1. < MAC & Bronchiectasis
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Lung cavities

Posted by maxraether @maxraether, Dec 8, 2025

I’m 68 with Bronchiectasis. Two year ago I was diagnosed with Pseudomonas and two lung cavities. The pulmonologist has only prescribed an antibiotic for a week when I have flareups which cause me to cough up blood. I have a hard time getting phlegm up even though I use a saline nebulizer once a day. I’m pretty active but I have had at least three flareups this past year. My recent CT scan showed one of my cavities grew some ( I believe they’re only one centimeter). He’s considering doing a biopsy but told me to wait 6 months. Hearing the word biopsy worries me to think it could be something more serious.

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Sue, Volunteer Mentor | @sueinmn | Dec 14, 2025
In reply to @ursala7 "@sueinmn Thank you. I'll have to get some help, I know, because I'm getting older now...." + (show)
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@sueinmn Thank you. I'll have to get some help, I know, because I'm getting older now. I don't have a pulmonologist yet. The one I saw 6 years ago, who diagnosed me after a CT scan, didn't follow up with me, because at that time I could not produce a sputum sample. She never even suggested methods I might try to loosen phlegm (which I learned later through forums and self-education). I never went back, because if she couldn't even help me with step one, then I had no confidence in her.
I have learned so much from the health forums. Do you know if there is a list of pulmonologists in Minnesota with a specialty in bronchiectasis?

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@ursala7 Where in Minnesota? Health Partners has one in St Paul, not sure if she's taking new patients if they aren't already in their clinic systems. And of course Mayo Clinic in Rochester has a greater MAC and Bronchiectasis department.

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ursala7 | @ursala7 | Dec 14, 2025

Thank you Sue, I'll check it out.

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sweethighland | @sweethighland | Dec 18, 2025
In reply to @sueinmn "@reneemc Sorry Renee, my computer burped earlier and my reply was lost. A long time ago,..." + (show)
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@reneemc Sorry Renee, my computer burped earlier and my reply was lost.

A long time ago, my old pulmonologist's experienced nurse told me "Our lungs are meant to be bathes in mucus. Trying too hard to get rid of all of it can actually irritate the airways and cause us to produce even more."

Back then I was using levalbuterol and normal saline, but spending an hour or more every airway clearance session, and never getting rid of the mucus - I felt like an ever-flowing fountain. She cut me to 20 minutes max after the nebs, and very gradually my mucus decreased. My throat and chest were less sore. And eventually my MAC and Pseudomonas went away (about 6 years ago.)

Now my airway clearance is after exercise, with only an occasional saline neb (I'll do them faithfully this weekend and next week before and after flying). It usually takes about 10 minutes to clear my lungs, and Ihave anywhere betweena few drops and a couple teaspoons of mucus. Later in the day, I may have a few more mini-sessions if I feel the need.

Have you considered cutting back the amount of saline or length of airway clearance to see if you produce less mucus?

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@sueinmn What you said was so true. The more we try to clear our lungs, the more they get irritated and produce more. I experienced that and I believe trying very hard with huff cough make my throat and lungs sore.

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sweethighland | @sweethighland | Dec 18, 2025
In reply to @sueinmn "@reneemc Sorry Renee, my computer burped earlier and my reply was lost. A long time ago,..." + (show)
Profile picture for Sue, Volunteer Mentor @sueinmn

@reneemc Sorry Renee, my computer burped earlier and my reply was lost.

A long time ago, my old pulmonologist's experienced nurse told me "Our lungs are meant to be bathes in mucus. Trying too hard to get rid of all of it can actually irritate the airways and cause us to produce even more."

Back then I was using levalbuterol and normal saline, but spending an hour or more every airway clearance session, and never getting rid of the mucus - I felt like an ever-flowing fountain. She cut me to 20 minutes max after the nebs, and very gradually my mucus decreased. My throat and chest were less sore. And eventually my MAC and Pseudomonas went away (about 6 years ago.)

Now my airway clearance is after exercise, with only an occasional saline neb (I'll do them faithfully this weekend and next week before and after flying). It usually takes about 10 minutes to clear my lungs, and Ihave anywhere betweena few drops and a couple teaspoons of mucus. Later in the day, I may have a few more mini-sessions if I feel the need.

Have you considered cutting back the amount of saline or length of airway clearance to see if you produce less mucus?

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@sueinmn Sue, how did you get rid of MAC and Psudo by adhering to airway clearance. Can you please share your methods and strategy?

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Sue, Volunteer Mentor | @sueinmn | Dec 18, 2025
In reply to @sweethighland "@sueinmn Sue, how did you get rid of MAC and Psudo by adhering to airway clearance...." + (show)
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@sueinmn Sue, how did you get rid of MAC and Psudo by adhering to airway clearance. Can you please share your methods and strategy?

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@sweethighland I got rid of MAC and Pseudo initially with nearly 2 years of antibiotics. My sputum samples at the end were mixed - some positive, some negative, but I needed to quit the antibiotics due to increasing issues with them.
So for 2 years I did twice daily saline & airway clearance, then got negative cultures. At that point I backed off to one a day saline and 2 a day airway clearance. Gradually, with getting my asthma better controlled I cut back to 2-3 times a week saline & daily airway clearance (after exercise is best for me.) Now I only use saline if I feel congestion or get a respiratory bug, but still do airway clearance - my pulmonologists, both specialists in Bronchiectasis and asthma have approved this routine. The only exacerbation I have had since 2023 was when I got Covid last year - then it was full-on twice daily budesonide, saline and airway clearance plus oral antibiotics and prednisone for 2 weeks.

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kris2468 | @kris2468 | Jan 11 10:17am
In reply to @maxraether "@kathyjjb Thank you for responding. I live in Naples Florida ( moved from Washington State 4..." + (show)
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@kathyjjb
Thank you for responding. I live in Naples Florida ( moved from Washington State 4 yrs ago). I’m not aware of any clinic that deals with Bronchiectasis near me. Thanks for your suggestions!

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@maxraether Hello. I have a pulmonologist in Naples who is very well educated on MAC/BE. His name is Dr Vishal Patel 708 Goodlette Frank N Naples, FL 34102. 239.212.0824 I am scheduled for seven clinical days at NJH in February and he was very supportive. There is also a Naples support group that you may be interested in joining. It’s a virtual monthly meeting.

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maxraether | @maxraether | Jan 11 11:54am
In reply to @kris2468 "@maxraether Hello. I have a pulmonologist in Naples who is very well educated on MAC/BE. His..." + (show)
Profile picture for kris2468 @kris2468

@maxraether Hello. I have a pulmonologist in Naples who is very well educated on MAC/BE. His name is Dr Vishal Patel 708 Goodlette Frank N Naples, FL 34102. 239.212.0824 I am scheduled for seven clinical days at NJH in February and he was very supportive. There is also a Naples support group that you may be interested in joining. It’s a virtual monthly meeting.

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Hello! Dr Vishal Patel is my pulmonologist too! I’ve been seeing him for the last three years. I’d be very interested in the Naples support group.

Thank you!

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sharonednaramsey | @sharonednaramsey | Jan 11 1:12pm
In reply to @kris2468 "@maxraether Hello. I have a pulmonologist in Naples who is very well educated on MAC/BE. His..." + (show)
Profile picture for kris2468 @kris2468

@maxraether Hello. I have a pulmonologist in Naples who is very well educated on MAC/BE. His name is Dr Vishal Patel 708 Goodlette Frank N Naples, FL 34102. 239.212.0824 I am scheduled for seven clinical days at NJH in February and he was very supportive. There is also a Naples support group that you may be interested in joining. It’s a virtual monthly meeting.

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@kris2468 I would love to get I do about this group

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kris2468 | @kris2468 | Jan 11 2:50pm
In reply to @sharonednaramsey "@kris2468 I would love to get I do about this group" + (show)
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@kris2468 I would love to get I do about this group

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@sharonednaramsey The leaders are Leslie Wasserman and Marian Fink. You can contact them via naplesfl@ntmir.org

The group is a wealth of information and support. All the best!

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kris2468 | @kris2468 | Jan 11 2:52pm
In reply to @maxraether "Hello! Dr Vishal Patel is my pulmonologist too! I’ve been seeing him for the last three..." + (show)
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Hello! Dr Vishal Patel is my pulmonologist too! I’ve been seeing him for the last three years. I’d be very interested in the Naples support group.

Thank you!

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@maxraether I learned about Dr Patel through the support group. Marian Fink and Leslie Wasserman are the leaders. You can contact them via
Naplesfl@ntminfo.org

Good luck!

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