Diagnosed with pseudomonas aeruginosa infection in my lungs

All this understanding of our lungs is a process, a long road. I do not mean to complain, but the doctors do not take their time to educate us. National Jewish Hospital is new to me as of this past November 2023, and they are the ones who started to educate me with their respiratory therapy department. I began incorporating the SmartVest at the end of this January 2024.
I only began consistent airway clearance in December 2023 with the Aerobika and saline 7% or sometimes I use saline 3 % with the AeroEclipse and Ombra compressor. My bronchiectasis was diagnosed ten years ago at which time I would only need albuterol in the nebulizer when I was sick with a chest infection, and my husband did manual palpitations for me and I steamed if I got really blocked up with mucus.
I only ever took antibiotic if I got a chest infection, except for the few times when I coughed up blood and my doctor put me on antibiotic as a precaution.
I believe most all of us will have a different story with our lung condition. I am now 76 and seems my bronchiectasis has progressed, so I am thankful that National Jewish accepted me as a patient four months ago.
I didn't do much to stop the bleed out in the 1990's, just saw the doctor right away who couldn't do anything unless I started bleeding again, and rested and coughed as little as I could and the blood clotted and after a week I was okay, just frightened it would happen again, but it didn't for many years later.
I do yoga and breathing exercises to keep me fit and walk my dogs most every day for 40 to 45 minutes, weather permitting. I only take multivitamins as well as Vitamin D and Vitamin C but not every day.
I belong to a national forum that meets for a Zoom coffee break the 2nd Wednesday of each month. It is helpful in many ways, the support and camaraderie we have; the guest speakers, some from Mayo Clinic, some from National Jewish, and other health professionals. Anyone can join. Here is the information:
Bronchiectasis and NTM Initiative
http://www.bronchiectasisandntminitiative.org
I would be happy to answer any questions you have.
Best wishes

Sweethighland, I just posted a comment in reply to your questions of Feb 19, '24. As I'm not good with the computer my reply to you went to connect.mayoclinic.org. I hope you received it.
Happy2023

Apologies in advance for a long-winded response:
While I have not personally had pseudomonas in my lungs, I've been battling a very rare multi-strain pseudomonas infection within my skin, primarily my face, sinuses, and underarms. No clue how or where it came from, and it has kept me in and out of the hospital due to sepsis for over a year. However, duri g one particularly nasty reoccurrence of the infection that engulfed my eye sockets and swelled my nose 3x its width, I began reading a ton of academic research papers, desperate to find a better treatment for it than zosyn +vanco (previously on it for 6weeks straight, cleared up, but returned within days of stopping antibotics). I worried it (and still do) would spread to my lungs, so I searched for effective treatment for that particular presentation. Of particular interest was the efficacy of adding Tobramycin to typical IV antibiotics used to treat pseudomonas. in cases of pseudomonas infection in the lungs, adding Tobramycin in many cases to IV antibiotics reversed the resistance of pseudomonas and cleared the infection. Tobramycin as a standalone treatment did not achieve this, however.
I essentially begged the ER doctor to consider this, and to my surprise, he was open to it. After one round of Tobramycin + zosyn + vancomycin, the swelling went down significantly on my face - I could open my eyes fully, I could open my mouth to bite into a sandwich, and my nasal passages began to appear normal (upon getting to the ER, I looked as if I was Shrek beaten by a baseball bat). The burning and oozing and pain started to relent.
It was a miracle for me. Unfortunately, after being admitted fully to the hospital, the ID doctor was clueless, stopped the treatment after 36 hours, discharged me on oral antibiotics, and all five strains of bacteria I had from the first hospitalization returned in a culture. I've been rehospitalized 5 times since then, unsuccessful in convincing any ID doctor to restart what was a miracle combo for me that saved my life. If any of your docs are like mine (Cleveland Clinic), you can expect resistance. However, in my case If they stayed with the regimen, theres no doubt I'd be cured. if you or someone close to you is excellent at advocating for your care, it's definitely something to ask about.

Tobramycin along with a beta lactam antibotic had a key synergistic effect. Essentially, it broke the outer membrane of the pseudomonas (even in cases where the strains were resistant to beta lactams), which allowed the beta lactam/other antibiotics studied to destroy the pseudomonas
They found a huge reason for why Tobramycin is synergistic and in many cases seems to reverse antibotic resistance mechanisms of pseudomonas is because it's excellent at destroying the outer membrane of the bacteria which allowes for the beta lactams/other antibiotics studied to circumvent the efflux pumps and other mechanisms that make pseudomonas resistant to monotherapies or previous antibiotic combinations.
I can't find all of the papers, however, you should be able to find these two by copying and pasting them into Google. I printed them and handed them to the ER doc, highlighting the Abstract section since that's basically all they're going to need to know/ read, assuming you're lucky to get a doctor willing to do so:

"Two Mechanisms of Killing of Pseudomonas aeruginosa by Tobramycin Assessed at Multiple Inocula via Mechanism-Based Modeling,"Jürgen B. Bulitta et al., April 2015.
"Resistance Emergence Mechanism and Mechanism of Resistance Suppression by Tobramycin for Cefepime for Pseudomonas aeruginosa," G. L. Drusano, Robert A. Bonomo, et al., Antimicrobial Agents and Chemotherapy p. 231–242, (2011).
I pray whatever your situation, you are cured quickly!
Kindest regards,
Tiffany

Oh I forgot to mention, they also make tobramycin in an inhalable form to directly target the lungs which might help further explain why it's effective as adjunctive treatment

Thank you.