Hi Mary Jane - That can be an issue! When I was on antibiotics, but had not yet learned about 7% saline, I too was unable to provide a sample.

My pulmonologist had me come in to the office where his nurse first handed me 2 bottles of water to drink. Next, she loaded a nebulizer with 10ml of 10% saline, and had me neb the whole thing, while trying not to cough. She also had me sipping on a third bottle of water. When I used the Acapela for a few minutes, and finally huff coughed with her coaching. I finally got enough for a culture. I asked what would have happened if that didn't work, and she said she would have done manual percussion on my chest and back. She said in 20+ years as a pulmo nurse, she only had to send 2 patients for bronchoscopies to get their samples.

The biggest things I learned - enough liquid in the body, getting as mush saline in as possible before coughing, and proper huff coughing technique (I had been coughing from my throat which wasn't engaging the bronchi.)

Is there any chance you can work with an experienced pulmonology nurse or respiratory therapist?
Sue