I tried the vest and it caused to much pain... I had surgery for blockage just before hand, so I had manual cpt after that. I did great on it for 3 years and doubled my fev1's. My insurrance wanted me to go back to the vest and my nurse who was doing the cpt at the time even pushed for the vest with the insurrance. Even after I had told them it doesn't work well for me and causes me pain. Still, they made me go back to the vest, at least I got the new vest, but in the end I lost all that I had gain over the past 3 years and then some. I still have my vest incase, sometime down the road, I may need it. But manual cpt is the only thing that really helped me. The Flutter Valve and the Acapella never worked for me, mainly cause I didn't have enough pressure behind my breathe for them to be effective. oh well.