MAC and Pseudomonas

Welcome to this very helpful group. I'm very sorry you need to be here, but believe you'll find it helpful. There are a lot of ways to prevent reinfection and I think you'll get other suggestions. Here's one link and pages that answer your question start on 28 or 29.
https://www.ntminfo.org/wp-content/uploads/2019/09/Guide-for-Patients-with-NTM-Infections-2019-09.pdf
I'm glad you're tolerating meds and feeling Ok.
Are you doing airway clearance?

I take them at night now after dinner with a ginger gravol and it seems better. I do airway clearance due to the COPD. That is the only symptom of COPD that I have.
Thank you for the link.

That's my biggest concern is reinfection as well. Things I've done: I increased my water heater temperature and installed an ultrafiltration undersink sytsem at my kitchen sink for drinking water and washing fruits and vegetables. I also installed a new shower head (one where the shower head drains), though I'm thinking about getting a filter for that as well. I don't take hot showers, which I miss. I just haven't been able to find a filter for shower. I also buy spring water when out of town. Spring water has a low to zero NTM count. When I was at NJH, I was tested for reflux and whether or not I'm prone to aspirating food. These are very important tests to get-if you haven't. Fortunately, I wasn't a high risk but there's no such thing as no risk, when it comes to aspirating food/drink. I was given swallowing exercises, which I did and now do periodically. Also, be aware of water vapor-washing dishes, opening a hot dishwasher, and the hot showers. The paper that pacathy posted is a good resource. I religiously nebulize with 7% saline 2x/day with huff coughs. I sure would like to reduce someday to 1/day, but it helps keep my lungs clear. I also always have a mask handy if needed. I'm happy to hear you are tolerating your meds and you are especially lucky to be able to take Azithromycin, it is the best gun there is for MAC.

Thank you, I will have to look into that type of shower head as we don't have a tub. I have never used a nebulizer is that helpful? I will have to be more alert and next year take more precautions when I swim.

You're welcome. Yes, nebulizing with 7% saline is recommended by NTM/BE experts and should be considered one of the most important aspects of treatment, along with antibiotics-in I think most people. I say most people because in some cases NTMs clear on its own-one of the reasons NTM doctors "watch and wait" for those that are asymptomatic or those with low culture counts. Most local doctors (including ID doctors) are not experts-in my opinion. MAC , when not macrolide resistant has a standard drug treatment-which you are on, so most local doctors are successful in treating. However, I'm amazed at how many people have started treatment and are not nebulizing, nor do they know their mycobacterium count. More nebulizing studies are needed but the few studies that I have come across have convinced me to keep it up. I attached 1 small study, still can't find the other study. Portland NTM Clinic should be starting a study of 100 participants with MAC,, looking at the potential effects of clearing the infection or improving treatment options. Can't wait to see the results, which should give us all a better idea on the effectiveness of 7% nebulizing. I use the Aerobika nebulizer with OMBRA compressor (like that since the tubing is changed with neb cup).

Thank you for these links, and I will talk to my Dr when I see him next about the nebulizing.