Anxiety and stress with Bronchiectasis

Thank you all for responding to my post about anxiety and stress with Bronchiectasis. I realize it was vague so I’ll add more detail. I was diagnosed with Bronchiectasis in Jan. 2020 but probably had it for years. I’ve had pneumonia numerous times before my diagnosis. I was a speech pathologist in the school system for 30 years and worked closely with young children which could have attributed to my recurrent infections. My pulmonologist only had me using Aerobika twice a day and I had done pretty well until now. Since May 2025 and September 2O25, I’ve had 3 respiratory infections ( one being pneumonia). It seems like these infections have started since my only grandson started daycare at 6months of age. I had to baby sit this past weekend and wore a mask the entire time because he has another cough. The good news is my new pulmonologist has me on a nebulizer 3 % and Brinsupri 25 mg that I started in early September. I have much less coughing and mucus. Basically, I feel fine physically but I’m struggling with constant uneasiness and anxiety worrying about things I can’t control ( like infections). Q

Thank you for the kind words.
Sputum induction is usually done by respiratory therapy, gradually increasing the saline percentage to stimulate coughing in order to get a specimen. It's less invasive than a bronchoscopy and often tried first.

Don't feel bad that you can't get it out. The therapist told me it's "not rare" for them to be unsuccessful. I only got a small "inadequate" bloody amount.
Are you using 7% saline and huff coughing before you try. That would increase your chances, I think, since you can get it loose and to throat.

Thanks @lmanells for sharing more details about your BE journey. Most if not all of us here started with a cough, suffered through numerous episodes of bronchitis and/or pneumonia, and in many cases, like mine, took a l o o o n g time to diagnosis. Mine was diagnosed as asthma for almost a decade. This diagnosis makes life challenging and there's a certain amount of resilience we build up to cope. Cliché-y, some days are better than others.

Very glad to hear you have gotten some relief from Brinsupri. We all hope that by being on this drug it will break the "vicious vortex" of inflammation, infection and damage to our fragile lungs. Also, great that you use hypertonic saline. Hypertonic saline is available in 7% concentration as well if you'd like to take it up a notch. What do you do for airway clearance? Common methods are autogenic drainage and huff cough.

To address uneasiness and anxiety about worrying about things we cannot control, it's helpful to assemble a supportive team: pulmonologist from one of the BE centers around the US. A knowledgeable pulmonologist can connect you with pulmonary rehab if needed. A knowledgeable pulmonologist will likely have a nurse and NP who you can contact during periods of exacerbation. Sometimes actively "doing something" about the BE will help to diminish anxiety and worry. When I find myself spiraling due to negative thoughts, I imagine a very large broom that comes down from sky and sweeps those thoughts away! Somedays I sweep a lot. Doesn't work all the time but sometimes it does!

There are number of resources here at Mayo connect. One of our members wrote a book and hosts a website for BE. https://www.letsbecleartoday.com . And, I was surprised to see in the public library, newish books about BE. Here is a screenshot of some of those books.

Hope this for starters helps a little bit.

I have a terrible time trying to fit two treatments a day for my Bronchiectasis. First nebulizer with saline and albuterol and then flutter valve. Then you have to clean everything. My life is very active and I didn’t feel like I had enough time in the day before this. I am very stressed and anxious about how to do this.
Any ideas or thoughts from people going through this. Thanks.
JJ

@pacathy Thanks.
Scoop also indicated to me that "mucus plugs" are drier harder. What I bring up that I call mucus is clear in the clear solo cup. As a matter of fact I realized recently that my white kitchen sink (that gets cleaned and bleached regularly plus boiling water for the drain) had no longer been looking stained yellow and I believe that represents the mucus going from yellow to clear!????
I see the pulmonologist this next week and will be taking in to him what I bring up to have him clarify what we call that which I am continuously bringing up..... small soft yellow/light green tinge soft pieces. I also took pictures of what I bring up to show him. So hopefully one way or another I will get the medical 'scoop' of what these are.
Thanks for the suggestion of looking up 'inflammatory cascade'. I had not come across that before.
Wonderful that your culture for MAC was negative. Hoping my second submitted sputum sample again tells me good news as the previous...."MAI not showing no respiratory pathogens".
Barbara

@pacathy I use 7% saline twice a day followed by aerobika. When I nebulize the saline, the coughs in the beginning are often dry and as I go on (about 15-20 minutes) they get wetter and I start bringing up mucus, BUT I seem to get it up to just before my throat where it stays until I decide to swallow it.. Is it possible that I don't have enough mucus to get it into my mouth? It feels pretty substantial as I swallow it but I don't really know how much is enough.
After nebbing I do aerobika 15 exhales into the device. Then I do huff coughing of two varieties. First I take a long inhale followed by 3 forceful quick huffs. I do this twice. Then I take a quick but full inhale followed by a long huff & do this three times. I do the whole aerobika routine 3 or 4 times, depending on how much mucus I seem to be getting up. Sometimes I get more from doing the aerobika. Sometimes I seem to be drained after the nebbing and the aerobika /huff coughing doesn't produce much. I do the variations of short and long huff coughing because I read that depth of the huffing can get to deeper or shallower parts of the lungs. I can't remember where I read or heard this. Perhaps I made it up (!!), but I have noticed that sometimes the long inhalation with short huff produces more mucus, and some times it is the very long huff that brings it up. Sometimes there is nothing from anywhere. I would really like to be able to capture the mucus because I have MAC and PA and I would like to see how things are going. I really would NOT like to have another broncoscopy.
As you well know, everyone has variations and routines that are different. I went into the excruciating detail above because I have found that I have benefitted from others' ideas and practices, especially with regard to nebbing and airway clearance.

@pacathy I use 7% saline twice a day followed by aerobika. When I nebulize the saline, the coughs in the beginning are often dry and as I go on (about 15-20 minutes) they get wetter and I start bringing up mucus, BUT I seem to get it up to just before my throat where it stays until I decide to swallow it.. Is it possible that I don't have enough mucus to get it into my mouth? It feels pretty substantial as I swallow it but I don't really know how much is enough.
After nebbing I do aerobika 15 exhales into the device. Then I do huff coughing of two varieties. First I take a long inhale followed by 3 forceful quick huffs. I do this twice. Then I take a quick but full inhale followed by a long huff & do this three times. I do the whole aerobika routine 3 or 4 times, depending on how much mucus I seem to be getting up. Sometimes I get more from doing the aerobika. Sometimes I seem to be drained after the nebbing and the aerobika /huff coughing doesn't produce much. I do the variations of short and long huff coughing because I read that depth of the huffing can get to deeper or shallower parts of the lungs. I can't remember where I read or heard this. Perhaps I made it up (!!), but I have noticed that sometimes the long inhalation with short huff produces more mucus, and some times it is the very long huff that brings it up. Sometimes there is nothing from anywhere. I would really like to be able to capture the mucus because I have MAC and PA and I would like to see how things are going. I really would NOT like to have another broncoscopy.
As you well know, everyone has variations and routines that are different. I went into the excruciating detail above because I have found that I have benefitted from others' ideas and practices, especially with regard to nebbing and airway clearance.

@bernadene24 I agree that details help. It sounds like you are making a valiant effort. I don't blame you for not wanting another bronch. Two other thoughts. If you have time, try waiting a few minutes between nebbing and doing huff coughing. Move around, take a walk, let it absorb.
Also think about your hydration status. If you're drinking a lot already and urine is light-med yellow, no need to increase and get over hydrated . If you know you don't drink enough, you could try that and perhaps mucus will be thinner. I hope you find something that works. It's so frustrating to try hard and not get samples.

@pacathy Thanks.
Scoop also indicated to me that "mucus plugs" are drier harder. What I bring up that I call mucus is clear in the clear solo cup. As a matter of fact I realized recently that my white kitchen sink (that gets cleaned and bleached regularly plus boiling water for the drain) had no longer been looking stained yellow and I believe that represents the mucus going from yellow to clear!????
I see the pulmonologist this next week and will be taking in to him what I bring up to have him clarify what we call that which I am continuously bringing up..... small soft yellow/light green tinge soft pieces. I also took pictures of what I bring up to show him. So hopefully one way or another I will get the medical 'scoop' of what these are.
Thanks for the suggestion of looking up 'inflammatory cascade'. I had not come across that before.
Wonderful that your culture for MAC was negative. Hoping my second submitted sputum sample again tells me good news as the previous...."MAI not showing no respiratory pathogens".
Barbara