I'm still getting used to the device, but it does seem to help bring up gunk. Whether it works better than nebulizing saline or using a flutter device, I'm not sure yet, but definitely another tool or option. The same company also make a device called Clear that includes an option for inhaling saline while using -- I haven't tried this machine. I received my cough assist device about 10 days after it was prescribed, from Viemed. If you are low income, make sure you ask about the company's hardship assistance plan. If approved you will only pay the annual Medicare deductible, no 20 percent co-payments. I hope you find it to be helpful.