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The 2nd North American Bronchiectasis and NTM Conference Patient Education Program will take place on December 1, 2025, and it is completely free to attend.  You can join in person at NYU Langone Health or participate virtually from anywhere. Many of our favorite bronchiectasis and NTM experts will be speaking, along with new voices who are helping shape the future of care, research, and patient support. This annual event brings together leading clinicians, researchers, advocates, and patients for a full day of learning, connection, and practical guidance. Whether you are newly diagnosed or have been living with bronchiectasis or NTM for years, this conference offers valuable insights into clinical care, airway clearance, inflammation, genetics, environmental factors, and the latest research discoveries. Why You Should AttendThis program delivers high quality education covering topics such as clinical care networks, international data, global advocacy, NTM epidemiology, genetics, airway inflammation, guideline updates, and emerging clinical trials. You will hear directly from respected leaders in the field, including:
Dedicated question and answer sessions give attendees the chance to hear expert perspectives on the issues that matter most. Registration DetailsSign up now to hold your spot: .nyulangone.org/care-services/bronchiectasis-ntm-program/ntm-patient-education-program Interested in attending the professional conference virtually? ($399) Contact Marla Hymes at [email protected] 212 263 5183 Agenda for December 1, 20259:30 AM Registration 10:00 AM Opening Remarks – Doreen Addrizzo Harris, MD 10:05 AM US Clinical Care Networks – Doreen Addrizzo Harris, MD 10:15 AM Canadian Database and Updates – Ted Marras, MD, MSc 10:30 AM Updates from Latin America – Marcela Munoz, MD 10:45 AM Global Awareness and Advocacy Initiatives – Timothy Aksamit, MD 11:00 AM Epidemiology and The Environment with NTM – David Kamelhar, MD 11:15 AM Question and Answer 11:35 AM Break and Lunch 12:15 PM Genetics in Bronchiectasis – Kenneth Olivier, MD, MPH 12:30 PM Inflammation in Bronchiectasis – Anne O’Donnell, MD 12:45 PM Guideline Updates – Ashwin Basavaraj, MD 1:00 PM NTM Updates – Shannon Kasperbauer, MD 1:15 PM Clinical Trial Update and Future Research Directions – Charles Daley, MD 1:30 PM Question and Answer 1:50 PM Closing Remarks – David Kamelhar, MD Need to Make Changes to Your Registration?Contact Marla Hymes at
[email protected] 212 263 5183 Reach out if:
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Did you know there’s an association between bronchiectasis and gastric reflux, as well as between NTM pulmonary disease and reflux?  Now, more than ever, leading U.S. bronchiectasis care centers are focusing on the role of gastric reflux. If your care team hasn’t evaluated you for reflux, it’s worth discussing. Why Reflux MattersManaging reflux can be crucial to preventing disease progression. Airway clearance alone might not be enough to stop inflammation and infection. Some individuals manage acid reflux with antacids, alginates, or medications like Pepcid. Others may need proton pump inhibitors (PPIs) such as Nexium or Prilosec to prevent precancerous conditions like erosive esophagitis or Barrett’s esophagus. However, the goal is often to minimize PPI use because stomach acid is needed to break down food and kill bacteria. Long-term use of these medications can cause nutrient malabsorption and bone loss. And, according to gastroenterologist Dr. Jeffrey King, lowering acid does not decrease reflux. Surprisingly, it can increase non-acid reflux. Silent Reflux and LPRWhile PPIs reduce acid production, they do not stop reflux. There is a condition called silent reflux, also known as laryngopharyngeal reflux (LPR). This involves the reflux of solids, liquids, and gases that can be both non-acidic and acidic. Substances such as water, milk, or bile, which are alkaline, can also reflux into the throat and voice, causing symptoms such as a sore throat, drippy nose, and hoarseness. Even though these substances are not acidic, they can still reach the lungs and potentially cause tissue damage, chronic inflammation, and disrupt the lung microbiome. Steps You Can TakeIf you have reflux, it’s important to take it seriously. Lifestyle changes can make a big difference:
These habits can help reduce reflux episodes and improve overall well-being. Always consult your physician before making any changes to your treatment plan. Together, you can find the best approach to manage reflux and support your lung health. “This multi-modality strategy has long been the standard for other chronic diseases, such as congestive heart failure, and bronchiectasis warrants an equally nuanced approach.” Dr PJ McShane  In a recent editorial published by Dr. Pamela McShane of the National Institutes of Health (NIH), she describes brensocatib, now marketed as BRINSUPRI™, as a breakthrough for the bronchiectasis community. This first-in-class DPP-1 inhibitor marks an important step forward in reducing inflammation and exacerbations for people living with bronchiectasis. However, Dr. McShane emphasizes that it is unrealistic to expect one drug to meet every patient’s needs. Instead, she encourages both clinicians and patients to view BRINSUPRI™ as part of a broader treatment plan that includes mucoactive agents, airway-clearance techniques, and, when appropriate, macrolide therapy. Where BRINSUPRI™ Fits in the Treatment LandscapeFor individuals already receiving long-term macrolide therapy, adding BRINSUPRI™ may further improve outcomes by targeting inflammation through a different mechanism. For those living with nontuberculous mycobacterial (NTM) infections, where macrolide therapy may not be possible due to resistance concerns, a DPP-1 inhibitor such as BRINSUPRI™ could represent an alternative strategy to interrupt the ongoing cycle of inflammation, infection, and mucus dysfunction that drives bronchiectasis progression. Evidence from the WILLOW StudyDr. McShane referenced findings from a subgroup analysis of the WILLOW study, where participants with Pseudomonas aeruginosa infection experienced a significant reduction in exacerbations when treated with brensocatib compared with placebo. This suggests that BRINSUPRI™ could benefit patients with chronic bacterial colonization, one of the most challenging aspects of managing bronchiectasis. The Importance of Multi-Mechanism StrategiesDuring her guest appearance at a Bronchiectasis and NTM Association support group, Dr. McShane reiterated that while DPP-1 inhibitors represent an exciting advance, they do not address every biological mechanism involved in bronchiectasis. She emphasized that future therapies must also target airway-epithelial health, mucus viscosity, and host-pathogen interactions to achieve long-term improvement. Dr. McShane also compared this approach to the multi-modality treatments already used for other chronic diseases such as congestive heart failure. Bronchiectasis, she argued, deserves an equally comprehensive and individualized model that combines medications, airway clearance, exercise, and infection control for the best outcomes. BRINSUPRI™ represents a long-awaited milestone, but it is only the beginning. The future of bronchiectasis management depends on integrated, multi-mechanism treatment plans that address both airway inflammation and mucus dysfunction, two central challenges of this complex condition. Editorial Reference:P.J. McShane. Are Dipeptidyl Peptidase-1 Inhibitors the Future Anti-inflammatory Treatment in Bronchiectasis? Archivos de Bronconeumología. DOI: 10.1016/j.arbres.2025.09.002
A recent Good Morning America segment introduced millions of viewers to bronchiectasis, a chronic lung condition that affects about 500,000 Americans.  Many people, including the woman interviewed, had never heard of it until diagnosis. What began as what she thought was pneumonia or a cold turned out to be a serious and progressive inflammatory disease that can cause ongoing coughing, shortness of breath, and fatigue. What Is Bronchiectasis?Bronchiectasis is a non-contagious chronic lung disease where the airways become widened and damaged, making it difficult to clear mucus. This creates a cycle of infection and inflammation that can worsen over time if untreated. Because its symptoms often resemble asthma, COPD, or chronic bronchitis, many patients go years without a correct diagnosis. Common symptoms include:
Living with Bronchiectasis“That tiredness, it’s like you really can’t do the things you want to do, even simple things around the house.” The GMA story described how bronchiectasis impacts both daily life and emotional well-being. Weather changes, fatigue, and infections can limit social activities or even make leaving home difficult. Over time, many people find that managing energy levels and incorporating airway clearance into daily routines becomes a key part of staying healthy. The Importance of Early DiagnosisOne of the biggest takeaways from the Good Morning America feature is that bronchiectasis is often misdiagnosed or missed altogether. If you experience a chronic cough lasting a long time, or two or more respiratory infections in a year, ask your doctor for a chest CT scan and referral to a pulmonologist. Early diagnosis helps prevent further lung damage and allows for timely treatment, including antibiotics, airway clearance therapy, and lifestyle support. Managing the ConditionThere is currently no cure for bronchiectasis, but it can be managed successfully. A comprehensive plan may include:
Why Awareness MattersResearch organizations and sponsors such as Insmed are studying bronchiectasis and related infections like NTM (nontuberculous mycobacteria). Their work, combined with patient education and advocacy, is helping to change how this condition is recognized and treated. Public awareness ensures that more patients receive proper testing and care before irreversible damage occurs. Moving Forward Bronchiectasis may be chronic, but it does not define those who live with it. Education, early detection, and community support are essential to improving quality of life.
Learn more about evidence-based strategies and resources at BE CLEAR with Bronchiectasis and watch step-by-step educational videos on the BE CLEAR YouTube Channel. To watch the Good Morning America segment click here. During this Respiratory Care Week, the most important takeaway is that there is no single method that works for everyone when it comes to airway clearance.  Dr Colin Swenson and Dr Wendi Drummond podcast speakers on NTM lung disease and bronchiectasis Each person living with bronchiectasis or other chronic lung conditions has unique needs, physical abilities, and comfort levels. What matters most is finding the combination of tools and techniques that help you breathe easier and stay consistent over time. Airway Clearance Is Both Science and ArtAll current bronchiectasis guidelines recommend working with a respiratory therapist to learn proper airway clearance techniques. These specialists can demonstrate breathing exercises, oscillating positive expiratory devices, and postural drainage positions that improve mucus clearance. But even with expert instruction, airway clearance remains as much an art as it is a science. Consistency, timing, and creativity all play a role. Some people prefer short sessions throughout the day, while others set aside dedicated time morning and evening. The key is to listen to your body and notice what feels effective and sustainable. Personal Consultations Can Make a DifferenceMany people find it helpful to schedule a consultation with me, Linda Esposito, to review their airway clearance routine. I demonstrate my own techniques and share the tools I use, then we talk about what you currently do and explore ways to make your routine more efficient and personalized. Together, we can identify adjustments and additions for your airway clearance toolkit that help you clear mucus more effectively and with less stress. Keep Learning and Keep BreathingRespiratory Care Week is a reminder to appreciate the incredible professionals who help us breathe better and to keep improving our own self-care practices. Whether you are new to airway clearance or refining your long-time routine, remember that progress comes from learning, experimenting, and adapting.
Let’s keep learning together and continue building confidence in our daily airway clearance routines. Have a listen to this podcast series featuring two podcasts on Airway Clearance!! Click here, then scroll down to read more blogs!! Respiratory Care Week is here, and it’s the perfect time to highlight the vital role of respiratory therapists and the tools that help people breathe better every day.  Yesterday I shared a post about Monaghan Medical, the makers of the Aerobika® and the AeroEclipse® and Ombra nebulizing system. Today, we’re continuing the celebration with a “PEP talk”—or better yet, an OPEP talk! What Is OPEP Therapy?OPEP stands for Oscillating Positive Expiratory Pressure. This therapy uses a small handheld device to help loosen mucus and open partially blocked airways. As you exhale through the device, it creates gentle vibrations that “unstick” mucus, making it easier to cough out. Two of the most popular OPEP devices are the Aerobika® and Acapella®. These tools are especially helpful for people living with bronchiectasis, COPD, cystic fibrosis, asthma, or other chronic lung conditions where mucus buildup is a daily challenge. For a step-by-step demonstration, visit my YouTube Channel – Clearance of Airways Playlist where I show exactly how these devices work and how to use them safely. Finding the “Goldilocks Zone” with a ManometerWhen it comes to OPEP, effort matters but more is not always better. Many people tend to blow too hard into their device, thinking it will move mucus faster. In reality, exhaling too forcefully can collapse smaller airways and reduce the effectiveness of airway clearance. That’s where the manometer accessory comes in. A manometer measures the pressure created during exhalation so you can stay in the “Goldilocks zone”—not too hard, not too light, but just right. If you use a manometer, your goal is to maintain a pressure between 10 and 20 cmH₂O throughout your exhalation. Staying within this range helps keep your smaller airways open and promotes optimal mucus movement. Pressures above this range can actually work against you, while pressures below may not provide enough resistance to be effective. Why OPEP Devices Matter for Bronchiectasis and BeyondFor people with bronchiectasis and other mucus-producing lung diseases, airway clearance is a daily essential. OPEP devices make that process more effective and less exhausting. Regular OPEP use can help:
Where to Purchase the Aerobika with ManometerPurchasing an Aerobika® with a manometer usually costs only about $10 more than the Aerobika alone. You can order directly from Tampa Specialty Pharmacy, a trusted distributor of Monaghan Medical products. OPEP therapy is one of the most empowering self-care tools for those living with chronic lung conditions. By learning proper technique and using the right accessories, you can make airway clearance more effective and comfortable—so you can focus on living, not just managing symptoms. To learn more, explore my YouTube channel and BE CLEAR blog for additional videos, tips, and patient-friendly education. BE CLEAR has a consulting relationship with Monaghan Medical. Did you know that Respiratory Care Week was created by President Ronald Reagan?  After surviving an assassination attempt in 1981, he established this important week, now celebrated during the last full week of October, to honor respiratory care professionals for their dedication and expertise. Recognizing the Experts Who Help Us Breathe EasierEach October, we take time to recognize their skill and compassion. Unfortunately, many in the bronchiectasis community still do not have access to respiratory therapists for one-on-one guidance. Hopefully, as bronchiectasis centers continue to expand, that will change. For now, we rely on education from companies in the lung health space like Monaghan Medical Corporation, maker of the Aerobika® and AeroEclipse® nebulizer. Their newly updated website is beautiful, informative, and easy to navigate: https://www.monaghanmed.com/ Reliable Products and Helpful PartnersNo endless scrolling on the internet trying to figure out where to get our devices or how to use them. Monaghan is also making it easier than ever to order devices like the Aerobika® with a manometer. You can now purchase it directly through Tampa Specialty Pharmacy (TSP). Need a prescription? No problem. The Monaghan website includes a link to their online partner, OLA Digital Health, where you can quickly obtain one. And here’s something I love: the Aerobika® is now available at Walmart pharmacies. That means if I’m traveling and accidentally leave mine behind (yes, it’s happened), I can simply pick one up at Walmart. A Company That Truly CaresIf you’ve contacted Monaghan’s Customer Service team, you already know how knowledgeable and responsive they are. They understand their products and genuinely care about keeping us informed and satisfied.
As a consultant for the company for years, I’ve had the privilege of visiting their immaculate upstate New York plant and speaking directly with the assembly line workers to let them know how vital their work is to our well-being. Monaghan Medical continues to support our community in a big way, and that matters, because for many of us, it’s a lifelong relationship. If you use airway clearance devices like the Aerobika® or the AeroEclipse® XL nebulizing cup, keeping them clean is one of the most important ways to protect your lungs and get the most out of your treatments.   These tools help open up your airways and create an inhospitable environment for bacteria and other pathogens. It's important to disinfect them regularly so they do not become a potential source of infection. For people living with bronchiectasis, this step is especially important. Bacteria such as Pseudomonas aeruginosa and nontuberculous mycobacteria (NTM) can grow in moist environments and are difficult to treat once they take hold. Regular cleaning and disinfecting of your Aerobika® and AeroEclipse® XL devices helps prevent contamination, protect your lungs, and keep your airway clearance routine safe and effective. The good news is that caring for your equipment does not have to be complicated. Once you understand the steps and make them part of your daily routine, it becomes second nature, like brushing your teeth. Taking a few extra minutes to clean and sterilize your devices can make a lasting difference in your respiratory health and peace of mind. I hope you find these easy-to-follow instructions helpful! Let me know in the comments below if you have any questions. When I talk about being clear with bronchiectasis, I don’t just mean lung function.  I mean clarity in three essential areas:
1. Keeping Your Lungs Clear with BronchiectasisMaintaining open, mucus-free airways is the foundation of bronchiectasis self-care. Daily airway clearance helps:
What to Include in an Airway Clearance Routine
For a deeper dive, explore my airway clearance Youtube playlist. 2. Clearing Up Misconceptions About BronchiectasisClear lungs are only part of the picture. We also need clear minds—free from misinformation. Unfortunately, inaccurate advice is common in online groups and social media. While personal stories can be comforting, they are not always based in science. Where to Find Reliable Information
3. Releasing Fear and Emotional Stress from BronchiectasisA bronchiectasis diagnosis often stirs strong emotions, including:
Strategies to Support Emotional Health
Living Well by Being Clear in Body, Mind, and SpiritWhen we commit to clarity in our lungs, mind, and spirit, we do more than manage bronchiectasis—we create conditions to thrive. By practicing daily airway clearance, choosing evidence-based knowledge, and tending to emotional well-being, we strengthen both our lungs and our overall quality of life. Understanding Bronchiectasis and MACI was diagnosed with two lung conditions--bronchiectasis (BE) and a Mycobacterium Avium Complex lung infection (MAC-LD).  Not long ago, both were considered rare. Today, thanks to better medical education and the widespread use of high-resolution CT scans, BE is being diagnosed more often. MAC, however, remains less common. These bacteria are present everywhere in our environment, but in most people they do not cause disease. The “Chicken or the Egg” QuestionWhen someone is diagnosed with both bronchiectasis and a MAC infection, doctors often describe it as a “chicken or the egg” scenario. Did the lung damage from bronchiectasis create an environment that allowed MAC to thrive, or did MAC infection trigger the development of BE? Risk Factors and Root CausesClues sometimes come from a person’s medical and lifestyle history. Pneumonia or chronic bronchitis, for example, can scar the lungs and lead to BE. In other cases, genetic factors may play a role. Occasionally, identifying these underlying conditions opens the door to targeted treatment. How My Story UnfoldedAlthough nothing is certain in my situation, I likely developed bronchiectasis after a severe pulmonary infection in my mid-50s. That inflammation may have made my lungs more vulnerable to MAC. And because MAC is everywhere—in soil, water, and air—exposure is difficult to avoid. For instance, during the years my husband and I lived upstate, I kept a large flower garden and regularly spread mulch. MAC thrives in mulch, which can easily become airborne and inhaled. Clearing a MAC Infection Through Self-CareFortunately, I was able to clear the MAC infection with a strong commitment to airway clearance, regular exercise, maintaining a healthy weight, and consistent stress management. These daily practices gave my body the best chance to heal and stay resilient. Why I Focus on Bronchiectasis in My BookIn my book, The BE CLEAR Method to Living with Bronchiectasis, I briefly share my “double-whammy” experience but focus primarily on bronchiectasis. That was intentional—many people with BE will never develop MAC or other Nontuberculous Mycobacterial (NTM) infections. Reducing Risk in Everyday LifeStill, it’s important to talk about practical prevention. Simple steps, like wetting soil before gardening and wearing a mask while working outdoors, can reduce exposure and give peace of mind to those who want to be proactive. Build Your Own Bronchiectasis Self-Care PlanIf you would like help putting together a daily self-care management program, I can support you. As an experienced health educator and coach, I’ve worked with hundreds of individuals to create personalized plans that fit their lifestyle—covering airway clearance routines, exercise, nutrition, stress management, and long-term wellness strategies.
Together, we can build a program that helps you feel more in control of your health and confident in your day-to-day life. The past several days have been nothing short of inspiring for the bronchiectasis and NTM community.  Between new research updates, clinical insights, and groundbreaking treatment news, we have so much to be hopeful about! It all began with a powerful video from Dr. Charles Daley of National Jewish Health, who was speaking with a patient group in Florida. His focus? The newly FDA-approved medication for bronchiectasis: Brensocatib (brand name BRINSUPRI™). Why This MattersFor decades, people living with bronchiectasis have had limited treatment options beyond airway clearance and antibiotics. The FDA’s approval of Brensocatib marks the first new therapy specifically approved for non-CF bronchiectasis, and the ripple effects are already being felt in the bronchiectasis care centers across the country. Dr. Daley explained that at National Jewish Health, clinicians will begin prescribing Brensocatib to patients who are most likely to benefit—including those who struggle with chronic infections like nontuberculous mycobacteria (NTM). Even more importantly, NJH will collect data from these patients to help determine the drug’s long-term effectiveness across different subgroups. A Standout FindingWhat truly lit up the conversation was one of the most exciting results from the pivotal clinical trial:
A New Chapter of HopeThese updates (see video for complete talk) remind us that the field of bronchiectasis care is finally moving forward. We are not standing still. From clinical trials to FDA approval to real-world prescribing, there is momentum, hope, and possibility taking shape. For patients, caregivers, and clinicians alike, this is the beginning of a new chapter—one where the words “stable lung function” carry the promise of more time, more strength, and more opportunities to live fully. Click to learn more about BE CLEAR resources, including the book and individual consultations. In patient education webinars, bronchiectasis expert Dr. James Chalmers often shares his enthusiasm for sputum.  One of his favorite teaching tools is a sputum color chart 💛💚💛—and for good reason. Why Mucus MattersMucus is part of the body’s defense system, trapping bacteria and harmful particles before they reach the lungs. But mucus also acts as a signal: when infection strikes, it can become thicker and shift toward a darker or greenish color. This change is caused by the release of myeloperoxidase (MPO), an enzyme from immune cells called neutrophils. MPO is powerful—it produces reactive oxidants such as hypochlorous acid to kill pathogens and helps form neutrophil extracellular traps (NETs) to capture microbes. While essential in fighting infection, excessive MPO activity can damage lung tissue and fuel chronic inflammation. |
AuthorLinda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease. Archives
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