Doing airway clearance 1x/day vs 2x/day

I hope I understand question about what was happening with postural drainage and reflux. (Apologies to those who’ve read story numerous times.) I had been to Mayo to get a diagnosis and treatment plan. They had a cancellation and appointments at Penn’s bronchiectasis clinic were 6 months out. I hadn’t been having problems with reflux when I saw them. Based on CT, I had mild bronchiectasis and was thought to have MAC and they taught me the airway clearance techniques mentioned (cultures neg for MAC). I was concurrently having large amounts of post nasal drainage and was being worked up by local ENT. Mayo added meds to help. My frontal sinus was opaque causing concern due to location. While I waited for frontal sinus surgeon appt, ENT had me do a course of oral AB’s and steroids followed by antibiotic drops in a head hanging position-lying across bed with head hanging off while they absorb. I combined that with some postural drainage positions since I was still thought to have MAC. I started having reflux while lying flat, but needed the antibiotics. My sinus cleared and MAC cultures were negative-very lucky! It then seemed prudent to stop lying flat since reflux can cause MAC , esp with bronchiectasis. I just told Penn doc when I saw him a couple months later.

I love my doctor and his team, but what they expect of me is impractical. I think they would recommend something different if they had the disease, and I tell them that. I found that I get great airway clearance by cycling. I am 70 and can do 10 miles (usually a lot more but at a minimum 10 miles) four or five times a week. (During the winter that's maybe 6 miles indoor— I find indoor cycling boring as all get out.) When I vacation I walk for at least a half hour a day without stopping in stores or anything— just walking. I will hit the flutter if I have an exacerbation (about once every two years) and use the vest when I can't cycle for an extended period of time. An 81-year-old with a pacemaker who does not already have an exercise regime should probably check with his docs and maybe a trainer/pt before starting anything, if that is what he wants to do. I find exercise good for the head and lungs— I am probably addicted to the endorfins. I get fatigued often too, but once on the bike, especially outside, I get my wind, or at least more than I had before I started pedaling. I have been doing pretty well for the last 15 years, being hospitalized only once when my infection became resistant to my antibiotic and we had to figure out a new medicine regime. Be honest with your doctor as to what you can and cannot do— there are many ways to skin this cat.

Everyone is different and may vary over time. After 2 years of xs sputum and an hour plus per day of postural drainage, a course of antibiotics cleared it all out and I’m back to 7% saline 1x daily and postural drainage occasionally
Over the six years of doing airway clearance, I’ve tried maybe ten different things, including vest, percussion, flutter, chest PT, breathing and drainage. And a lot of exercise!
Just keep trying things until something works for you, but be prepared to adjust if your situation changes.

Incidentally, my bronchiectasis expert doc told me 7% would be too irritating but I’ve been using it for years now with no problems except when I’m sick when I need to go down to 3%

Wow...dulwich....you did good.
Curious....what type of bacteria did you have and how long were you on the antibiotics. Were you on the typical Big Three?
Sometimes I think doctors forget that everyone is different...some cannot tolerate 7% and some can.
Barbara