Hi @eeileen. I will definitely let you know the next thing they suggest if the perels don’t work which I don’t think they will. I’m supposed to give it another month to see if things get better on their own before trying something else. For me, the cough gets worse in the afternoon and evening and I cough a lot before bed but when I fall asleep, I can sleep through the night. Cold and hot seem to make me cough more too. I have some small to moderate pleural effusion on my chest xray. My surgeon said it is normal to still have fluid build up but I wonder if my body isn’t handing the excess fluid well. I’ve read some things online that it could contribute to a cough.