I have recently changed centers, and have been retrained in the use of the vest.. To my surprise, i actually started to get junk up.. I had always said: " i'm not productive" wrong, i just needed to be taught the correct way of doing it... Amy (bittyhorse) had answered the post "how do you feel about all the medication" part of her answer was "If you think about it, if the meds really sustained us then why we would all of a sudden just stop responding? Why would our FEV1 go down, why would it take so much more effort to get the junk out? And going with that, the meds don't make us live longer *it is how we us them.* You can do your nebs and stop there, but if you don't get the garbage out then you really didn't help yourself.. All you did was open the airways to allow more gunk in or allow more air to get behind the gunk and stay trapped.. That was exactly what i was doing for so many years.. So if you think that you or your child is not doing the vest the right way, then i would check it out ASAP.. Take care and God Bless <img src="i/expressions/vest.gif" border="0"> joni