Hi, Sue, i am in Canada, and my pulmonologist is hard to reach. I have bronch and ntm and have never had an exacerbation. I do worry about ending up in the ER with docs who don't have a clue about these conditions. I will raise the issue with my pulmo on my next visit. In the meantime do you have any suggestions about exacerbations and dodging ER lack of knowledge? I am using an Aerobika and have no other meds or treatment. My shortness of breath is getting worse.