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Some people spent yesterday, Black Friday, shopping for good deals. I spent the day making new videos for my BE CLEAR with Bronchiectasis YouTube Channel.  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 TooI 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 ChannelI’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 TipIf 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 ChannelI’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
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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.  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 HostIf 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 PresentIf 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 AppropriateFor 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 HealthPeople 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 EnduredThe 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. Do 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.  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. “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.  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 MindfulnessExercise 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 CreativityBefore 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 ItBronchiectasis 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 BrinsupriIn 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.
Having bronchiectasis means pacing ourselves. It means showing up for the things we care about, but doing them in a way that respects our energy.  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. Mention 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.  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 BiobankI 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 ResearchThere 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 ResearchSo 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. And that counts. An Upcoming Research Opportunity for Our CommunityAfter 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. The 2nd North American Bronchiectasis and NTM Conference Patient Education Program will take place on December 1, 2025, and it is completely free to attend.  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 AttendThis 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 DetailsSign 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 [email protected] 212 263 5183 Agenda for December 1, 20259:30 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
[email protected] 212 263 5183 Reach out if:
#bronchiectasis #NTM 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 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 MattersManaging 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 LPRWhile 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 TakeIf you have reflux, it’s important to take it seriously. Lifestyle changes can make a big difference:
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. “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  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. 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 LandscapeFor 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 StudyDr. 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. 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 StrategiesDuring 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. 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
A recent Good Morning America segment introduced millions of viewers to bronchiectasis, a chronic lung condition that affects about 500,000 Americans.  Many people, including the woman interviewed, had never heard of it until diagnosis. What began as what she thought was pneumonia or a cold turned out to be a serious and progressive inflammatory disease that can cause ongoing coughing, shortness of breath, and fatigue. What Is Bronchiectasis?Bronchiectasis is a non-contagious chronic lung disease where the airways become widened and damaged, making it difficult to clear mucus. This creates a cycle of infection and inflammation that can worsen over time if untreated. Because its symptoms often resemble asthma, COPD, or chronic bronchitis, many patients go years without a correct diagnosis. Common symptoms include:
Living with Bronchiectasis“That tiredness, it’s like you really can’t do the things you want to do, even simple things around the house.” The GMA story described how bronchiectasis impacts both daily life and emotional well-being. Weather changes, fatigue, and infections can limit social activities or even make leaving home difficult. Over time, many people find that managing energy levels and incorporating airway clearance into daily routines becomes a key part of staying healthy. The Importance of Early DiagnosisOne of the biggest takeaways from the Good Morning America feature is that bronchiectasis is often misdiagnosed or missed altogether. If you experience a chronic cough lasting a long time, or two or more respiratory infections in a year, ask your doctor for a chest CT scan and referral to a pulmonologist. Early diagnosis helps prevent further lung damage and allows for timely treatment, including antibiotics, airway clearance therapy, and lifestyle support. Managing the ConditionThere is currently no cure for bronchiectasis, but it can be managed successfully. A comprehensive plan may include:
Why Awareness MattersResearch organizations and sponsors such as Insmed are studying bronchiectasis and related infections like NTM (nontuberculous mycobacteria). Their work, combined with patient education and advocacy, is helping to change how this condition is recognized and treated. Public awareness ensures that more patients receive proper testing and care before irreversible damage occurs. Moving Forward Bronchiectasis may be chronic, but it does not define those who live with it. Education, early detection, and community support are essential to improving quality of life.
Learn more about evidence-based strategies and resources at BE CLEAR with Bronchiectasis and watch step-by-step educational videos on the BE CLEAR YouTube Channel. To watch the Good Morning America segment click here. |
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
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