My coughing increases, I notice an increase in phlegm (I use a flutter valve nightly) and I experience a general loss of energy and shortness of breath.

Hi Jane & Sue, It's interesting to learn how others experience this illness; how we encode it in our language. During the relatively brief period that I've been visiting this discussion forum I've had confirmed my existing belief that I am lucky to have a relatively mild case of Bronc. It was approximately 10 years ago when inexplicably I began to have frequent (usually once or twice daily) very mucous productive coughing episodes. In those "early days" I was able to trigger an episode simply by sitting in a recliner in a semi-recumbent posture. In addition, I experienced frequent spontaneous such episodes sufficiently unpredictably and mucous productive that I began to carry a toilet roll in the car to deal with mucous production.

My primary doc referred me to a pulmo who performed a bronchoscopy fully expecting to confirm MAC. To his consternation that didn't happen. In the meantime primary doc Rx'd Cipro which resolved a febrile "flare up." The pulmo wanted to investigate further with a CT scan. Primary and I decided that he would simply manage flare ups with antibiotic tx. I rocked along for probably a couple of years on that regimen with the flares occurring aprox. 2 x year. My primary closed his practice and a new primary referred me to another pulmo who followed me for a year or so during which time he ordered a Respirtech Percussion Airway Clearance device (aka, my Thumper).
Amazingly Medicare picked up the entire cost of the thing which I now own outright. I have be very compliant with a 2 x daily half-hour sessions accompanied by saline inhalation Tx.

Over time I began to describe Bronchiecstasis as a chronic lung disorder which resulted in greater vulnerability to acute bronchitis episodes. At that time I didn't particularly think of those episode sas Bronchiecstasis "flare-up" but rather as acute bronchitis episodes to which I was more vulnerable by dint of the underlying Bronchiecstasis disorder. BTW, the bronchitis episodes were always accompanied by fever. Even a low grade fever makes me feel lousy, really "sick." These occurred almost like clockwork twice each year. Eventually, my doc(s) agreed for me to have a few tabs of whatever antibiotic I was using on hand at home so that I could start on the medicine at first sign of fever. BTW, I did eventually test positive for MAC.

I've always felt that a good measure of overall improvement is simply the frequency of flare-up occurances. Regrettably, so far I've never been able to reduce below 2 x annually. Next week I increase from 0.09 to a 7% saline inhalation. I'm hoping I tolerate it and also hope for a good therapeutic response.

Well, this is a long and kinda rambling post, but I'm struck by how I think about this problem has evolved and how it compares to others' experiences. In health, Don (Thumper Guy)