pseudomonas question

Melissa75

Administrator
So, despite searching on "pseudomonas" and "mucus color" in the forums and reading lots of past topics, and getting sad at seeing responses from people who have passed (but feeling grateful that their ideas and thoughts are still here), I still have a few questions. <br><br>Here's the background: I turned in sputum a couple weeks ago because I'd lost weight, was having night sweats and my lower left lobe felt bad--achy and stretched feeling. I also was on and off SOB and having trouble with my cardio workouts. My mucus was yellow vs. clear, but less quantity. <br><br>I fully expected the culture to come back normal and the my explanation for the problem would be a cold virus followed by inflammation from the fires we lit (dumb, never again) to keep warm during the loss of power from that East Coast snow storm. <br><br>What's so crazy is that I've felt much much worse--fever, chills, constant body and lung ache, copious dark green mucus--and had the culture come back normal. So, to have this gnawing discomfort come back as my first pseudomonas growth was a surprise. <br><br>Does what I described sound like your typical "caught-it-early" pseudo exacerbation? With weight loss and SOB/tightness being the main symptoms? <br><br>And after finishing a treatment for pseudo, do you typically do a repeat sputum culture to see if the growth is less or gone? I know most people with CF chronically have pseudo, but maybe when you (your child?) first started culturing it--did they check again? (My pulmo said there was no need to check my sputum unless I didn't feel better.)<br><br>Is sputum color a good indication for you? (For me it doesn't seem to be.) Maybe texture though. I agreed with someone in an old thread who noted a difference between jello texture vs. pudding, with the latter being bad.<br><br>Thanks!<br><br><br>
 

Melissa75

Administrator
So, despite searching on "pseudomonas" and "mucus color" in the forums and reading lots of past topics, and getting sad at seeing responses from people who have passed (but feeling grateful that their ideas and thoughts are still here), I still have a few questions. <br><br>Here's the background: I turned in sputum a couple weeks ago because I'd lost weight, was having night sweats and my lower left lobe felt bad--achy and stretched feeling. I also was on and off SOB and having trouble with my cardio workouts. My mucus was yellow vs. clear, but less quantity. <br><br>I fully expected the culture to come back normal and the my explanation for the problem would be a cold virus followed by inflammation from the fires we lit (dumb, never again) to keep warm during the loss of power from that East Coast snow storm. <br><br>What's so crazy is that I've felt much much worse--fever, chills, constant body and lung ache, copious dark green mucus--and had the culture come back normal. So, to have this gnawing discomfort come back as my first pseudomonas growth was a surprise. <br><br>Does what I described sound like your typical "caught-it-early" pseudo exacerbation? With weight loss and SOB/tightness being the main symptoms? <br><br>And after finishing a treatment for pseudo, do you typically do a repeat sputum culture to see if the growth is less or gone? I know most people with CF chronically have pseudo, but maybe when you (your child?) first started culturing it--did they check again? (My pulmo said there was no need to check my sputum unless I didn't feel better.)<br><br>Is sputum color a good indication for you? (For me it doesn't seem to be.) Maybe texture though. I agreed with someone in an old thread who noted a difference between jello texture vs. pudding, with the latter being bad.<br><br>Thanks!<br><br><br>
 

Melissa75

Administrator
So, despite searching on "pseudomonas" and "mucus color" in the forums and reading lots of past topics, and getting sad at seeing responses from people who have passed (but feeling grateful that their ideas and thoughts are still here), I still have a few questions. <br><br>Here's the background: I turned in sputum a couple weeks ago because I'd lost weight, was having night sweats and my lower left lobe felt bad--achy and stretched feeling. I also was on and off SOB and having trouble with my cardio workouts. My mucus was yellow vs. clear, but less quantity. <br><br>I fully expected the culture to come back normal and the my explanation for the problem would be a cold virus followed by inflammation from the fires we lit (dumb, never again) to keep warm during the loss of power from that East Coast snow storm. <br><br>What's so crazy is that I've felt much much worse--fever, chills, constant body and lung ache, copious dark green mucus--and had the culture come back normal. So, to have this gnawing discomfort come back as my first pseudomonas growth was a surprise. <br><br>Does what I described sound like your typical "caught-it-early" pseudo exacerbation? With weight loss and SOB/tightness being the main symptoms? <br><br>And after finishing a treatment for pseudo, do you typically do a repeat sputum culture to see if the growth is less or gone? I know most people with CF chronically have pseudo, but maybe when you (your child?) first started culturing it--did they check again? (My pulmo said there was no need to check my sputum unless I didn't feel better.)<br><br>Is sputum color a good indication for you? (For me it doesn't seem to be.) Maybe texture though. I agreed with someone in an old thread who noted a difference between jello texture vs. pudding, with the latter being bad.<br><br>Thanks!<br><br><br>
 

Havoc

New member
Well, let me see if I can help. The color of mucus isn't affected by bacteria, rather it's the neutrophils that the body sends to fight the infection. So, it's possible to culture a nasty looking sputum sample and it come back clean and vice versa.

My suspicion is that you've been colonized with PA for awhile and this is the first good culture you have been able to get.

Usually cultures are repeated post-treatment, but since CFers usually never totally get rid of anything, it's not the best indicator of a successful treatment regimen. Typically, cultures are obtained at every clinic visit, so it's more of a routine than a necessity and I agree with your doc's statement. Although, it is nice to see growth go from heavy to moderate or few. Weight, PFTs, feeling better and lack of excessive mucus production with cough are better indicators of a successful antibiotic course.

Mucus color is an indicator, but for most it's not the best. My best indicator is feeling tired. That's invariably my first symptom of an exacerbation, followed shortly by a productive cough (I don't normally have a chronic cough). Viscosity and consistency don't seem to be good indicators.

I hope this helps.
 

Havoc

New member
Well, let me see if I can help. The color of mucus isn't affected by bacteria, rather it's the neutrophils that the body sends to fight the infection. So, it's possible to culture a nasty looking sputum sample and it come back clean and vice versa.

My suspicion is that you've been colonized with PA for awhile and this is the first good culture you have been able to get.

Usually cultures are repeated post-treatment, but since CFers usually never totally get rid of anything, it's not the best indicator of a successful treatment regimen. Typically, cultures are obtained at every clinic visit, so it's more of a routine than a necessity and I agree with your doc's statement. Although, it is nice to see growth go from heavy to moderate or few. Weight, PFTs, feeling better and lack of excessive mucus production with cough are better indicators of a successful antibiotic course.

Mucus color is an indicator, but for most it's not the best. My best indicator is feeling tired. That's invariably my first symptom of an exacerbation, followed shortly by a productive cough (I don't normally have a chronic cough). Viscosity and consistency don't seem to be good indicators.

I hope this helps.
 

Havoc

New member
Well, let me see if I can help. The color of mucus isn't affected by bacteria, rather it's the neutrophils that the body sends to fight the infection. So, it's possible to culture a nasty looking sputum sample and it come back clean and vice versa.

My suspicion is that you've been colonized with PA for awhile and this is the first good culture you have been able to get.

Usually cultures are repeated post-treatment, but since CFers usually never totally get rid of anything, it's not the best indicator of a successful treatment regimen. Typically, cultures are obtained at every clinic visit, so it's more of a routine than a necessity and I agree with your doc's statement. Although, it is nice to see growth go from heavy to moderate or few. Weight, PFTs, feeling better and lack of excessive mucus production with cough are better indicators of a successful antibiotic course.

Mucus color is an indicator, but for most it's not the best. My best indicator is feeling tired. That's invariably my first symptom of an exacerbation, followed shortly by a productive cough (I don't normally have a chronic cough). Viscosity and consistency don't seem to be good indicators.

I hope this helps.
 

Melissa75

Administrator
Thanks, yes, that helps. The neutrophil thing makes sense, and I think my primary care dr explained it that way. Your suspicion that the pseudo has been in my lungs for a while makes sense with the 5% drop in FEV1 each yr for the past three years And then back when I was feeling more awful but my FEV1 was higher and steady, my infections seems to clear pretty well, though briefly, with Avelox--and I remember my pulmo saying that abx wasn't useful for pseudo. (Talk about that whole deductive guessing and medical science, and make sure you educate yourself concept. :)

So, I'll wait out the abs and see how I feel when they're done. And eat more. More greens. Sheesh, I already am the kale queen.
 

Melissa75

Administrator
Thanks, yes, that helps. The neutrophil thing makes sense, and I think my primary care dr explained it that way. Your suspicion that the pseudo has been in my lungs for a while makes sense with the 5% drop in FEV1 each yr for the past three years And then back when I was feeling more awful but my FEV1 was higher and steady, my infections seems to clear pretty well, though briefly, with Avelox--and I remember my pulmo saying that abx wasn't useful for pseudo. (Talk about that whole deductive guessing and medical science, and make sure you educate yourself concept. :)

So, I'll wait out the abs and see how I feel when they're done. And eat more. More greens. Sheesh, I already am the kale queen.
 

Melissa75

Administrator
Thanks, yes, that helps. The neutrophil thing makes sense, and I think my primary care dr explained it that way. Your suspicion that the pseudo has been in my lungs for a while makes sense with the 5% drop in FEV1 each yr for the past three years And then back when I was feeling more awful but my FEV1 was higher and steady, my infections seems to clear pretty well, though briefly, with Avelox--and I remember my pulmo saying that abx wasn't useful for pseudo. (Talk about that whole deductive guessing and medical science, and make sure you educate yourself concept. :)

So, I'll wait out the abs and see how I feel when they're done. And eat more. More greens. Sheesh, I already am the kale queen.
 
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