I choose to move through life while living with bronchiectasis for more than 30 years.
Maggie Hart Art including picture of the lungs
I was diagnosed long before most people knew what this disease was or how to treat it. I have had two lobectomies and have faced every challenge bronchiectasis can bring. I continue to survive and thrive through determination, self-education, and fierce advocacy for myself.

A Life Built on Movement and Mindfulness

Exercise has always been my constant companion. I had an early intuition that making my lungs as strong as possible would help protect my health. I was a long-distance runner in my younger years. Now, at age 66, I practice yoga, meditation, and aerobic exercise several times a week. Movement keeps me grounded, focused, and emotionally steady.

Finding New Purpose Through Creativity

Before going on full disability due to BE, I worked as a Licensed Independent Clinical Social Worker. When that chapter closed, I turned to creativity. Art became my new way of expressing myself, first through watercolor and then through digital AI art.

I am now an award-winning watercolor artist and digital creator. Art continues to bring me presence, joy, and emotional release.
One of my greatest joys is creating AI images for children with cancer. I am part of a global Facebook community that sends artwork to pediatric cancer units around the world. It is one small way to offer comfort, connection, and imagination during the hardest moments. A mission that is very close to my heart.

Living with Bronchiectasis Not Defined by It

Bronchiectasis has not stopped me from living. It has given me a deeper sense of purpose. I embrace joyful moments, practice gratitude for every day of wellness, and create space for physical, emotional, and spiritual self-care. I am deeply grateful for this BE community. We share compassion, support, knowledge, and encouragement. It is so much easier to cope when we remember that none of us is alone.

Hope for the Future with Brinsupri

In August, with FDA approval of the first-ever treatment for bronchiectasis, I was grateful to be among the first patients to begin taking Brinsupri™. My early response was encouraging, with less lung inflammation and a surge of energy. I had to pause treatment because of an unrelated issue. I remain hopeful and excited to resume in the New Year.
]]><![CDATA[Pacing Ourselves During the Holidays]]>Sun, 23 Nov 2025 10:59:18 GMThttps://www.letsbecleartoday.com/be-clear-blog/pacing-ourselves-during-the-holidaysHaving bronchiectasis means pacing ourselves. It means showing up for the things we care about, but doing them in a way that respects our energy. ​
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It means offering to help, but choosing the parts we can do comfortably and at our own pace.

It also means conserving energy so we can enjoy the festivities too. And remember, you never have to overexplain yourself. The people who love and care about you do not need a manual to understand that you are doing your best.

As you plan and prepare for Thanksgiving and the upcoming holidays, keep this gentle reminder close.
]]><![CDATA[The Lung Microbiome and Why Your Voice Matters]]>Sun, 23 Nov 2025 10:43:44 GMThttps://www.letsbecleartoday.com/be-clear-blog/the-lung-microbiome-and-why-your-voice-mattersMention the word “microbiome” and my ears perk up. So you can imagine how excited I was to visit Dr. Leopoldo Segal’s laboratory at NYU Langone.
Linda Esposito visiting Dr. Leopoldo Segal's NYU laboratoryPicture
His team focuses on the lung microbiome, and much of their research involves identifying non-culturable microbes that live in the lungs and may influence whether or not we experience exacerbations.

Why I Joined the NYU Biobank

I am genuinely thrilled to participate in the biobank. Years ago, I signed off on them having access to my data and all bodily secretions. It was my way of contributing to science because I often do not qualify for clinical studies for bronchiectasis or MAC infections due to my low frequency of exacerbations.
​
Call me a little eccentric, but knowing that my data, sputum, and blood are now in their system and biobanks makes me feel proud.

Much more on this to come.

Why Patient Input Matters in Research

There are so many ways to get involved in research, whether by participating in a clinical trial or simply taking the time to complete surveys. I used to think those survey requests were a way for companies to sell my information to insurance companies. I was skeptical until I learned more.
​
Now I understand that the FDA requires patient input, which is why so many surveys exist. And when companies decide where to invest their research dollars, they rely on hearing from us to understand what the community truly needs.

Surveys Count as Research

So now, even when I am not feeling motivated, I still fill out the initial screening questions to see if I qualify for an interview or a detailed survey. That is also research.
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And that counts.

An Upcoming Research Opportunity for Our Community

After Thanksgiving, I will post an opportunity for our community to participate in a new survey.

I hope you will keep all of this in mind and fill out the preliminary information. And the good news is that we will be paid for our time. I firmly believe that all stakeholders should be on equal footing. Scientists are compensated for their time and expertise, and we should be too.

If you choose to donate your honorarium to charity, that is entirely your decision. What matters most is that we have a seat at the table and that our time is valued.
]]><![CDATA[FREE  2nd North American Bronchiectasis & NTM Conference Patient Education Program]]>Sun, 16 Nov 2025 20:11:17 GMThttps://www.letsbecleartoday.com/be-clear-blog/free-2nd-north-american-bronchiectasis-ntm-conference-patient-education-programThe 2nd North American Bronchiectasis and NTM Conference Patient Education Program will take place on December 1, 2025, and it is completely free to attend.
Bronchiectasis and NTM experts from North America
You can join in person at NYU Langone Health or participate virtually from anywhere. Many of our favorite bronchiectasis and NTM experts will be speaking, along with new voices who are helping shape the future of care, research, and patient support.
​
This annual event brings together leading clinicians, researchers, advocates, and patients for a full day of learning, connection, and practical guidance. Whether you are newly diagnosed or have been living with bronchiectasis or NTM for years, this conference offers valuable insights into clinical care, airway clearance, inflammation, genetics, environmental factors, and the latest research discoveries.

Why You Should Attend

This program delivers high quality education covering topics such as
clinical care networks, international data, global advocacy, NTM epidemiology, genetics, airway inflammation, guideline updates, and emerging clinical trials.
You will hear directly from respected leaders in the field, including:


Dedicated question and answer sessions give attendees the chance to hear expert perspectives on the issues that matter most.

Registration Details

Sign up now to hold your spot:
.nyulangone.org/care-services/bronchiectasis-ntm-program/ntm-patient-education-program

Interested in attending the professional conference virtually? ($399) 

​Contact Marla Hymes at
marla.hymes@nyulangone.org
212 263 5183

Agenda for December 1, 2025

9:30 AM
Registration
10:00 AM
Opening Remarks – Doreen Addrizzo Harris, MD
10:05 AM
US Clinical Care Networks – Doreen Addrizzo Harris, MD
10:15 AM
Canadian Database and Updates – Ted Marras, MD, MSc
10:30 AM
Updates from Latin America – Marcela Munoz, MD
10:45 AM
Global Awareness and Advocacy Initiatives – Timothy Aksamit, MD
11:00 AM
Epidemiology and The Environment with NTM – David Kamelhar, MD
11:15 AM
Question and Answer
11:35 AM
Break and Lunch
12:15 PM
Genetics in Bronchiectasis – Kenneth Olivier, MD, MPH
12:30 PM
Inflammation in Bronchiectasis – Anne O’Donnell, MD
12:45 PM
Guideline Updates – Ashwin Basavaraj, MD
1:00 PM
NTM Updates – Shannon Kasperbauer, MD
1:15 PM
Clinical Trial Update and Future Research Directions – Charles Daley, MD
1:30 PM
Question and Answer
1:50 PM
Closing Remarks – David Kamelhar, MD

Need to Make Changes to Your Registration?

Contact Marla Hymes at
marla.hymes@nyulangone.org
212 263 5183
Reach out if:
  • You registered for virtual attendance but now prefer to attend in person
  • You registered for in person attendance but now prefer to attend virtually

#bronchiectasis #NTM 

]]><![CDATA[Understanding the Link Between Reflux and Bronchiectasis]]>Mon, 10 Nov 2025 11:28:30 GMThttps://www.letsbecleartoday.com/be-clear-blog/understanding-the-link-between-reflux-and-bronchiectasisDid you know there’s an association between bronchiectasis and gastric reflux, as well as between NTM pulmonary disease and reflux?
PPIs, alginates and other reflux remedies
Now, more than ever, leading U.S. bronchiectasis care centers are focusing on the role of gastric reflux. If your care team hasn’t evaluated you for reflux, it’s worth discussing.

Why Reflux Matters

Managing reflux can be crucial to preventing disease progression. Airway clearance alone might not be enough to stop inflammation and infection.

Some individuals manage acid reflux with antacids, alginates, or medications like Pepcid. Others may need proton pump inhibitors (PPIs) such as Nexium or Prilosec to prevent precancerous conditions like erosive esophagitis or Barrett’s esophagus.

However, the goal is often to minimize PPI use because stomach acid is needed to break down food and kill bacteria. Long-term use of these medications can cause nutrient malabsorption and bone loss. And, according to gastroenterologist Dr. Jeffrey King, lowering acid does not decrease reflux. Surprisingly, it can increase non-acid reflux.

Silent Reflux and LPR

While PPIs reduce acid production, they do not stop reflux. There is a condition called silent reflux, also known as laryngopharyngeal reflux (LPR). This involves the reflux of solids, liquids, and gases that can be both non-acidic and acidic.

Substances such as water, milk, or bile, which are alkaline, can also reflux into the throat and voice, causing symptoms such as a sore throat, drippy nose, and hoarseness. Even though these substances are not acidic, they can still reach the lungs and potentially cause tissue damage, chronic inflammation, and disrupt the lung microbiome.

Steps You Can Take

If you have reflux, it’s important to take it seriously. Lifestyle changes can make a big difference:

  • Avoid eating several hours before lying down, exercising, and airway clearance
  • Elevate the head of your bed
  • Avoid trigger foods such as fatty foods, alcohol, caffeinated and carbonated drinks, and chocolate​
  • Manage stress and anxiety​

These habits can help reduce reflux episodes and improve overall well-being.

Always consult your physician before making any changes to your treatment plan. Together, you can find the best approach to manage reflux and support your lung health.
]]><![CDATA[Brensocatib (BRINSUPRI™): A Breakthrough for Bronchiectasis]]>Sat, 08 Nov 2025 21:07:42 GMThttps://www.letsbecleartoday.com/be-clear-blog/brensocatib-brinsupri-a-breakthrough-for-bronchiectasis“This multi-modality strategy has long been the standard for other chronic diseases, such as congestive heart failure, and bronchiectasis warrants an equally nuanced approach.” Dr PJ McShane
Dr. PJ McShane for the National Institute. of Health
In a recent editorial published by Dr. Pamela McShane of the National Institutes of Health (NIH), she describes brensocatib, now marketed as BRINSUPRI™, as a breakthrough for the bronchiectasis community. This first-in-class DPP-1 inhibitor marks an important step forward in reducing inflammation and exacerbations for people living with bronchiectasis.
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However, Dr. McShane emphasizes that it is unrealistic to expect one drug to meet every patient’s needs. Instead, she encourages both clinicians and patients to view BRINSUPRI™ as part of a broader treatment plan that includes mucoactive agents, airway-clearance techniques, and, when appropriate, macrolide therapy.

Where BRINSUPRI™ Fits in the Treatment Landscape

For individuals already receiving long-term macrolide therapy, adding BRINSUPRI™ may further improve outcomes by targeting inflammation through a different mechanism.

​For those living with nontuberculous mycobacterial (NTM) infections, where macrolide therapy may not be possible due to resistance concerns, a DPP-1 inhibitor such as BRINSUPRI™ could represent an alternative strategy to interrupt the ongoing cycle of inflammation, infection, and mucus dysfunction that drives bronchiectasis progression.

Evidence from the WILLOW Study

Dr. McShane referenced findings from a subgroup analysis of the WILLOW study, where participants with Pseudomonas aeruginosa infection experienced a significant reduction in exacerbations when treated with brensocatib compared with placebo.
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This suggests that BRINSUPRI™ could benefit patients with chronic bacterial colonization, one of the most challenging aspects of managing bronchiectasis.

The Importance of Multi-Mechanism Strategies

During her guest appearance at a Bronchiectasis and NTM Association support group, Dr. McShane reiterated that while DPP-1 inhibitors represent an exciting advance, they do not address every biological mechanism involved in bronchiectasis.
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She emphasized that future therapies must also target airway-epithelial health, mucus viscosity, and host-pathogen interactions to achieve long-term improvement.

Dr. McShane also compared this approach to the multi-modality treatments already used for other chronic diseases such as congestive heart failure. Bronchiectasis, she argued, deserves an equally comprehensive and individualized model that combines medications, airway clearance, exercise, and infection control for the best outcomes.
BRINSUPRI™ represents a long-awaited milestone, but it is only the beginning. The future of bronchiectasis management depends on integrated, multi-mechanism treatment plans that address both airway inflammation and mucus dysfunction, two central challenges of this complex condition.

Editorial Reference:

P.J. McShane. Are Dipeptidyl Peptidase-1 Inhibitors the Future Anti-inflammatory Treatment in Bronchiectasis? Archivos de Bronconeumología. DOI: 10.1016/j.arbres.2025.09.002
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