Mycobacterium Kasasii And MAC

@lbrooklyn I have not had this strain of NTM, but it is similar to other types like MAC in that it is slow growing.

Here is an article specifically about it:
https://www.ncbi.nlm.nih.gov/books/NBK430906/
As you are thinking, a second sputum culture is warranted, to be sure it wasn't a false positive, this is covered in the evaluation section of the article. Sensitivity testing is also recommended. The testing can take six to twelve weeks, but due to the slow-growing nature of NTM, the delay is not concerning in the absence of severe symptoms.

Did the pulmonologist have you start daily airway clearance? If not, it is possible they are not well-versed in treating bronchiectasis and NTM.

Speaking for myself, I would insist on a second culture that includes at least 3 samples from 3 different days and sensitivity testing before considering antibiotic therapy. If the doctor protests, maybe you can find another one, or an Infectious disease specialist.

What led to the diagnosis in December?

Thank you for this. No he has not spoken about airway clearance. I’ve actually started this myself a few weeks ago. He basically shut me down with any other suggestions at this point he only wants me to go for the CT and then he’ll discuss further. Prior to this I barely even got a cold. This past summer, I had acquired Covid, which affected me systemically. I had terrible stomach pain, and with all the testing the bronchitectasis was discovered. And then a CT. I believe strongly that the reason my lung function improved is because I’ve been doing autogenic airway clearance and nebulizing with 3% saline daily.

Do you have the option of seeking a NTM/ bronchiectasis specialist? I personally don't have a lot of confidence in "my way or no way" docs.

Yes, I do, but that would mean going out of network.

@lbrooklyn
Sorry to hear your struggle with your doctor for further testing and the decision of in network or out of network.
I hate having to say this but sometimes we have to find the supposed right 'kind' words and the supposed right 'attitude' when approaching doctors so not to ruffle the doctors feathers in hopes of getting him or her to do what we/you want and believe one needs, further sputum testing. Where are you located, Brooklyn, NY? One other patient, recently, very much had the same problems you have voiced and it did not go over well when she talked with the doctor, they have their ego involved and then they have to stay within the regulations of who they should refer you to according to the health insurance plan etc. etc.
Glad you decided to do all you have learned with your own 'research', so far, to help yourself.
Wishing you all you need on this journey we find ourselves on.

This site has been amazing. I’ve learned so much. My pulmonologist has no knowledge or recommendations of AcT or supplements to reduce inflammation. They only believe in conventional medicine.

When I was diagnosed with NTM and bronchiectasis about 7 months ago the doctors asked me to have several tests which I did. I also researched for hours for a good doctor. I found one of the best in this field. She is about an hour from me which is no big deal. She also works with an infectious disease doctor who I very happy with.
Research in your area for a doctor that specialized in just your disease. They are out there you just need to find one.
Good luck! I am not on the antibiotic regimen yet. I am looking into alternatives. I do not want to put all the chemicals in my body.

Sometimes you can appeal to the insurance company if they do not have a suitable physician for you. Bronchiectasis is a rare disease, with a limited pool of experts, and M. Kanasii is very rare.

Maybe using the information in the link I provided can help you get either the pulmonologist or primary to refer you "Out of Network due to Medical Necessity"?

Also, here are the current protocols regarding when/how to treat - you can demonstrate that the doctor is clearly not following them.
https://ntminfo.org/wp-content/uploads/2020/07/NTMguidelines2020.pdf
They are a lot for a layperson to wade through, but what the clinicians and insurance need to see. New guidelines are due out soon, we just don't have a date yet.

Finally, here is the current NTM/Bronchiectasis Centers of Excellence listing - more practitioners will be added as they clear the approval process.
https://connect.mayoclinic.org/discussion/the-bronchiectasis-care-center-network-33-centers/
I hope you can find some help.