@tra4179, have you ever tried a Primatene Mist Inhaler? The inhalers are over-the counter and somewhat expensive--about $30.00. I realize you probably do not have asthma, but this great product saved my life when I had SOB attacks. In my case, because of having Covid twice and radiation for cancer in the throat, my vocal cords paralyzed. For over one year these attacks were getting worse, until a great ENT diagnosed the condition and performed a tracheotomy. Toward the end of that miserable year, I began using the inhaler. It helped me to breathe until the surgery could be scheduled. It was a lifesaver for sure. By the way, you can purchase them much cheaper sometimes on eBay. It would be worth a try until you can get a few different opinions as to what is causing your condition. Did you have Covid? It messed up people's vocal cords in some instances, which can cause SOB. An ENT (or two) would do a nasal scoping to determine if they are functioning properly. To ease your mind, if the vocal cords are partially paralyzed, you probably would not need a tracheotomy. There are many surgical techniques to help with vocal cord issues. I cannot have surgery to correct the vocal cord paralysis, because radiation changes the tissue, where it could become necrotic. Best wishes to you.