Any suggestions for expelling tenacioius mucus plugs?

I have a sad but probably not uncommon tale:
I tried long and hard to get up some sputum on my own the first time my PCP and I were wanting to rule out MAC. He sent me to a pulmonologist who of course wanted to do a bronchoscopy (cha-ching cha-ching!). So I had one that confirmed the MAC diagnosis. Then when it was time to give sputum again, the same old story. Couldn't do it. My poor dog was so upset, watching me hack and cough and cry trying. At that point I was on the meds and had an ID doc. I knew I needed to find a respiratory therapist who could help me. Do you think I could find one in this city of a million plus people and a major medical school/center? Nope! Seems you gotta be sick in a hospital before an RT could help with that. My local ID doc who also happens to be on the faculty at the medical center was more than frustrated. He contacted the county TB clinic and I went down there. The nurses were willing to help me but I couldn't get an order from the TB medical director. I was facing the possibility of another bronch, which my ID doc was adamant that I shouldn't have.
Long story short (ened): I drove up to Denver for the weeklong evaluation at NJH and they gave me what I needed and showed me how to cough up sputum on my own. Now I suggest if you're having problems and don't want to travel to one of the few respiratory centers that specialize in MAC, have your ID doc write you a script for 7% saline, get an Aerobika and Ombra and watch some YouTube videos on how to do it, if they exist. Good luck!

Yes, thanks Candace did clarify that for me. From what I have recently learned and now understand is that many cannot produce the mucus for sampling. For me it is the opposite and that is good in one way and not so wonderful in another way. I produce it all day long and have to clear it nearly constantly. Which again leads us back to "we are all different."
Thanks,
Barbara

To: coffcoff and ALL
Yes, thank goodness for NJH. If it had not been for my research over 20 years ago when my Mother had Emphysema I would not have known about NJH. It was I myself that made the appointment at NJY. NOT any of my local doctors suggested going to a special medical center with a Bronchiectasis department etc., Of course when I mentioned to the doctors that I had made the appointment at NJH, they all highly supported my decision. That was after nearly a year and a half of walking into their offices, often, with a spit cup saying something is wrong. Finally, as I have said before, it was the 35lb weight loss that got the PCP to order the final no contract C Scan after two doctors suggestions saying post nasal drip and then two of them changing to a diagnosis of allergies of which I kept saying to both" I don't have any symptoms for either type of allergies". I refused going through the allergy tests. I had all the following tests before the final correct test to say Bronchiectasis, one chest X Ray, three ENT's endoscopes, two upper ultra sounds, 1 swallow test, one upper C Scan and finally the C Scan without contrast of the lungs showing the Bronchiectasis.
Our journeys have been challenging to most all of us as it is for a while and during our final diagnosis of Bronchiectasis and MAC.
Wishing all of us, me also, the time, strength and fortitude to not give up in finding answers to our problems, needs and ways to help ourselves.
Happy New Year all..... and a big welcome to 2025 with much success in all we are challenged with.
Barbara

Are you nebulizing in this position?

Yes, I am.