@lreid51 Hi Lynn. I forgot to mention that I did recently finish a 90 day low dose of azithromycin for the PA. My pulmonologist says that azithromycin not only fights bacterial infections but also has anti-fungal properties. I will probably undergo another round soon. I also agree with the others that smoke (fire or otherwise), scents such as many types of candles, air fresheners, perfumes, exhaust, scented body lotions, higher elevations, cold weather cause labored breathing. For those who also have allergies or who have sinus issues and use saline irrigation/rinses, there is one that my allergist recommended with xylitol (I ordered NeilMed Sinus Rinse with Xylitol). He also said that there are benefits to the lungs and ears using Xylitol. I did do a little research, and it does seem there is something to this.