I didn't realize it could be an albuterol reaction until an hour later, when my "anxiety attack" was well past anything I'd ever experienced. The technician just gave me a low mark on the test. She was concerned as she escorted me to the front door of the hospital, but I was assuring her that I would be okay as soon as I got a chance to sit down and relax. The doctor diagnosed "severe COPD" and added the Incruse via a telephone call. The doctor who first prescribed the Advair isn't around any more. Parker, CO is a booming suburb of Denver, and young MDs run through here like a revolving door, and thus that first doctor is long gone. I did go back to the same practice much later, but the floors were dirty, some of the people in the waiting room were not masked, and the NP was dismissive when I asked about side effects. But I did have a good relationship with my primary, an experienced NP who shared my views on little medicine, good prevention. The insurance company had started covering Spiriva, and I mentioned to her my earlier good experience with it (which I got through the same practice but different doctor), and she gave me a prescription for it. My second Spiriva inhaler was defective. The little pin was missing the spot to release the med. It was about three days before I realized that was happening. I already had an appointment for a regular physical with my NP, so I just didn't take anything until that appointment. She was alarmed at my condition and asked me if I had any Advair left. I said, yes, and she said start taking it immediately, and I did. A year later, I was doing okay and asked if I could try reducing the Advair, and she agreed to give it a try. I felt the same as on the higher dose. At the time, I was newly in remission from Stage III estrogen-receptor breast cancer. It was during my chemo that the gasping episodes had begun. That desperate gasping abruptly ended a couple of weeks ago. It was just a few days ago that I read that anxiety was a listed side effect for the chemo. The reasoning, however, was that it was natural to feel anxiety during cancer treatment. That's not illogical, but it ignores the fact that anxiety, depression, and any number of "mental" states can be triggered by chemical reactions to medicines or foods or any sort of allergy. It never occurred to me that my anxiety could be a function of the chemo until it ended abruptly. It reminded me of a friend who told me that one morning he woke and his chemo-induced neuropathy was gone, 15 months after completing chemo. My chemo ended 13 months ago. Though I still experience neuropathy (and just learned that it could be permanent), for the first time since that first anxiety attack after beginning chemo, I can carry my rubbish to the dumpster and walk to my mailbox and back to my apartment without collapsing inside the door and gasping and heaving for 5 to 10 minutes. I did write a letter to my current pulmonologist to tell him about my belief that the albuterol triggered a reaction and described it to him. I know that my letter will go into my computer record, and we can discuss it at my next appointment. I have a new primary, because the NP I had has been reclassified as internet only in a restructuring of the practice, and the practice assigned me to someone else. I left the practice (even though I liked everyone who worked there) because the last five times they were to call me back on something, I never heard. The re-making of their practice seems to have everyone confused about who does what. The last time I was in their office, I was the only patient there, and was left waiting for 40 minutes for a referral document, and no one was tending the reception desk. When I rang the bell, I had to give my name, age, etc., and then she said, "Oh yeah. I needed your DOB." She had set the document aside and forgot why it was sitting there. But then I had to ring again 10 minutes later because my ride had arrived. She said she would email it to me. She didn't! But they did enter it in the computer and I received a call from the pulmonologist saying they had received the referral, but I didn't get an appointment as we discovered they don't take my insurance. That was the part she forgot: she was supposed to call a list of pulmonologists, find one who accepted my insurance, and then give me the referral document. So I went shopping for a pulmonologist and a new primary. It took me three months to get an appointment with the new primary, an internist who had been serving his residency at Baylor College of Medicine 40 years ago during the time that my former boss was head of Internal Medicine there. That distant connection was the only thing that stood out in a list of names. He is a self-admitted pill pusher and sees that as the role of internal medicine. However, he was unhurried, attentive and said he is willing to work with me as a sort of geriatric physiatrist, helping me to coordinate all these caregivers. After reading all this, you must feel like the little boy giving his book report: "In this book about penguins I learned more about penguins than I ever wanted to know."