Hi Michelle. You mentioned that you called the clinic on Monday and they said to call back on Wed. if the coughing got any worse. How is she doing today? I have to say in our experience swimming almost every day is great exercise. It helps to build strong lungs. Encourage her (if you don't already) to.... I'm sorry I'm assuming she knows how to swim well... to retrieve things from the bottom if she is able. Start shallow and progress from there. I think I mentioned before, we had a pool when we lived in Arizona and my girls loved to dive for stuff they'd throw into the bottom of the pool, they enjoyed diving off the board and my youngest loved to just tool around the pool with her snorkel and mask. They were 7 & 10 when we left Arizona. A trampoline will also do wonders for the lungs. All the jumping jiggling things up. If your daughter is doing those things and coughing during or shortly after I would see it as a good thing. Sorta like PT. My daughters would both cough extra after jumping on their friends trampoline last year. It's when the coughing gets to be fits or spasmadic and they can't catch their breathe or it's keeping them from sleeping that I get worried to the point of "lets see if you can be seen". From what I"ve noticed in my own girls (mostly the older one because the younger one almost seems like she doesn't have CF) is that she does great after she gets off IV antibiotics for about three weeks then the cough comes back (which I know, a cough is normal for CF'ers) and she tends to start sliding backwards. My oldest has been hospitalized regularly almost every three months this school year until March. Fingers crossed, she is doing well and that little slide backwards didn't just keep on going like it had been. I hope that we have broken that "pattern". Like someone mentioned earlier, going with your gut feeling and just calling the clinic. Our clinic has a nurse line that you can speak to before deciding that your child needs to be seen. Being 5 hrs. away from your clinic makes it difficult to just pop on in, I know. Does your daughter have a pediatrician or Family Practice doc she sees for regular stuff? What part does he/she play and how closely do they work with your CF doc? Perhaps having them check her out, take a listen, do a breathing test, take an O2sat. It used to be when my daughter was starting to get sick her sats would start dropping. I used to just pop into the local med. supply store and use the disply to check out her sats. They don't have them around much these days, the store I went to. Also, how is she at keeping up with the other kids, is she getting short of breathe, and her appetite? All those are things to think about when you wonder if she's coming down with something again. You probably know all this but I know I didn't until my daughter was like 8 or 9. When it comes on slowly you don't notice, at least I didn't. Now I watch like a hawk, how they breathe when they are sleeping, how often and how much they eat etc. And last of all, how is she feeling? How does she say she feels? I hope that she is doing well and full of energy with less coughing and her fevers gone. Please let us know how she is. I hope that I have given some insite at least to how we deal with coughs and possible exaserbations(sp). Liza (mom of 2 CF'ers, 16 & 12)