The Vest is not used in SA (at least I don't know of anyone who has one in SA yet, I think it's a cost thing), so to answer your question I don't have it so always travel without it, and just do my usual routine of nebbing and ensuring I cough up a lot. I always take my nebulizer. As long as you can get up the junk I don't think it matters how. Find a physiotherapist that can teach you "active cycle breathing" (shallow breaths, medium, deep, then huffing etc). My routine consists of bronchodilator neb, then Hypertonic Saline neb while I do the coughing/breathing. I also find doing 5mins with a skipping rope a great physio-substitute, it is easy and quick enough but intense enough to get your lungs working to loosen the gunk. Try it.