MAC with sinus issues

Not diagnosed with MAC but I have CRS (chronic sinusitis w/o polyps). If I have a sinus infection it usually starts with some trigger, which leads to sneezing and some crusting at my nose. If left untreated by my home program it usually ends up in my lungs and they get gunkier even though my sputum sample does not grow anything. The respiratory culture usually show lots of neutrophils, however, indicating inflammation and possible infection (probably colonization in my case). I do not necessarily cough more during a sinus infection unless it has gone to my lungs. Even without infection my "cough times" happen several times a day anyway (at night, eating, talking a lot, laughing etc).

ENT told me recently that for sinus infection to clear it needs 14 days of antibiotics. Sometimes more if it's recalcitrant. It's difficult to get a nasal culture unless the infection is very active. My home program includes rinsing with saline and budesonide, steaming (when there's pressure/stuffiness), Sudafed, Tylenol. For the crusting I use Ayr and sometimes muprirocin sparingly. All this on top of airway clearance 2x day! Hope you feel better!

I’ve had sinus issues since shortly after being diagnosed with Mac over 6 years ago. It strangely started with my ears being plugged while flying. I’ve also had fluid in my ears and post nasal drip since then, although that has improved to the point that I no longer use nasal sprays unless I get a sinus infection. I’ve found that the best thing for me is to faithfully take Mucinex twice a day, which I take for my lungs but it seems to keep my sinuses from getting clogged up with thick secretions. I’ve never had a nasal culture analyzed.

I’ve seen a couple of specialists about my sinuses and they’ve recommended treating symptoms, which I have been doing. For me, I always know I’m getting sick (eg an exacerbation) if my sinuses worsen and so I get that treated with antibiotics before it moves into my lungs. It feels like we all have to figure out a treatment plan for managing symptoms. I’ve found that this forum has been really helpful in get information on what works for other people.

I've had significant sinus issues and had intermittent horrid coughing episodes from all the drainage before my CT that looked like MAC (cultures negative). Docs then started being aggressive in trying to get drainage under control. The bad coughing episode improved with nasal sprays-Astepro and steroid initially and later added Ipratropium. I also do sinus rinses with mometazone using Neilmed's Squeezie. I do them 1-2x/ day depending on on season and intermittently I try just saline without the steroid. Rare coughing episodes now.

Btw, first pulmonologist thought bad CT could be due to sinuses, but Ent was skeptical. I did review and Japanese thought it related, "sinobronchial syndrome," as I recall, and had several studies. (Haven't looked lately.)
Good luck. The coughing can be exhausting.

What time of day do you take Astepro? My kids have had such success with it I thought I'd give it a try. Daytime dose seemed to work great but the p.m. dose (bedtime) seemed to irritate my throat and kept me from sleeping.

I use mine when I get up and at bedtime. I have dry mouth syndrome, and use Biotene mouthwash at bedtime. It prevents thr guy throat you are describing too.
My daughter does her second dose at suppertime.²