Welcome, Joanna, to our group. When you are first diagnosed with MAC, it can feel as if your entire world has been turned upside down - new medications (and their side effects), coughing (and coughing up blood), having to change the way you live life...it can seem overwhelming.

Let's start here "...Given that everyone has a different experience of this condition I’m wondering how to think about the progression of things..." Getting rid of the infection should be #1 - you are lucky we are nearly into 2025 as the protocols have changed, and if the 3 drugs don't do the trick, there is an inhaled antibiotic that can be added. After that, it depends...my Bronchiectasis has been stable per CT for 5 years now, the nodules went away after treatment, I have a new med to control my underlying asthma, and my pulmonary function has not worsened. Not everyone is so fortunate, but I believe asthma control, airway clearance, 7% saline, diet and exercise have helped (though I have slacked off on the exercise while healing from shoulder surgery.)

And you asked, "...Also wondering about altitude as I love to ski..." Everyone is different, so I can only share my own experience - while I had an active MAC infection and was on the meds, I could not tolerate even 5000 feet without severe altitude sickness symptoms, so I was leery of the mountains for a few years. Now, as long as I give my body a day to acclimate before vigorous activity , I have no problem.

Finally, I am not surprised by your doctor's prohibition on hot yoga - mycobacteria thrive in a warm, moist environment, and become concentrated in small spaces, that's why Dr Falkinham is so adamant about avoiding indoor hot tubs and spas too. He would definitely agree with your doc about hot yoga.

Have you begun doing airway clearance? @irenea8 is a great resource to consult about how to do it safely with hemoptysis.
Here is a great video on why we do it, Dr McShane is one of our best resources: