I have found that if I don't use a bronchodilator the 7% saline is much more irritating? Do you have a bronchodilator (albuterol or levalbuterol) that you can neb or use with and inhaler before your saline?

Hemoptysis led to my diagnosis of bronchiectasis & MAC almost 4 yrs ago. My first pulmonologist didn’t appear concerned unless the amount was significant. Usually my cough would produce bright red blood & some clots. This might happen several times in a day or over the course of a few days, then not happen for weeks. It was more than 2 yrs post diagnosis before airway clearance was suggested & this resulted from my ongoing concern about the hemoptysis. The incidents became more frequent-every 2-3 wks-& my Dr. suggested antibiotics. She had me consult with an infectious disease Dr. who did not think my general health warranted treatment. I saw them both in early June fully expecting hemoptysis to occur any day, but my last incident was mid May. Since then only light blood in a couple of coughs while nebulizing. Early in my use of the 7%, I did stop it when my throat became irritated & I coughed up blood. Fortunately this did not last for me as I became used to the 7%. I hope this helps you. Take care Linda