Chicken or the Egg?

I have two diseases–bronchiectasis (BE) and a Mycobacterium Avium Complex (MAC-LD) lung infection. Both were considered rare, but with increased medical professional education and the use of High Resolution CT scans, BE is being diagnosed more frequently than in the past. However, a MAC infection is rare. These bacteria are everywhere in our environment and it is unusual for them to cause disease.

When people are diagnosed with both bronchiectasis and a MAC infection at the same time, which is my situation, doctors frequently say that it is a “chicken or the egg” situation. Did the bronchiectasis damage and inflammation allow the MAC to set up shop in the lungs or did the MAC infection cause the BE?

Some answers to this question can be found in a person’s medical and lifestyle history. For example, having pneumonia or bronchitis might have caused the scarring in the lungs, the bronchiectasis. A deeper dive might uncover genetic causes and in some cases, these underlying conditions might be treatable.

Although in my case nothing is certain, I probably got the BE from a bad pulmonary infection in my mid-50s that led to inflammation and a welcoming environment for MAC. As I said, MAC is ubiquitous–it is in the soil, water and air. At one point, my husband and I moved out of Manhattan to upstate New York. I had a huge flower garden during the eight years we lived there and spread heaps of mulch and soil. MAC loves mulch and because it is fluffy and easily airborne, it can find its way into the lungs and for some people, cause disease.

In my recently published book, “The BE CLEAR Method to Living with Bronchiectasis” https://amzn.to/333htls I mention my double-whammy diseases but focus on bronchiectasis. This was a deliberate choice as there are many people who have BE and will never get MAC or any Nontuberculous Mycobacterial (NTM) infections.

At the same time, I feel I should talk about it so that people, if they so choose, can minimize their risk with simple solutions such as wetting soil to prevent dust and wearing a mask while gardening.


#bronchiectasis #NTMLungDisease #maclungdisease