Three-year-old Riley Rothenberger is strapping on her vest so her little lungs will loosen the mucus to help her breath easier.
"They really don't know any different. They've been doing it since they were born," said Riley's dad Ryan Rothenberger. "They've been really good about taking the enzymes and doing the treatments. They haven't resisted doing those things too much."
Riley and her little sister Alexa have Cystic Fibrosis - a life-threatening genetic disease that primarily affects the lungs and digestive system.
"They look healthy and that's the unique part of the disease, because there is a war raging on inside of their bodies that we're trying to keep at bay as best as we can," said the girls mom, Billie Rothenberger.
That includes using chest percussion and keeping cold medicine within close reach.
"When they get colds they're quicker to go on antibiotics than other kids," said Billie.
For billie and Ryan nebulizers, lung therapy treatment, and 20 pills per child are part of their daily routine to keep their precious little girls healthy.
"In the 1950s the life expectancy was about 5 years old and now I think it's in the upper 30s to 40s, so we fully expect for them to have long healthy lives. They're just going to have to work pretty hard to make that happen," said Billie.
She says the time spent using the vest and percussors have bonded her family together.
"CF is just part of what we do everyday. This is our family time. Twice a day we sit down the four us and it's not normal. But, it's normal for us."