Dear Jane, I was like you unable to cough up phlegm. Bronchoscopy was necessary to diagnose the infection. I progressed from
1. Accapella alone to
2. Aerobia with nebulized saline to
3. The Vest with nebulized saline.
Accapella did not cut it for me and could not withstand heat sterilization, so I stopped it. The respiratory therapist at NJH taught me to use Aerobica along with nebulized saline. During the first three days of my stay at NJH, I had to repeat airway clearance with 7% and 10% saline to loosen up thick mucous in the lungs. After that, only 7% was prescribed for home use. Later, I found The Vest to be the best device. Initially, the Vest was set on one fixed frequency. But, after learning about the Minnesota Protocol that changes frequencies during a session, I become more productive. What works for me now is 20 minutes on The Vest with simultaneous nebulization of 7% saline, followed by autogenic drainage. Others do it differently because their needs are different.

If you are interested in having a guided autogenic drainage, go to the App Store, download Autogenic Drainage and just follow the directions in the Application. It takes 4-5 minutes/session.

From experience, I really recommend having NTM respiratory therapist to help you decide what the best course of airway clearance is best for you. You may have to make several adjustments like I did. It took me over 2 years to get to this point. The therapist is another yet NTM specialist you need to have in your life. The RT will also teach you how to clean and sterilize all the tools you use for airway clearance which is very important to prevent reinfecting your lungs.
Best of luck.