I started on the inhaled Amikacin/Arikayse in Feb. I had some voice changes that corrected themselves within a couple weeks. I did cough a lot during treatment but that subsided too. No coughing up blood or any of the other scary stuff. Doing the Arikayse treatment after nebulizing any Albuterol and Saline is what helped me stop coughing so much because everything was all opened up and easier to tolerate. I also found doing the treatment before bed and gargling with very warm water after treatment helped with the voice issue since your vocal chords are resting through the night and not being used. Good Luck. It's been very successful for many patients.