How to understand Sputum/Bronchoscopy and CT changes over time

Hi Karen,
I’m sure if we put our heads together, we can come up with airway clearance suggests.

*What do you do for airway clearance?
*Can you go somewhere to get an induced sputum sample with 10% HS?

I had 3 negatives but my CT scan looked suspicious for MAC. It was identified by bronchoscopy.

M. gordonae is often a lab contaminant and not treated. It might not have come from your lungs.

Best,
Linda Esposito

When at the Mayo now 3 weeks ago, I bought a nebulizer there that works great. I’m using 3% saline solution and an Aerobika . The respiratory specialist gave me a special mouthpiece (PariLCPlus) for the nebulizer with tubing. He showed me how to use the aerobika while nebulizing. That said, I just can’t cough up enough sputum for a decent sample.

It sounds like you've had excellent airway clearance advice. You might want to ask your therapist the following:
-how much sputum do they need? I was once working with a therapist who was doing manual therapy on me and I coughed up a dime size sample. We sent it to the lab and it grew MAC.
-could you use 7 or 10 % just for the sputum sample?
-have you tried exercising before airway clearance?
-what about postural drainage? Many therapists don't like it because it increases the probability of reflux but sometimes it boils down to priorities
-what about using the smartphone autogenic drainage app?
-would a hand-held massage gun make a difference?

I hope this is helpful,
Linda Esposito

I was diagnosed with Bronchiectasis and there was also (allegedly) some type of bacteria detected after having constant bronchitis events in November 2022, December 2022 and February 2023. I had an CT scan with all kinds of lung issues including GGO, detection of bronchiectasis and likely some type of MAC. I also provided sputum samples. Initially, H-Influenza was detected, and after begging the doc for an antibiotic, he relented and I was put on doxycycline for 10 days. Prior to that, I had been living with fevers every day from November 2022 to June 2023 when I got the antibiotic. Also, my cough sounded like a plugged up drain, and I was bringing up disgusting sputum (color and taste). A culture test 8weeks later showed up “abnormal” in my portal. I was sent to the ID who was all set to start me on the big 3. I asked her specifically what are you treating me for. She looked in her records and saw that the specimen wasn’t finished being processed. She assumed that because pulmonologist sent me to her, I had been diagnosed with MAC already. She was embarrassed and called the lab to determine when the final diagnosis would be. 2 more days. So she called me then and said it was bacteria gordonae. We don’t treat that. Well, after this experience, with no follow ups after the H-influenza or CT scans requested or sputum samples requested I decided I should go to the Mayo Clinic. Tried to go to Phoenix, but they don’t treat Bronchiectasis there - Rochester, MN or Jacksonville, FL. I chose Rochester. I was there 2 weeks ago. I had all sorts of tests including CT of chest and sinus, Esophogaus - barium scan, rhinoscopy. Yes - they found all kinds of problems, including the the Bronchiectasis has spread as well as the likely MAC (infection) spread since last year. They said “moderate to severe” on the scan. In any case, I’m supposed to be sending 3 sputum samples to Mayo. I’ve sent two. I can’t seem to cough up any sputum now, even though I have the same sounding cough as I have had for a year. Any ideas for how to produce for a sample? I’m supposed to return to Mayo in 4-6 months. The two samples I’ve sent have come back “negative” for the stain, but I guess they’re being cultured too. I do nebulize, but I don’t cough up anything with that either. Thanks in advance for any advice!

My pulmonologist suggested that I just nebulize with albuteral, no salt, and try coughing to get a sputum sample. This is just to get a sample. Hope this helps.