Do we need airway clearance if no symptoms?

Posted by tglatthorn @tglatthorn, 8 hours ago

Currently, I have bronchiectasis and Ntm abcessus, but no real symptoms. Night sweats stopped. No fever, not much coughing. When I do airway clearing with the nebulizer, it makes me cough a lot. It brings up spit, bubbly - like Im just coughing back out the moisture I am breathing in. And my ribs ache from the coughing. When my coughing is natural, I can get actual sputum, thick and greenish or yellow/ white clumps in the bubbly stuff - if there’s something that needs to come out.
I’m not nebulizing and I feel ok. My pulmonologist is annoyed with me for not nebulizing. The other (main) reason I don’t is high anxiety about the nebulizer having to be sterilized and not being sure anything would get all the hoses and parts truly clean without an exhausting process. I am afraid nebulizing could make me sicker if I breathe in unsterile air. I’m 73, working part time, and I have afib, postural orthostatic tachycardia (I get faint from standing or walking) and other chronic issues that create fatigue. Is it ok if I just get mucus come out when it wants to?

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Sue, Volunteer Mentor | @sueinmn | 7 hours ago

@tglatthorn Do you need airway clearance? Yes - you answered your own question - when you cough you bring up yellow/green sputum with white clumps - that is where the germs hide and multiply.

Maybe you need some coaching in how to effectively do airway clearance, because properly done it should not make your ribs hurt.
Here is a good video about how and why -

What are you using in the nebulizer ? Albuterol? Saline solution? If saline, maybe 7% is too strong and irritating, and the doc can prescribe 3%.

As for cleaning and sterilizing your nebulizer - forget the hoses, you only need to do the nebulizer cup and mouthpiece. Here is one video explaining how:
https://sterilizerguide.com/how-to-sterilize-nebulizer-parts/2
(Note - if you have M abscessus, the vinegar soak is not enough. Boil or steam.)

Did you have any instruction from your doctor's team about how to do airway clearance?