Nebulizing saline

Nebulizing with hypertonic saline has been a godsend to me. I went from a great deal of struggling to clear my lungs to being able to clear my lungs more easily (especially the first several huff coughs). A different question is how it that your pulmonologist has not suggested it? Perhaps they do not see many bronchiectasis patients and/or have not kept current on bronchiectasis treatment.
https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2024/01/Up-to-Date-Bronchiectasis-in-adults-Treatment-of-acute-and-recurrent-exacerbations-UpToDate.pdf
Hypertonic saline can be purchased without a script through Amazon and other places. So you could give it a try and experiment for yourself. I would report to pulmonologist, however, the increased shortness of breath. It is possible that removing more mucus via hypertonic saline might relieve some of your SOB.

I was just diagnosed with BE. Ct showed "mild BE". Pulmanologist didn't say whether it was mild - just said BE. Anyway he prescribed 7% sodium solution to be nebulized 2x a day. It's really inexpensive.
I have a me ulizer that attaches to the aerobika which I felt easier than doing separately. He told me to use it at level 5 on the aerobika but that makes the muscles in my chest ache and ribs. Today I did it at 3 then turned up to 4 or 5 throughout the nebulizer treatment.
The solution definitely made me cough (good they said) but I'm not coughing up much mucus blobs just thin watery bubble saliva filled mucus. They want a mucus sample to check for MAC so I will keep trying (or maybe no plugging in there?)
How long have you had BE? Do you have MAC? What measures have you taken to reduce NTM's from your BE world? Like water filtrations, mask if gardening, dusting, etc.

Thanks for your replies. Diagnosed December 2024 and then February 2025 bronchoscopy discovered mycobacterium abscessus NTM. No treatment besides Aerobika until now. Reluctant to do antibiotics cuz they wreck quality of life. Don't understand why pulmo hasn't prescribed saline. He has never treated m abscessus before. Expertise is nonexistent where i live.

I think you answered your own question, your doctor is not familiar with treatment protocols. Do you have any possibility of getting referred to a specialist, even if you must travel?

If I was in your situation, what I would do is to find some of the references for using saline, take them to my doctors and ask for a prescription if they will give one, or are least their agreement for you to try it on your own. If health care is scarce, the last thing I would want to do is anger the doc so they fired me as a patient.

I'm working from my phone, so limited ability to find my links.When I try I seem to lose what I just typed. So I'll post this then try to find the link and post it.

Here is the current European protocol:
https://publications.ersnet.org/content/erj/early/2019/04/05/1399300302143-2018
Sorry I can't get my other links to work.

Yes to nebbing with saline. Yes to doing everything you can to see a specialist. Even if you have to travel. Even if you have to self pay (which isn’t an option for many, I know). It can take a long time to get in to a specialist so I would not delay on considering that option. If on the fence you can always cancel before the appointment. But it could easily be a 3-6 month wait. And that’s after you’ve jumped through all the hoops just to get on the schedule. Abscessus can be trickier to treat than MAC, which itself is tricky to treat, so having an experienced practitioner would be important to me.

Do not want to anger my pulmo. He is a great guy and very compassionate. At least he admitted his lack of experience. Might know what to do if i end up in ER.

Be honest with your dr. He was honest with you. You need care. Get it however you need to.

Don't be afraid to approach your doc respectfully with this info! @beejenigma is right - he admitted unfamiliarity with your infections should not be unhappy to learn about the resources here on Mayo Connect. He may even welcome the information- doctors are welcome here!

Thank you all for the great responses. I will definitely tell him where i'm getting all this good info.