Thanks for your reply:). I was coughing ridiculously when I finally received my bronchiectasis diagnosis. But it has greatly improved now (thank goodness). I actually coughed only a little bit up at times so I think that is why he ordered the vest. I tried the nebulizer first and it didn't cause much improvement in clearing my lungs so he ordered the vest. It has helped move more stuff out of my lungs, but it is still not a lot. I read the instructions on how to use the Acapella device as it was sent to me in the mail. I am glad to have this alternative but will be anxious to hear about your appt. in Oct. and if it has kept your lungs stable so please provide an update on how that goes. Good luck!