@dispatchpat Your description of white or clear sputum makes me think that if you have active MAC it is at a very low level.

It also makes me wonder -
Are you nebulizing albuterol, or using an inhaler? I found 2 puffs on the inhaler is just as good as a neb, and adds less liquid to the mix. How much saline are you nebulizing in a day? I have 4ml vials, but I have been given some as large as 15ml - that would be way to much liquid for the lungs.
Is it possible that 7% saline is actually irritating your lungs and causing more mucus production? Some members stepping down to 3%, or alternating the two, is less irritating.

Two other considerations that determine when/whether to treat are the MAC "load" in your body - how much bacteria is found in the culture, and how your lungs look on a CT. This video can be helpful in explaining the decision process.

After using the Big3 for over 18 months, failing to get rid of MAC, and switching to airway clearance with saline, here is my personal point of view. I would need to be shown CT evidence of advanced nodules and/or cavities before I would ever go on the meds again. The effects of the treatment can be rapid and severe, or slow and gradual - but over time the heavy antibiotic regimen takes a toll on the body. It took 2 years after stopping antibiotics to completely regain my lost weight and energy. I still have less stamina than before (of course I am 5 years older😒)

Sue
PS I do 10-15 minutes of airway clearance a day, then walk away. Yes, I do cough stuff up throughout the day, some days more than others, but like you, I get tired of it. You need to decide how much is enough for you.
S