This is so true "BUT we have it and a good effective session of ACT gives me a real good sense of accomplishment. It doesn’t happen every time, but when it doesn’t it pushes me to try harder/better the next session."

As long as "trying harder/better" doesn't mean "trying too much." I haven't had a lot of sputum coming up the past couple weeks, but yesterday I had a great "garden workout" - I mowed at a pretty good pace (about 1/3 acre), took a break, then went weeding - bending, reaching, standing up, down again, etc. Last evening I probably coughed up as much mucus as I did in the past week, including some thick globs that had been around for a while. The good news - all of it was clear or white. The bad - my ribs are a little sore today.

I just wrote a piece about PT in a shoulder surgery discussion how it is not always done in the gym. I believe airway clearance is the same.

Here's a challenge for anyone who is bored with their routine - find a task in your home or yard that involves bending, reaching and stretching. Neb, take a brisk walk (or push your mower for a few minutes), then do the task at as quick a pace as you can. It doesn't need to be hard. When I was quite ill with MAC, I used to put the basket of unfolded laundry on the floor, fold it on the table or bed, deliberately placing piles "just out of reach" so I had to stretch, then walking back and forth to dressers, cupboards and closets to put it all away. My huff coughing afterward was always productive, and I got a hated task done.