Tom, that doesn’t sound good to me. I used to cough so hard as a younger person that there were would be tears running down my face and I’d literally pee in my pants. Fast forward to age 60 and I suddenly had a major hemoptysis that nearly killed me. Trauma to the lungs is one of the major causes of hemoptysis so in my humble opinion, any treatment that causes you to cough until you almost pass out should be reconsidered with your pulmonologist and see if you might be able to nebulize with something gentler. There is only so much of that your lungs can take before there is a rupture. The very reason huff coughing exists is because it’s gentler on the body. Perhaps try having very warm water nearby when you nebulize? It may help bring up the mucus more easily. Just wanted to reach out b/c I would hate what happened to me to happen to anyone else. It’s a miracle I’m alive.