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When I was first diagnosed with bronchiectasis, one of the most confusing parts of the journey was figuring out who should be managing my care. Should I see a pulmonologist? An infectious disease specialist? A respiratory therapist?  Over time, I realized something important: bronchiectasis is a complex condition that often requires a team of experts working together. Fortunately, in the U.S., this type of coordinated care is becoming more common. The Bronchiectasis & NTM Association has created a Care Center Network designed specifically to support people living with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. These specialized centers bring together clinicians with expertise in diagnosing and managing these conditions. The goal is simple but important: reduce the time to diagnosis and provide comprehensive, high-quality care. What Is a Bronchiectasis Care Center? A bronchiectasis care center is a specialized medical program where multiple healthcare professionals collaborate to diagnose and manage bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. These centers typically include pulmonologists, infectious disease specialists, respiratory therapists, dietitians, pharmacists, and mental health professionals who work together to provide coordinated, comprehensive care for patients. Why Specialized Bronchiectasis Care Is Important Bronchiectasis and NTM infections are being diagnosed more frequently worldwide. Yet many patients still experience long delays before receiving an accurate diagnosis or appropriate treatment. Patient surveys have shown that many individuals feel their care is fragmented and that support services are limited. Other complex medical conditions have demonstrated that multidisciplinary care improves outcomes. Diseases such as cystic fibrosis, HIV, and cancer are often treated in specialized centers where multiple experts collaborate to manage all aspects of the disease. Bronchiectasis care centers are built on a similar model. What Patients Should Expect From a Bronchiectasis Care Center A bronchiectasis care center focuses on coordinated, patient-centered care. While each center may operate differently, most share several key features. Patients can generally expect:
More specific services will include: Education and ongoing monitoring Care centers often provide follow-up appointments and patient education between visits. Access to additional specialists when needed Patients may be referred to experts such as dietitians, mental health professionals, or pulmonary rehabilitation programs. The Bronchiectasis Care Team Because bronchiectasis affects many aspects of health, care centers rely on a multidisciplinary team of specialists. Pulmonologists and Infectious Disease Specialists Pulmonologists focus on lung structure and airway disease, while infectious disease physicians evaluate bacteria identified in sputum cultures and determine whether treatment is necessary. Collaboration between these specialists is often essential when managing bronchiectasis and NTM infections. Program Coordinator Many care centers include a program coordinator, often a nurse, who serves as the main point of contact for patients. This person may help coordinate testing, obtain medical records, communicate with providers, and assist patients with navigating their care. Respiratory Therapy and Airway Clearance Airway clearance is a cornerstone of bronchiectasis treatment. Respiratory therapists teach techniques to help patients clear mucus from their lungs and guide them in using airway clearance devices such as nebulizers, positive expiratory pressure devices, and chest oscillation vests. Nutrition Support Bronchiectasis can sometimes affect appetite and digestion. Some patients experience reflux, reduced appetite, or unintended weight loss. Maintaining adequate nutrition is important for lung health, and dietitians can help patients develop individualized nutrition plans. Mental Health and Social Support Living with a chronic lung disease can affect emotional well-being. Anxiety and depression are common among patients with bronchiectasis. Mental health professionals and social workers can help patients address emotional challenges, navigate healthcare systems, and connect with supportive resources. Additional Specialists Involved in Bronchiectasis Care Because bronchiectasis can be associated with other conditions, additional specialists may become involved in care. These may include: • gastroenterologists for reflux and digestive issues • ear, nose, and throat specialists • allergists and immunologists • genetic counselors • thoracic surgeons For example, gastroesophageal reflux disease (GERD) is common in bronchiectasis and may worsen lung symptoms. How to Find a Bronchiectasis Care Center If you are interested in receiving care at a specialized center, the Bronchiectasis & NTM Association maintains a Care Center Network across the United States. Even if most of your care is provided locally, many patients benefit from periodic consultations with specialists at these centers, who can help guide treatment decisions. Frequently Asked Questions Do I need to go to a bronchiectasis care center? Not everyone needs to receive all of their care at a specialized center. However, many patients benefit from at least one consultation with clinicians who have expertise in bronchiectasis and NTM lung disease. Can I still see my local doctor? Yes. Many patients continue to work with their local pulmonologist or primary care physician while also consulting with a specialized center. This collaborative approach helps ensure continuity of care. What specialists treat bronchiectasis? Bronchiectasis care often involves a team that may include pulmonologists, infectious disease specialists, respiratory therapists, dietitians, pharmacists, mental health professionals, and social workers. Why is airway clearance important? Airway clearance helps remove mucus from the lungs, reducing infections and improving breathing. Respiratory therapists often teach patients how to perform these techniques and use airway clearance devices effectively. These are encouraging times Bronchiectasis and NTM lung disease are complex conditions, but patients should not have to manage them alone. Specialized bronchiectasis care centers represent an important step toward improving diagnosis, treatment, and long-term outcomes. By bringing together pulmonologists, infectious disease specialists, respiratory therapists, dietitians, and other professionals, these centers provide comprehensive, patient-centered care that can make a meaningful difference for people living with bronchiectasis.
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After several years, I finally cleared a Mycobacterium avium complex (MAC) infection. It was a long journey that required patience, consistency, and a deep commitment to my health.  What Is Mycobacterium Avium Complex (MAC)?MAC is a type of nontuberculous mycobacterial (NTM) lung infection. It often occurs in people with bronchiectasis. Bronchiectasis (BE) can cause mucus to build up in the airways, creating an environment where bacteria are more likely to grow and persist. However, it is not always clear which came first. Did the bronchiectasis create the conditions for the infection, or did the infection contribute to airway damage and cause the BE? In some cases, it truly can be a “chicken or the egg” situation. Symptoms Can Vary WidelyPeople experience MAC very differently. Some individuals struggle with symptoms such as night sweats, debilitating fatigue, chronic cough, and daily sputum production. Others may have very few symptoms and feel relatively well even while the infection is present. Because symptoms and disease severity can vary widely, treatment decisions are often individualized and difficult to make. When Antibiotics Are Recommended for MACWhen my infection was first diagnosed, my doctor recommended antibiotic therapy. Standard treatment for MAC often involves several antibiotics taken for a long time — often over a year. Choosing a Different Initial ApproachIn my case, after careful discussion with my physician, I initially chose a different approach. As an experienced health coach, I decided to focus on myself as my only client and see whether I could clear the infection without starting antibiotics right away. I committed to what I called building a brick house. Rather than relying on one single intervention, I focused on laying one brick at a time through consistent airway clearance, regular exercise and movement, and healthy lifestyle practices, including stress management and reflux control. At the same time, I continued to monitor my condition closely with my medical team and understood that antibiotics remained an option if my condition worsened. A Long but Meaningful JourneyIt was not a quick or easy process. But after several years, my cultures finally cleared. My experience is not meant to suggest that everyone can or should follow the same path. Many people with MAC absolutely require antibiotic treatment, particularly those with cavitary disease or who are very symptomatic. This decision should always be made with a physician who is well-trained in bronchiectasis and Non-tuberculous Mycobacteria lung diseases, such as MAC. But my journey is a reminder that there can sometimes be more than one path forward. Steady, consistent care of our lungs and overall health can make a meaningful difference over time. For me, the process of building that brick house, one daily habit at a time, became the foundation for protecting my lungs and supporting my long-term health. *Common Questions About MAC Lung Disease*How long does it take to clear a MAC infection? MAC infections can take a long time to treat or resolve. When antibiotics are used, treatment often lasts at least 12 months after cultures become negative. If cultures are not converting by six months, the protocol is often changed to daily medication rather than three times a week, and an inhaled antibiotic might be added. Do all people with MAC infection need antibiotics? Not always. Some people with mild symptoms and no cavitary disease may opt for "watchful waiting" and be monitored closely before starting treatment. Others, particularly those with more severe disease or significant symptoms, may benefit from antibiotic therapy. Decisions about treatment should always be made with a pulmologist and/or infectious disease doctor who specializes in bronchiectasis and MAC lung disease. Can lifestyle habits help support lung health with MAC or bronchiectasis? Absolutely! While lifestyle practices are not a cure for bronchiectasis and chronic lung infections, consistent habits such as airway clearance, exercise, stress reduction, reflux management, and good sleep can play an important role in supporting lung health and overall well-being.
My story and the practices I used to build a stronger and more resilient body are discussed in my book, The BE CLEAR Method to Living with Bronchectasis, available on Amazon. This post is for educational purposes only. It reflects my personal experience and should not be considered medical advice. Never change your treatment plan without discussing it with your medical team. In the inspiring video Living and Breathing with Art, Maggie Hart shares her personal journey with bronchiectasis and chronic lung disease, a condition she has lived with since age 28.  Despite facing significant medical challenges, including two lobectomies, Maggie reflects on how art has become a powerful source of calm, grounding, and peace in her life. As a former licensed independent clinical social worker, Maggie brings a deep understanding of the emotional and mental toll of chronic illness. She speaks openly about anxiety, uncertainty, and fear, and how creative expression has helped her navigate these challenges. Through painting, Maggie finds a space where she can be fully present, momentarily setting aside illness and worry to immerse herself in the creative process. Her artwork often tells a story of strength and resilience. One particularly meaningful piece, Breath and Flowers, was created before her second lobectomy and helped Maggie reframe her lungs as something beautiful and life giving rather than something to fear. She also shares her old doors series, which symbolizes the doors that close and open throughout life, mirroring the emotional journey so many people experience while living with chronic illness. The video includes a gentle, guided art exercise using only a pen and paper. It is designed to help viewers slow down, relax, and tap into their imagination. Maggie emphasizes that artistic ability is not required, reminding us that we are all wired for art and self-expression. She also offers a thoughtful reminder to be mindful of art supplies that may be harsh on the lungs, reinforcing the importance of creativity that supports both emotional and physical well-being. Maggie’s message is a beautiful reminder that art can be more than a hobby. It can be a tool for healing, reflection, and connection, especially for those navigating life with chronic illness. Thank you, Maggie, for sharing your story. You are the soul of our bronchiectasis community. Maggie's Video
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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
March 2026
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