Do we need airway clearance if no symptoms?

Currently, I have bronchiectasis and Ntm abcessus, but no real symptoms. Night sweats stopped. No fever, not much coughing. When I do airway clearing with the nebulizer, it makes me cough a lot. It brings up spit, bubbly - like Im just coughing back out the moisture I am breathing in. And my ribs ache from the coughing. When my coughing is natural, I can get actual sputum, thick and greenish or yellow/ white clumps in the bubbly stuff - if there’s something that needs to come out.
I’m not nebulizing and I feel ok. My pulmonologist is annoyed with me for not nebulizing. The other (main) reason I don’t is high anxiety about the nebulizer having to be sterilized and not being sure anything would get all the hoses and parts truly clean without an exhausting process. I am afraid nebulizing could make me sicker if I breathe in unsterile air. I’m 73, working part time, and I have afib, postural orthostatic tachycardia (I get faint from standing or walking) and other chronic issues that create fatigue. Is it ok if I just get mucus come out when it wants to?