Hi. Welcome to our COPD community. And thank you for the great question. I look forward to what other community members will have to say about your question based on their own experience. In the meantime, I do have a response for you. For this procedure, you are usually put under general anesthesia -- which, I think, suppresses your cough reflex. That said, it's important to discuss these concerns with your doctor, who can can provide you with detailed information about the specific risks during surgery. Sharing your worries can also allow your doctor to tailor the procedure to minimize potential risks. What do you think? John. community moderator