Can a CT Scan improve without meds and no sputum?

It is my understanding after seeing Dr. Pamela McShane in Texas (before she moved to a position with NIH in Wash DC); that you need 2 negative sputum samples in a row, then in my case, she recommended I continue the Big 3 AND nebulized Arikayce for another year. Everyone's anatomy is different. MAC is VERY slow growing & slow to culture. If you have no sputum, she recommends nebulizing with 7% hypertonic saline/airway clearance to get sputum out, & if still no sputum, possibly need to ask about a bronchoscopy to check status in lungs & get sputum samples. Just my opinion. I've been on the big 3 for 11 months & Arikayce nebulized since March 7, 2025. Best wishes to you !

I have actually had an induced sputum test. The respiratory therapist has you breathe a 10% saline solution and within a few seconds of holding that in, I had some very good sputum samples. It maybe a solution for some who cannot produce sputum rather than an invasive bronchoscopy.

That's interesting. How did that work? How often did you have to hold your breath during nebulizing? And for how long? I'm wondering if I can try that with my 7% saline

I am on Bacterium 2X a day, I do exercise and use AIRBOKia 3x aday and albuterol nebulizer 4X a day . and I have not seen a change in my CT scans, however I do feel better.

I use 7% at home twice a day to help my airway clearance. With the 10% at the DR.'s, I start coughing within 15-30 seconds and produce a good sample in 3 or 4 minutes.
When I nebulize at home with the 7%, I usually do the saline first for about 30 minutes, then use my areobika to help force the sputum out.
I had to try different techniques to get an ACT (airway clearance technique) that works best for me.
Best of luck. This is a tough disease, but being consistent with the ACT can make it manageable.

do you have coughing?

I have very little coughing. I have seasonal allergies and if I am coughing I will use sinus rinsing and that seems to really help stop the coughing. For me it seems if I can keep my sinuses clear it helps my lungs a lot and I stay healthier.
Good wishes!

I was diagnosed with NTM at the beginning of the COVID shutdown. After a lung biopsy for a couple of one-inch spots, I underwent a year of heavy antibiotic use and was able to tolerate them well. I also began the nebulizing two or three times per day. I have been doing nebulizing for five years. I measure and track the output each day. It has variations at times, but has been reasonably consistent.
I have recently experienced a significant reduction in the output from my nebulizing, even when I use it once a day.
Change One
I have had significant sleep apnea that I have been treating for ten years. The full-face mask and Somnifix mouth tape have not consistently alleviated my mouth breathing. I had used heavier tape, which held my mouth closed all night, which has cut my events to the low single digits. My sleep has improved significantly in a shorter time.
Change Two
I have recently been doing an hour of full-body exercises every day, which is new for me.
Question
I was told that the bronchitis would only worsen over time and not improve. I don't want to have false optimism about the changes. Has anyone else experienced a significant reduction in bronchitic symptoms? If so, what did your improvements correlate to for you?

@espresso2go
I see that you've been a member for a while, but this is your first posting. Welcome!

I was diagnosed with bronchiectasis 3 years ago and thought to have MAC, but cultures were negative. I'd been half sick a lot the previous few years with terrible coughs and low grade temps. I've improved a LOT with treatment of my mild asthma and aggressive treatment of my sinusitis. No recent fevers and coughs are minimal. Since sinusitis is controlled, I rarely have sputum.

I know the MAC specialists think exercise is a great tool for airway clearance and I believe improved clearance could stabilize the bronchiectasis. Others here report stabilized bronchiectasis as well.
I can't speak to the impact sleep apnea treatment would have except to say that sleep is important for healing in general. My pulmonologist stressed its importance.

I haven't had a CT in past year, but my PFT's had improved, good already, but better. Pulmonologist was very happy.

@espresso2go
I am on no meds and have MAC/BE, diagnosed in 2022, and remain stable after the 3 years. I use the Aerobika twice a day w/o saline or other and walk 1-2 miles a day. My CT scans can show changes with some areas lessened and others showing some growth. I have no symptoms other than an occasional cough and some fatigue and limited sputum production. My last CT scan this past August, which I have done every 6 months at NJH, shows a slight increase in BE in my right lung and lessened MAC on the other side. Next time, it could be the opposite -- or no growth at all, or for that matter worse, but both still in existence. Airway Clearance is extremely important and ridding yourself of the mucus through AC, small or not, can make a difference in how you feel and the progress of this disease.