I've been debating on what my next topic would be for a couple of weeks, and I kept going back and forth between constipation, blue-light exposure and bronchitis. Raise your hand if you're sad I didn't go with constipation.....
None of you?
I don't believe it.
Blue-Lights will be next unless I get struck by a lighting bolt of inspiration for something different.
I got struck by the lightening bolt of buying up the whole dang Hobby Lobby in the month of November. My days off were filled with decorating my house permanently and seasonally. We've been in the house nearly 3 years and a lot of the decor we have had is rather ratchet. My husband (it's still weird to say that because how am I old enough and/or mature enough to have a husband??) says that I made the house look like adults live there and not college kids. LOL It took me a month, because for shopping and errands, I try to go out in public in very planned and strategic ways. I mentally map out my destinations to make a loop, and I try to time it for like 1pm - 3pm, because I hate traffic soooomuchOMG. I have fulfilled a short term goal of decorating for two holidays in a row. I am not a human that is gifted with the ability to pick things out in the store and properly envision them in my house, all "going" together. Lots of returns. Countless returns. This is stressful, but fun..
Topic for today is a thing that is stressful yet N O T fun: bronchitis. If you have never had bronchitis.... consider yourself #blessedandhighlyfavored
Bronchitis is this weeks long.......condition..... where your lungs morph into balloons made of sandpaper, that someone lights on fire, and then you cough every night for a whole 12 hour night shift for two weeks...or four, and sometimes you cough 'til you pee on yourself!
And then you cry.
And that is bronchitis. Or at least that's how it's been for me.... TWICE.
From the Cleveland Clinic:
"Bronchitis occurs when the bronchioles [pronounced: bronk-ee-oles] (air-carrying tubes in the lungs) are inflamed and make too much mucus...
Acute or short-term bronchitis is more common and usually is caused by a viral infection. Episodes of acute bronchitis
can be related to and made worse by smoking. Acute bronchitis could last for 10 to 14 days, possibly causing symptoms for three weeks...
I'm going to make the point of this blog right here and now. What would you think I'm going to say is the most important word in the definition of bronchitis provided above?
Mucus? No...Smoking? No...
VIRAL? DING DING DING!
Viruses. If you've been reading these blogs... "I'd like to thank my fans, without them none of this would be possible..." You now know that antiBIOTICS do not treat VIRUSES!
...and on the 3rd day (He rose again, in accordance with the scriptures....) when you present to the Urgent Care Clinic or your doctor's office, with a big ole hacking sandpaper lung cough, that you've had for 3 days...and you feel terrible and you say to him or her, "they normally just give me a cortisone shot and a Z-Pack to knock it out"... a little part of our souls die. That's right. Our souls die. A little more each day.
What's the trend here? OVER USE OF ANTIBIOTICS for $1,000, Alex. omgR.I.P. Alex Trebek. What a legend.
All of America has done 1 of 2 things in the Year of Corona. I feel like we're going to stop using B.C. and A.D. to record dates in history and start using A.C. - After Corona. We are in Year 0 A.C. America has either praised and worshiped the doctors, healthcare providers, and nurses of the world as living, breathing miracle workers... Or... you've ripped us to shreds like a cheetah on a baby deer because we are all just getting rich off of giving out drugs (this makes me wheeze-laugh). But then! Everybody wants to demand a z-pack and a steroid shot for every single runny nose and cough on the planet - which are largely caused by viruses (don't worry... pictures coming soon) and we KNOW this is wrong - but in order to keep you satisfied- we are "forced" to give in to your demands. Do y'all see the pickle we're in? Constant pickles.
Have I ever told y'all that for years, ever since I saw that movie with Will Smith where they turn into those white aliens with fangs because they contract a super-virus, that I have since believed that that is how the world will end? That is what I believe. Super-bugs will kill us all. So, in my day to day life - I do the very hard and painful work of rejecting your requests for antibiotics for symptoms you've had for less than 7-10 days. It's hard to be hated, but somebody's gotta do it.
*Trumpets are playing.*
*Curtains open.*
*The people are clapping.*
I can't find any graphics on google. LOL! What a buzz kill. I have been searching for a bout 4 hours at this point, and they just don't have what I want. I wanted a pie chart. And nobody made one. So y'all just gonna have to read words.
From Up To Date (the medical database that healthcare providers most commonly reference for clinical guidance and subject review):
Viruses — Viruses are the most commonly identified pathogens [germs] in patients with acute bronchitis [5-9]. In two case series [research studies], viruses accounted for about 60 percent of cases in which pathogens were identified [6,9]. The most common viral causes of acute bronchitis include [5,6]: ●Influenza A and B ●Parainfluenza ●Coronavirus types 1 to 3 ●Rhinoviruses ●Respiratory syncytial virus ●Human metapneumovirus
Other pathogens — Bacteria are uncommon causes of acute bronchitis, accounting for only 6 percent of cases in a single series evaluating adults hospitalized with acute bronchitis [6]. The bacteria most commonly associated with acute bronchitis include Bordetella pertussis [which most of us are vaccinated against], Mycoplasma pneumoniae, and Chlamydia pneumoniae [6,9,10]." (2)
Now. Lemme tell y'all what your Z-Pack WILL treat: Mycoplasma pneumoniae... "Mycoplasma" for short... guess what that is... "Walking Pneumonia". For this, I grant you, a Z-pack. And some steroids.......... if you've been coughing for 10-14 days or more LOL
Here's another one from the Annals of Internal Medicine. No, not anals. Annals. facepalm.
I'm going to break this paragraph apart and translate:
"The vast majority of cases (≥ 90%) of uncomplicated acute bronchitis have a nonbacterial cause... [self explanatory]
...microbiological [meaning looking at the germs under a microscope] study of uncomplicated acute bronchitis...[average adult that does not smoke or have chronic lung problems like COPD, lung cancer or fibrosis]...
...identifies a pathogen [we actually get a sample of your mucous in a variety of ways, send it to the lab, and we get a name to a face - we are able to identify a specific germ that is making you sick]...
in the minority of cases, ranging from 16% to 40% (17, 35-38)... [only 16-40% of the time, a pathogen can be identified. Because there are thousands of little viruses that just come and go, that can cause bronchitis, and they perhaps don't come back year to year, or they don't make you sick enough that we need to get a respiratory/sputum (phlegm) culture]...
...This variability is most likely due to the epidemic nature of agents that produce uncomplicated acute bronchitis and limitations in viral and bacterial identification techniques. [they come and go; you have to have mucous to spit up; or you are very sick and we stick a tube with or without a camera down your throat while you are asleep and get loogie.]....
...Specific viruses most frequently associated with acute bronchitis include those that produce primarily lower respiratory tract disease [in your lungs versus in your face]...
....(influenza B, influenza A, parainfluenza 3, and respiratory syncytial virus), as well as viruses that more commonly produce upper respiratory tract symptoms (corona virus, adenovirus, and rhinoviruses)...
...Unless bacterial superinfection is present (defined as pneumonia with an infiltrate on chest radiography), antibiotic treatment does not affect the clinical course of viral respiratory infections. [you had a viral bronchitis that became a bacterial one and you got way sicker, either because you also picked up this bacterial someplace else, or you went into the hospital and got it there]. (7)
WHEW. That was a lot.
What was the key line from all that?
"...antibiotic treatment does not affect the clinical course of viral respiratory infections."
You are going to get better without an antibiotic... 90% of the time.
Some of you smarty-pantses out there are looking at that 60% and saying... ummm what about the other 40% or even the other 10%?
Well SMARTY McSassypants - bronchitis also has NON-INFECTIOUS causes as well... like smoking! Dust inhalation. Chemical inhalation. Anybody ever worked or lived in or around sugar cane?? That is some mean air when sugar cane cutting season is happening, I tell you what!
And another thing McSassy, as far as the bacterial causes go... "To date, only Bordetella pertussis, Mycoplasma pneumoniae, and C. pneumoniae (TWAR) have been established as nonviral causes of uncomplicated acute bronchitis in adults. As a group, these agents are associated with 5% to 10% of all cases of uncomplicated acute bronchitis in adults." (3) What are the symptoms of bronchitis? Baaaaaaaaaby - If you ever had it - you know! But here's a cute picture.
A cough, deep, often painful, sometimes "productive" (producing mucous that you can spit out), but not always, COUGH is the cardinal symptom of bronchitis, and it will often be the patient's worst-ranked symptom. Steroids are indicated in bronchitis, because bronchitis is an inflammatory condition. Isn't that nice?
Symptomatic treatment, along with rest and staying super hydrated are the main modes of treatment. Look - you're going to feel bad for probably a couple of weeks.
You're going to be uncomfortable for a little while.
If you take an antibiotic for 7-10 days and you mysteriously get better during that time frame... guess what... you would have gotten better anyway. You can do it.
If you are coughing so much that you cannot eat, sleep, or you are peeing on yourself or throwing up - you need to be medicated for that. This is where you deserve cough syrups, tessalon pearles (a God-send), cough drops, humidifiers. All that good stuff.
What needs antibiotics?
A bronchitis that becomes a pneumonia - which you discover by having a visit to your friendly urgent care NP or family doctor, and getting a chest x-ray. If you have symptoms like abdominal pain, chest heaviness, fever >101.5, profound fatigue, whole-body symptoms likes weakness and aches, or even feeling confused - you need to be evaluated and medicated.
Just a reminder - just because your snot or phlegm is yellow or green does not mean you have a bacterial infection. This is #fakenews.
This is so fun!!! Click this link:
"Why so thick? Why so green?
When the white blood cells (your immune system cells) in the mucosa (the pink lining of your nose, mouth, eyes, etc.) encounter an irritant or infectious organism, they respond by producing enzymes to repel the invaders. These enzymes contain iron, and that’s what gives the nasal discharge the green color. And if the mucus sits around (as when you’re sleeping), it becomes more concentrated and so may appear darker yellow or green. This is the natural order of things, whether the offending agent is a virus (which is the most common cause of sinus infection) or a bacterium.
There are times when antibiotics should be considered. For example, antibiotics might be worth considering when
the infection drags on for more than 10 days, or if it gets worse after a week
the discharge is thick and uniformly white (that is, it looks like pus)
there is a high fever that isn’t improving
there are severe symptoms that do not respond to the usual over-the-counter sinus and cold remedies."(6)
Man, this was really gross. I am so passionate about "being the change I wish to see" when it comes to over use of antibiotics and inappropriate use of antibiotics for viral conditions. I hope my passion for this is evident. Listen, what difference does it make if you have to take an antibiotic for 10 days and wreck your gut (helloooo diarrhea) or if you have this respiratory thing that will go away on it's own in the same amount of time, and you're taking all the symptomatic meds anyway? Ya know?
Your BEST defense against bronchitis, pneumonia, colds, issssss... Prevention.
Wash your hands with soap and water before you ever touch your face, your contacts, your eyes or your mouth.
Clean your phone with a bleach wipe or whatever you believe in every single day!
Eat mostly fruits, vegetables, lean meats, and drink a lot of water.
Exercise your body - get your heart and lungs pumping.
Not to be a trigger puller or anything, but.... masks worn over noses and mouths are going to prevent a lot of these random viral illnesses, guys. Whether ya like it or not.
Hey, and uh, quit smoking!
We're all going to get sick sometimes. All we can do is our best. No. That's not all we can do. We can not take antibiotics all the time too.
The end.
:)
(1) https://my.clevelandclinic.org/health/diseases/3993-bronchitis
(2) https://www.uptodate.com/contents/acute-bronchitis-in-adults?search=bronchitis%20pathogen&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=1#H2989892354
(3) https://www.acpjournals.org/doi/10.7326/0003-4819-134-6-200103200-00021
(4) https://www.medicalnewstoday.com/articles/327258
(5) https://www.medicalnewstoday.com/articles/327431
(6) https://www.health.harvard.edu/blog/dont-judge-your-mucus-by-its-color-201602089129
(7) https://www.acpjournals.org/doi/10.7326/0003-4819-134-6-200103200-00021