Hello Ling, It is rather a long and unusual story. But to answer your question, I did not know about nebulizing or flutter devices etc. But during all those years my instinct was to lay down and using breathing techniques (self learned) cough up the mucus once a day. So i was clearing what i thought was all of the mucus once a day. And somehow i got by for quite a few years that way. I did not even have a formal diagnosis of Bronchiectasis but I suspected or assumed i had it. Then, when i finally had an exacerbation it was a doozy. After treatment for that and finding a good pulmonologist, I started the nebulizing etc. As i am getting older and Bronchiectasis worsens, i could never get away without nebulizing twice a day.