You do have an awesome Pulmonologist! Is she taking new patients? :)? I have been rocking along with Dupixent when gradually over the past several months my secretions have significantly increased. Not sure what flipped the switch on that! I, also am on Albuterol and Breztri, and Dupixent since 11/23 after valve placement. To my understanding, ensifentrine is an enzymatic like Daliresp but just administered via nebulizer. Not crazy about taking new drugs until they get some post market reviews so thought why not try Daliresp. I am waiting for a CT chest for follow-up to see if that reveals anything. More than likely will decide to return to Duke and the Interventional Pulmonolgy group for guidance. Thank you so much for sharing your information. I don't come across too many that actually have a feel for the medical side of the disease.