For me, educating people about bronchiectasis isn’t just about explaining the disease—it’s also about advocating for early diagnosis. The sooner people receive the right care, the better their outcomes.
That’s why I actively share insights on LinkedIn, where I’ve built a strong community of over 8,000 connections, including many respiratory therapists and clinicians. Engaging with this network is another way I advocate for early detection, ensuring that more people recognize the signs of bronchiectasis and get the care they need as early as possible. ⭐️⭐️This is my latest LinkedIn post:⭐️⭐️ There are people who have bronchiectasis (BE) and also have asthma and/or COPD. However, according to Dr. Charles Daley, one of the top BE and NTM doctors in the world, there are others who are incorrectly diagnosed with asthma or COPD when, in fact, they have bronchiectasis. As he recently said: (This transcription may contain minor errors.) “I would go out on a limb here and say, even though I can’t prove this point, I think most people with bronchiectasis have never been diagnosed, because to get diagnosed, the clinician, the provider, has to order a CT scan. And if you don’t do that, then they’re going to just say your chronic cough is asthma, or it’s COPD, or as allergies is something else, but until you get the chest CT, you can’t see the dilated airways. And once you do that, then you can call this bronchiectasis. There are many paths that lead to the condition bronchiectasis, but the symptoms are really what should drive the thinking about bronchiectasis. So a person has a chronic cough for months, often it’s producing sputum. They often have recurrent infections, and we call those exacerbations… So those are the things that should key the clinician to say, maybe this isn’t asthma. Maybe I should get an imaging study and figure out if this is bronchiectasis.” Respiratory therapists: If you’re working with patients who are coughing, have sputum and are not improving on their current treatment, they might have bronchiectasis. Please bring it to the attention of your team physician. New bronchiectasis treatments are in the pipeline with some becoming available this year. These treatments could greatly improve the quality of life for your patients. #RespiratoryCare #PulmonaryHealth #RespiratoryTherapist #Bronchiectasis #NTM #Asthma #COPD
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For the first and only time in 2025, I’m offering 10% off all my services for February—or until my schedule is fully booked. This won’t happen again this year‼️
Even at my regular rates, the value I provide is significant—which is why I don’t offer discounts often. When you book an initial consultation, here’s what you get: ✅ A detailed review of your questionnaire responses before we meet. ✅ A 75-minute deep dive into your concerns. ✅ A personalized set of resources curated just for you. But it doesn’t stop there. Once you become my client, you’re not just getting a one-time consultation—you’re gaining a trusted partner in your bronchiectasis journey. Who Am I? I’m Linda Cooper Esposito, MPH—Yale-educated, highly experienced, and fully dedicated to helping people with bronchiectasis live better lives. I currently work exclusively with bronchiectasis clients, and my LinkedIn recommendations span over a decade. Most importantly, I’m a good listener. Managing bronchiectasis isn’t one-size-fits-all, and I take the time to understand your lifestyle, your goals, and your challenges—no cookie-cutter templates. What I’m Not: ❌ I’m not ‘Coach Linda.’ I use my full name because I stand behind my work with credibility and integrity. ❌ I’m not a clinician, and I don’t give medical advice. Instead, I empower you with knowledge so you can make informed decisions with your healthcare team. ❌ I’m not here to judge. I support you, encourage best practices, and help you navigate your health—without shame or pressure. Ready to Get Started? Whether you’re booking for the first time or returning as a client, this is your chance to lock in my only all-services discount of 2025. Here’s how to book: 1️⃣ Visit LetsBeClearToday.com (link in bio) 2️⃣ Go to the Consultation page 3️⃣ Select a service and complete your booking https://www.letsbecleartoday.com/store/p2/Comprehensive_75_minute_consultation.html?#/ Once you book, I’ll personally reach out to schedule our Zoom or phone session—whichever you prefer! ‼️ Important: This is my only site-wide discount in 2025. Buy now, use it whenever—your purchase has no expiration date! Let’s connect and take the next step together! #Bronchiectasis #BronchiectasisCoach #NTMLungDisease #MACLungDisease #BeProactive #BeClearMethod https://www.letsbecleartoday.com/store/p2/Comprehensive_75_minute_consultation.html?#/ This year we anticipate having the first-ever FDA-approved treatment for bronchiectasis—brensocatib.
Many have asked me about the criteria for brensocatib eligibility and it remains uncertain. The FDA will ultimately determine who can access it, whether by restricting it to high-risk populations or allowing clinicians more discretion in prescribing it. For the clinical trial, participants had to be classified as frequent exacerbators—those experiencing two or more exacerbations per year requiring antibiotics. But that was just the trial’s criteria. Going forward, clinicians will most probably ask for an open policy that will allow them to determine who might benefit most. After all, the mechanism of brensocatib in bronchiectasis is to reduce inflammation—and inflammation is at the core of this disease, regardless of exacerbation frequency. In fact, many of us experience significant symptoms even without frequent exacerbations. So it stands to reason that reducing symptoms would improve quality of life and be a major benefit to our community. Does this give you hope? Are you someone who likes to try new treatments right away, or do you prefer to wait, see how others respond, and then decide? www.letsbecleartoday.com #Bronchiectasis #brensocatib #clinicaltrials #AspenStudy #exacerbations #flareups #hopeisintheair Living with bronchiectasis means walking a tightrope. Every single day, we’re managing so much: airway clearance, equipment sterilization, battling fatigue, and still trying to live a full, vibrant life.
It can feel like a lot - because it IS a lot. But here’s the truth: we’re not alone in this journey. Each of us is trying to find that delicate balance between being vigilant about our health and actually ENJOYING our lives. Some days that balance feels impossible, and other days? We proudly hit all our marks. Right now, there’s frustratingly little scientific research about our daily self-care practices. How do we really sterilize equipment? What’s the best approach to drinking water or showering? We’re often left piecing together advice from manufacturers, healthcare providers, and our own community’s shared experiences. My advice? Listen to your body. Follow your device instructions carefully. Talk to your medical team. And most importantly - be kind to yourself. If you’re someone battling frequent infections, you’ll naturally be more cautious. If infections have been rare for you, you might take a more relaxed approach. But no matter where you are on this journey, remember: we’re in this together. ❤️ #BronchiectasisWarrior #ChronicIllness #SelfCare Wouldn’t it be wonderful if there were only one way to do airway clearance? The truth is, there isn’t—and that’s okay. In fact, airway clearance is highly individualized, and as much an art as a science.
At every professional bronchiectasis conference I’ve attended, the message about airway clearance has been consistent: it should be taught by a respiratory professional and tailored to each person.Unfortunately, many people don’t have access to specialized education. While progress is being made, we’re not there yet. In the meantime, peer education and webinars have become invaluable resources. A frequent topic in these discussions is the use of devices like the Ombra compressor with AeroEclipse nebulizer cups. One advantage of this system is that the nebulizer cup can connect directly to an Aerobika OPEP (Oscillating Positive Expiratory Pressure) device. This combination is taught by National Jewish Health in Denver, Colorado—a leading lung hospital. Their method involves inhaling medicated mist and exhaling into the Aerobika, which creates lung vibrations. They believe this helps the saline mist penetrate deeper into the airways. Alternatively, specialists like Dr. Pamela McShane recommend a different sequence: nebulizing first to coat the airways with saline, followed by tools like the Aerobika, vibration vests, or breathing techniques to mobilize mucus. So, which method do I use? It depends. If I have plenty of time, I’ll nebulize first. If I’m in a hurry, I’ll attach the nebulizer cup to my Aerobika to save time. The key takeaway is that airway clearance isn’t one-size-fits-all. We shouldn’t compare ourselves to others or feel like we’re doing something wrong if one technique doesn’t work for us. One tip from experts: avoid exhaling too forcefully or coughing harshly to expel mucus. Doing so can cause floppy airways to collapse, making it harder to clear our lungs. Instead, aim for slow, steady breaths—easy does it. Do you have a preferred method? Share your experience below! (BE CLEAR has a consulting relationship with Monaghan Medical) #bronchiectasis #airwayclearance #removingmucus #phlegm #sputum #nebuliser #Aerobika Keep your devices functioning properly, make de-scaling a monthly habit!
How to De-Scale Your Equipment: ✔️ Soak the disassembled device in a 50/50 solution of white vinegar and water for 1 hour ✔️ Wash and disinfect as usual Important: De-scaling is not the same as sterilizing—vinegar only provides low-level sterilization. ✅ Bonus Tip: Don’t forget to check your compressor filter—it may be time for a change! Check out my YouTube channel for helpful airway clearance videos: https://youtube.com/playlist?list=PLYv0bQel-IptGJS3KoAuOsyt7ia0_AkBW&si=jr5A0b1LvwkkDRmk Don’t forget to subscribe to my YouTube channel for more tips‼️ (Consulting relationship with Monaghan Medical) #Bronchiectasis #AirwayClearance #Aerobika #Acapella #Nebulizing #Nebuliser #Nebulizer After my recent post about joining clinical trials, so many of you have shared your incredible experiences with me—it’s been truly inspiring!
Below is a summary of observations, highlighting a common consensus: a lot can be learned about a company by how they treat their patient advisors and clinical trial participants. Their approach reflects their values and commitment to patient-centric care. Key indicators of respect and care: ⭐️Responsiveness: How quickly and thoughtfully they respond to emails and address participant concerns. ⭐️Fair Compensation: Whether participants are compensated fairly, transparently, and without unnecessary delays. ⭐️Transparency in Adverse Situations: In cases where a clinical trial is terminated early—due to the drug not performing as expected or causing significant side effects—whether participants are promptly informed with honesty and clarity. Clinical trials are more than just data collection; they’re about building relationships. Participants should feel like valued members of a team—one that genuinely appreciates their contributions. When companies acknowledge the burden of living with a disease and treat participants with respect, it fosters trust, loyalty, and a shared sense of purpose. This patient-first approach not only encourages continuing participation but also creates a supportive environment where individuals feel hopeful about their future. It’s about demonstrating that every participant matters—not as a statistic, but as a person. #ClinicalTrials #PatientCare #Pharmaceuticals #PatientAdvocacy #ResearchEthics Did you know there’s an association between bronchiectasis and gastric reflux, as well as between NTM pulmonary disease and reflux?
Now, more than ever, leading U.S. bronchiectasis centers are focusing on the role of gastric reflux. If your care team hasn’t evaluated you for reflux, it’s worth discussing. Why? Because managing reflux can be crucial to preventing disease progression. Airway clearance alone might not be enough to prevent 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. Additionally, long-term use of these medications can cause nutrient malabsorption and bone loss. It’s important to note that while PPIs reduce acid production, they do not stop reflux. There is a condition called silent reflux, also known as laryngopharyngeal reflux (LPR), which involves the reflux of solids, liquids, and gases that can be both non-acidic and acidic. Substances like 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. Despite not being acidic, these substances can still get into the lungs, potentially causing tissue damage, chronic inflammation, and impacting the lung microbiome. That’s why it’s important to take reflux seriously if you have it. Lifestyle modifications, such as not eating several hours before lying down, elevating the head of your bed, and weight loss if you’re obese, can help reduce reflux episodes. Always consult your medical team before making any changes to your treatment plan. ⭐️ Feel free to share! ⭐️ #Bronchiectasis #MACLungDisease #NTMLungDisease #ChronicCough #AcidReflux #Reflux #GastricReflux #ThroatClearing #Mucus #Phlegm #PostNasalDrip #Hoarseness Treating someone empirically means providing medical treatment based on clinical judgment and educated guesses rather than waiting for definitive diagnostic evidence. This approach is often used when immediate intervention is important, such as starting broad-spectrum antibiotics for a suspected infection before identifying the exact pathogen. Once more diagnostic information is available, the treatment can be refined to target the confirmed cause more accurately. During a recent exacerbation, despite five days of increased airway clearance, I was still feverish and unwell. I saw a nurse practitioner at my pulmonologist’s office, provided a sputum sample on a Wednesday, and received the results the following Monday. Thankfully, I had already started antibiotics and was feeling much better by then. Interestingly, none of the major bronchiectasis pathogens were found in my sputum. This might seem puzzling, but it’s important to understand that a sputum analysis screens for a panel of bacteria. The absence of a major pathogen doesn’t rule out less virulent bacteria that could disrupt the lung microbiome and cause inflammation or infection. While reviewing my medical files, I found my 2018 bronchoscopy report identifying Neisseria as “non-pathogenic.” However, research by Dr. Sanjay Chotirmall, which I discussed in a September 2022 post, suggests Neisseria subflava can be a determinant of more severe bronchiectasis in some patients. I shared my bronchoscopy report discovery with Dr. Leopoldo Segal during the North American Bronchiectasis and NTM professional conference. He seemed very interested, as much of his research focuses on the interplay of bacteria, fungi, and viruses in the lung microbiome. I took the opportunity to invite myself to his laboratory at NYU Langone this spring. I look forward to my visit and sharing his exciting research with everyone!! #Bronchiectasis #LungHealth #EmpiricalTreatment #Microbiome #Antibiotics We express a strong desire for new treatments for bronchiectasis and NTM Lung Disease, yet during a webinar with Dr. James Chalmers, a surprising revelation emerged. When patients were polled, only a small number said they had participated in research or would be willing to.
WOW! Is it just me, or does this seem like a disconnect? Certainly, there are good reasons why someone might not want to participate in a clinical trial. However, for those who meet the criteria, I ask that they remain open to discussing participation with their doctor. Dr. Anne O’Donnell at the recent North American BE/NTM Patient Conference, emphasized the importance of participation in research. (The following is a transcript and may contain minor errors): “Everything we did 10-15, years ago was …taken from the cystic fibrosis bronchiectasis knowledge. But it turned out that a lot of these that work in cystic fibrosis bronchiectasis actually don't translate well to non-CF disease. So, fortunately, now we're in the era of new development for bronchiectasis. Some of the drugs are truly novel. Some of them are actually repurposed drugs…old drugs that are being looked at specifically for this disease. It takes a lot of time to develop a drug and a lot of money, and generally, from the (inception) it takes about five years to bring it to a clinical trial, and then those clinical trials usually take up about six years and then if the drug has a positive trial, it has to be evaluated by the FDA and the regulatory agencies around the world and that can take several years. This all takes a lot of money and that's why it's not like we have late breaking drugs every year…(We) want to know that the drug is safe and effective, we want to know that the new therapeutic makes patients feel better, function better and survive better. So, it's a big hurdle to get a new drug and we're fortunate right now that things are in the pipeline and even close to completion.” With this in mind, the next time you have the chance to complete a trial survey or participate in a clinical trial, please consider it. Your involvement could be a crucial step toward discovering new treatments.✨✨ #bronchiectasis #clinicaltrials #MACLungDisease |
AuthorLinda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease. Archives
February 2025
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