@clinenan Have you tried nebbing with a lower concentration of saline to see how your lungs react?

Years ago I started with .9% (normal) saline vials and they worked fine. While I was being treated for MAC in 2018 & 2019 7% saline became popular, but my pulmonologist was hesitant because of limited data and my asthma, so we tried 3% and it was fine too.

At the end of 2019, I stopped antibiotics and transitioned to 7% saline (at first diluting it with 3% and working up to straight 7%.) I also used levalbuterol nebs first to avoid a bronchospasm from the saline. A few years later, I was transitioned to Symbicort (generic) for my asthma, which was a life-changer for me. The asthma flares from weather and pollen are gone, and I only need asthma nebs when ill (like when I had Covid in 2024.)

For the past 6 years, I have continued with Symbicort, occasional 7% saline & daily airway clearance (exercise gets my mucus out) and have been MAC free, with stable BE and stable asthma.

Maybe you can talk to the doc about a trial - ramping up as far as you tolerate?

@clinenan Welcome to this wonderful supportive group! Asthma here too. I find 2 puffs of albuterol 10 minutes before nebulizing with 7% saline helps a lot, as does sipping something warm (herbal tea or water) while nebulizing. Frequent breaks are helpful. During those breaks perform some huff coughs in the hopes of expelling built up phlegm.

One of my favorite videos for learning to do the huff cough