Dear Ling, It is a rather long story as to why I managed my Bronchiectasis without anything other than "coughing up" daily for so many years. I cannot say I avoided MAC since I was never tested for it all those years. But when I finally saw a better Pulmonologist just a few years ago he did test me for it twice and so far it has come up negative. But I do have chronic or mucoid strain Pseudomonas which is just as bad or worse. I do have days when I feel my airways are more constricted from more inflammation. On those days the mucus is harder to expel and I feel worse. But my Dr has never suggested an inhaler or even Albuterol since I am quite certain the Albuterol would make my heart race as I am prone to that now. I guess I would ask if your Pulmo is someone who specializes in Bronchiectasis. If not you might consider finding one that does. Inflammation is a big part of Bronchiectasis but so is infection. They go hand in hand. Another Pulmo might tell you to use saline but maybe you just do not have any reason for it yet. I lived with some level of infection for many years until I had a doozy of an exacerbation. No doubt letting it go that long made my Bronchiectasis worse but I cannot say for sure. I do know that the saline and flutter and positional drainage are critical for me now. If I did not answer something please feel free to ask. I really wish you well Ling and hope you can manage your Bronchiectasis better than I did! Anything I can tell you to help I am happy to.