For me it is the very viscous sputum which is very hard to clear from my chest. Having to nebulise 5mg Salbutamol, Ipratropium, 6% saline, Gentamicin and then using my NIPPV as a cough assist (keeps my airways open so that sputum can be cleared from my chest) postural drainage, acapella and self administered clapping all done twice a day is so fatiguing and depression is always a danger. This is a day to day challenge, if an exacerbation occurs then two weeks of combined IV antibiotics, IV aminophylline and repeated (sometimes two hourly) blood pressure, temperature, pulse rate, breathing rate and O2 saturations intermingled with many blood tests and possible xrays or scans. Occasionally a painful blood gas test has to carried out as well. I hope that one day a very quick turbo charged method of drugs that are nebulised now will appear so that your medicines can be taken outside the home whilst walking in the fresh air instead of an hour of solid nebulising followed by the chest physio inside, all alone.