Greetings all! For those who celebrate, Happy Thanksgiving! Interesting developments in regard to my voice and health, and a PSA for those who may find it useful. After being partially misdiagnosed with asthma for over two decades, my pulmonologist now thinks I may have either Vocal Cord Dysfunction or Inducible Laryngeal Obstruction, both rare and sort of untreatable. If you or someone you know has been diagnosed with asthma but gets no relief from medications, here is some useful info. VCD and ILO are commonly mistaken for asthma, which inflames the alveoli in the lung walls, causing issues breathing out, leading to carbon dioxide overload in the lungs. VCD and ILO have similar symptoms and triggers, but are a general hypersensitivity of the vocal cords and larynx, restricting airflow in rather than out, often with wheezing and coughing fits. Asthma can accompany either of them. It can be triggered by hot, stuffy air, certain food / drink, or anything in the air you breathe (smoke / vapes / cleaners / perfumes / colognes / allergens), and it causes a LOT of suffering, often accompanied by a productive cough (coughing up phlegm), and subject to bronchial infections, requiring antibiotics. It makes those affected sensitive to any kind of chemical smell -- cleaners, air fresheners, perfumes, colognes, even smoke and vape pens. I've even been found sensitive to the smell of wood from certain trees. The difference is knowing which is causing your attack. I determine this by reversing my peak-flow meter (most doctors supply these to asthma patients) so I can compare my flow rate in to my flow rate out. It's not a perfect system, but it does help in determining any discrepancy between the two. When doing this, it's important to maintain a good seal on the flow meter with your lips, especially when reversing for intake flow, as it was not designed for doing so. I have found, however, that I apparently have attacks of both natures. What's important to know is that bronchiodilators do nothing for VCD or ILO. Onset and recovery times are vastly different from VCD / ILO, and only asthma responds to bronchiodilators. These are the key tell-tale signs. It is often exercise-induced (sometimes mislabeled exercise-induced asthma). The best thing to do is stop whatever you're doing and let things calm down, or in the case of airborne irritants, get away from the source. In short, remove yourself from whatever brought it on. I have also found that acid reflux (GERD), otherwise known as heartburn, can cause this. In these cases, I have found that vanilla ice cream can help stop an attack, though it takes a few minutes and I often need 1-2 bowls. Menthol cough drops can also help, but they MUST be menthol, pectin will not work. But they are only a temporary fix if an irritant is involved, because a bronchial infection is likely. Now for the part that lots of people will not want to hear, but it is necessary, and I hope I don't lose fans saying this, but it is necessary, and quite frankly, losing fans over this will say far more about those who leave than I. These disorders make the world a gas chamber for people who have them, and among other things, smoke, particularly tobacco smoke, and even the chemicals in vaping are a huge trigger for these disorders. I had to give up a good career in commercial trucking because the copious amounts of diesel exhaust and cigarette smoke around truck stops and shipping / receiving yards was keeping me sick, and though I can still sing, it has impacted my voice. Those of us who suffer with this disorder are highly sensitive to such irritants. I myself cannot be within 100 feet (perhaps more) of an active smoker, and even the smell of it on someone's clothing can cause an attack. Those who smoke and vape need to understand that it simply isn’t appropriate to do so around others. It has never been, but the vast majority of society let this pass simply because it doesn't affect them, envoking a sense of entitlement amongst those who partake. And for many people with asthma, VCD or ILO, this can mean death. Unfortunately, that is speaking for others for whom it may cause serious problems, and we can't tell you when this is a problem, because we have to leave immediately. This is a major reason being in public is no longer safe for me. In fact, I cannot safely breathe air over 68F without an attack and require a closed, controlled, air-conditioned environment, even in winter, going through 4-6 tubs of vanila ice cream and 100-200 menthol cough drops weekly just to keep my suffering to a minimum. So, please, if you smoke or vape, please be responsible and considerate, and do so away from others and common areas where other people have to walk by or near entrances or exits. It's simply not cool and not fair to others with health problems to do so where they have to walk by / through or have to breathe it in. That includes drive-through lines, because sooner or later we have to open our windows. In addition, certain irritants in the smoke / vape also hang on the air, unseen, for several minutes after the smoke is gone, creating a veritable "booby trap" for those of us with these disorders. We cannot "just hold our breath", nor should we have to. I myself cannot do so for more than a few seconds. So please, show some consideration for others. It won't kill you to move a reasonable distance out of the line of fire. But there are people you can inadvertently kill if you don’t. I hope this explains this sufficiently, and that at least some of you find it useful in helping yourself or others.