@couchtater I am definitely trying to get all that in place! It's only been 8 months since my breathing has been just out of control so the doctors so far I think want me to try absolutely everything else. I respect that but I'm not sure if they understand how debilitating it really is to have the breathing issues and RA! It's like life is just plain difficult. Period. So I'm planning to go to a great pulmonary hospital to get opinions from those who deal with this stuff all the time. I'm so happy to hear Nissen helped!!!! There's hope!!!!