Hi Sue. You did a beautiful job in spelling out in "layman" terms about the process in sputum testing. I've been dealing with MAC for almost 3 years now. I'm currently on oral Levofloxacin to try and treat Pseudomonas yet again. This has been the 5th time in three years. If this does not work I'll probably have to again do the 28 days of Tobramycin. I am on my third pulmonary doctor. First one immediately put me on the Big 3 for positive MAC. After 6 weeks I was taken off because I was not able to tolerate them. The doctor said he was probable not able to help me. Instead of doing a referral he just "quit" me. Through this forum another MAC sufferer told me of a doctor she found. He was 3 hours away but I got an appt. What a God send this man was. He guided me through my off and on infections and last summer I asked if he had someone closer to me to continue to manage my situation. He did recommend someone within 1 1/2 hrs away. I had been doing well up until the most recent positive pseudonymous report. One question I do have and I did present it to my current pulmonary doc... When sputum was tested at Emory the Pseudomonas was classified 1+ thru 4+. 4+ was the worse. So I asked my current doc how my sputum was classified at U. at B'ham he just said something like, "we don't rate that way." Any idea on what he means? Also he did say when he treats Pseudomonas using Tobramycin he usually does two weeks on and two weeks off. Is that schedule what you've experienced. I thought I'd seen on this forum that they would do one month on and one month off. It seems I've read that you have a lot of experience with the alternating treatments. Love your insight. So helpful. Faye

@sueinmn Yes on different culture results. I have had 8 sputum cultures over the last 2.5 years. 4 Positive and 4 Negative. My first one came back Mycobacterium intracellulare (although looking at my medical portal there was considerable confusion at the lab before they finally came up with that). My second one came back Myocobacterium abscessus (after once again confusion at the local lab in TN, they sent the sample to some lab in CA to get the final result. My next 4 samples were sent to NJH (National Jewish Health in Denver) by my request. The first 2 were Negative the next one Positive for M. abscessus (but "few" colonies, only sensitive to Amikacin), the 4th one Negative. Then I switched my pulmonary care to Mayo clinic in Jacksonville, FL. I had 1 Negative culture followed by the last which was again Positive for M abscessus but only 2 colonies. Because of the low colony count my doctor was not concerned as all my other parameters were not changed and was told to continue my daily airway clearance and come back in 1 year. So the moral of my story is that you really can't trust labs with little NTM experience, insist on getting results from places such as NJH or Mayo or similar. Bill

@sueinmn I have mycobacterium abscesses in my sinuses. I had sinus surgery to correct chronic sinusitis. I did not have an AFB test prior to surgery. The doctor did one now because I'm 8 months post surgery and my sinuses are still infected. I'm also wheezing as this seems to be affecting my chest. I brought up this concern to my doctor and they ordered a chest CT with contrast. That came back normal. It seems as if the doctor has ruled out the infection in my lung just by the CT results. However, the more I read, I hear that a sputum test is needed to diagnose this in the lungs. Could I have this in my lungs but have a normal CT? Also, as I wait for doctors to determine the best treatment, I have also found out that my ferritin level has dropped to below the norm (36). Back tracking here, but I had ferritin infusions 4 years ago, as well as a uterine ablation to stop that bleeding and a colonoscopy to rule out internal bleeding. So I have not been losing blood over the past 4 years, and yet my ferritin is down to 36. Can this infection rob your body of stored iron? Could I have had this in my body for several years? I've been struggling with overall malaise, sinus pain, pain in joints, migraines, exhaustion, wheezing, etc, for many years now. Please provide any insight you may have.