What am I doing wrong? How to get a good sputum specimen for a culture

Can I ask you what kind of 'wedge' do you use and how do you place it. I'd like to start postural drainage but don't know where to begin. Many thanks.

Hi @blixtentoo, Link below for wedge I use. In addition to wedge, we also put head of bed up on some blocks. Both of these together have helped my reflux. Honestly, the wedge alone was not enough. Now the sleeping angle is somewhere between 28-30 degrees. Those maneuvers (wedge and blocks) were an attempt by hubby to avoid purchasing an adjustable bed. That said, we do have an adjustable bed in guest room which I occasionally use for postural drainage.

It's sensible to know where the bronchiectasis is in your lungs so you can target that area with the correct PD position. Theoretically, your pulmonologist will review scan with you and point out the areas to focus on.

What I do is hoist up my hips with bent knees up on the wedge (or fully raised foot end of adjustable bed). This creates a slope for me when I lie down. Right side then left side. I do this after upright autogenic drainage (AD app) and lying down flat. It takes a lot of time especially in the morning. It's very much a drag and my hope is that some of the future medications will either 1) decrease the mucus and/or 2) help the mucus come up in less time. Hope springs eternal!

I've read that some also use inversion tables for postural drainage. Maybe that would hasten things? Some people use folded blankets on the floor to create a slope. It takes some fiddling to figure out what works for you. It seems to me that a simple collapsible cot like bed could be designed with a downward slope.
https://relaxtheback.com/products/contoursleep-side-sleeper-bed-wedge?_pos=2&_sid=3bb772ad3&_ss=blixtentoo

@lilianna It depends on the day if I use an albuterol inhaler or levalbuterol via nebulizer. They have both been effective for me. For sputum culture I try first thing in the morning after taking a glass of water and mucinex and the neb routine. Please keep in mind that I have had bronchiectasis for some time and have not tested positive for NTM etc so far. With airway clearance twice daily I am trying to keep it that way.

After watching Dr. Shane's video on airway clearance I have eliminated the aerobika during the saline neb, so inhaling directly into my lungs and not through the aerobika. So much better and the gunk comes up easier. In fact I have eliminated the aerobika from my routine altogether. (Amen one less item to clean/sterilize). Instead, I use well controlled breath holds and releases and postural drainage. After upright and lying down autogenic drainage, I position myself on my sleeping wedge on each side to create a downward slope for anymore gunk to drain. It takes a few breath holds, squeezes and the gunk moves down and out. I hope this helps you somehow.

If you continue to have issues with not being able to get a sample, how about trying 2 vials of saline in a row?

I have had success nebulizing 2 vials (4cc each) of 7% saline to increase what I cough up. To deal with the oropharyngeal contamination, I keep start with 2 glasses in front of me, one empty and one with sterile water. Before I cough each time, I rinse my mouth with the sterile water and spit in the other glass. This routine has gotten me acceptable samples. I was intimidated for a long time by the requirement for submitting at least 5 cc, but I found that if the sample was good quality, they would process a smaller sample.
Good luck!

I tried postural drainage several times for about 10 minutes and nothing happened. How long does it take? I am discouraged because I only get white stringy mucous up sometimes with little white chunks.
I have only gotten the one viable sputum test out of 3 attempts.
I do autogenic drainage and the aerobika. All suggestions welcome.

@sallyb827 The correct angle slope is important with postural drainage, and it depends where your bronchiectasis is. Morning works best for me as mucus has pooled overnight and there seems to be more of it then.

Some have success with their bottom part on a sofa and head/neck supported by a pillow on floor. Or stack blankets on the floor. Or use the foot of an adjustable bed. Or inversion table.

Experiment with lying on your left, right and back sides. Personally, I find active cycle of breathing easier to do when inverted as it's a bit quicker than AD. If mucus is really stubborn try 2 vials of 7% sodium chloride in nebulizer before postural drainage proceeded by a bronchodilator. Avoid eating/drinking 2 hours before inverting yourself especially if you have reflux. Hope this helps you. It's all so frustrating!
https://bronchiectasis.com.au/physiotherapy/techniques/the-active-cycle-of-breathing-technique