No sputum - how to test

@atlantabec Has your doctor tried doing induced sputum testing, where they have you go into respiratory care and have you inhale saline to cough up sputum? I started there and still was only minimally effective. My "samples", which were largely just spit, repeatedly got rejected as insufficient (with at least 5-6 in-clinic tries). My respiratory care clinic also had no idea how to coach someone to bring up sputum, they just gave me the saline neb and told me to breath deeply. After I started airway clearance at home and got experience in terms of nebulizing saline and breathing exercises, I sensed that I could do a better job of getting a sputum sample on my own (which I definitely cannot do without AC). I asked my pulmonologist for sample cups and did my own at home. Success! The key to my success for me (and we are all different): 1) I nebbed two 4 ml vials of 7% saline with the Pari sprint cups, for me the Pari sprint cups deliver a stronger amount of saline mist which helps to loosen up the little bit of sputum that I have; 2) I used my active breathing and autogenic breathing exercises to pull up as much as I could. It is not a lot, but it recently got the job done for the first time ever. We are all different and I know others have success with adding postural drainage which is something I still need to experiment with, but as someone who just could not bring anything up when this started last fall, I can share that you can (likely) learn to do so, but it will take a bit of time and effort on your part to figure out what works best for you.

For those who simply cannot get any sort of sputum up for testing, my understanding as to what my doctor would do in that scenario is that he would monitor post-treatment by CT, and if future CT's suggest further infection possibly follow up with bronchoscopy. I think that's a "we will cross that bridge if and when we get to it" conversation. Other doctors may have other approaches, hopefully others here will share their treatment experiences as you certainly are not the first to have this issue.

Thank you for your comment. We haven't gotten there yet with trying the sputum, etc. b/c just on round one of treatment. I will have the f/u CT's, and I guess f/u broncoscopy if needed. My doctor is a MAC specialist fortunately here in Atlanta so I trust him that he's up to date with protocols. I just don't love the complete lack of control with this diagnosis. Doing this treatment only to have to go thru these cycles repeatedly for the rest of our lives. I guess we're all in the same boat, and I'm trying to move to a better head space. Thanks again.