Mr. Joe Wilson is a 79-year old man with emphysema, COPD, parkinsonism, and is on 2L of oxygen full time. Despite his condition, Joe is always ready to do therapy. Joe loves the Smart vest he gets tx 3 times a week. In the beginning, Mr. Wilson was not wearing his BiPAP at night and was having increased shortness of breath. When asked why he wasn't wearing his BiPAP, he replied that he wasn't able to tolerate the full face mask. Our therapist was able to get him a nasal mask, and since then he has worn his BiPAP every night for at least 8 hours and has had decreased shortness of breath episodes.