Through sputum culture results. I was severely malnourished due to pharyngeal dysphagia and lung treatment was put on hold at the time. I was recently evacuated by a pulmonologist at Cleveland Clinic who reviewed all my records from my pulmonologist at Mayo. He wanted to do a bronchoscopy for additional cultures. I told him of my concern regarding equipment that even though sterilized could still harbor bacteria. His response was that they only use”one time use “ scopes that are then discarded. I’m seeing my pulmonologist at Mayo this week and will discuss his suggestions with her. I am still very significantly under weight and am not sure of my plan of care as of yet. In the meantime I do my ACTs, AerobiKa and my vest .