Paula - Have you tried reducing the intensity or duration of your airway clearance to see if you are inadvertantly increasing your sputum production?

Here is what I mean - you airways need mucus to function. If during clearance you strive to get to zero mucus coming out, your body will respond by producing more mucus to coat your airways, leading you to more coughing and clearance... It can become a vicious circle. The goal is actually to keep stagnant mucus from pooling and becoming a harbor, not to get rid of all mucus.

Seven years ago, I was taught buy an old-time respiratory RN to clear for 10-15 minutes and stop. If I later coughed up a bit more, so be it. I was pretty sick with MAC and Pseudomonas at the time, so I cleared for 15 minutes 3 times a day.

When I changed pulmonologists and stared using 7% saline, everything I was reading was about people clearing it all out, so I tried - often for 30 minutes or more. The result - sore throat, sore ribs, more mucus - misery. My new Pulmonologist had a staff RT, and when I complained to her, she said "You're trying too hard. 15-20 minutes AT MOST." Then she explained about doing too much and creating more mucus. I backed off, only doing more during an exacerbation.

Now, infection free for over 5 years, exacerbation free for 2, I do airway clearance for 5-10 minutes once or twice a day after using my inhaler and exercising. I had stopped 7% saline with my pulmo's blessing, but now have restarted 1-2X/week because it helps during smoke/allergy season.

There are a couple other people on this group giving shorter clearance a try - I'll see if I can remember who, and ask how they are doing.