I was told I had a "minimal lung defect" a few months ago, after taking numerous heart, lung and other tests to figure out why I had been having some strange, though fairly mild, breathing problems. No wheezing or coughing, just a sensation of running out of air and need to take aeveral deep breaths. It felt as if I had just "forgotten" to breathe. I was referred to an ENT, who said I had cronic rhinitis and some sinusitis, too, as I recall. She prescribed Flonase and later Atrovent. Around this same time, my PCP casually mentioned that the lung tests showed I had a "minimal lung defect." He apparently thought he already had told me about this, but he hadn't. I thought the lung tests had come back completely normal. My doctor said this condition amounted to a mild form of asthma. Since the breathing problems seemed to have gone away since I started on the Flonase and Atrovent, I just filed it away in my brain as another piece of interesting but not critically important information. I felt relieved to have an explanation for what I had been experiencing. Unfortunately, the breathing problems now seem to be back, but in a more intrusive way. It's happening more often, and instead of "forgetting' to breathe, I frequently feel as if my chest cavity is contracting, and I need to take a deep breat to expand it again. (I don't know if I'm describing this very accurately, but it's the best I can do at the moment.) To make matters worse, my health plan recently dropped Flonase from its drug formulary and substituted Nasarel. Although I got my ENT to authorize an off-formulary prescription for the Flonase, I discovered when I went to renew it that the authorization expired 4 days after the renewal! I spent hours on the phone trying to get the Flonase instead of the Nasarel, as I had done a side by side comparison of side effects and found that Nasarel was significantly worse in areas to which I'm particularly sensitive. But in the end, they said I had to try the Nasarel first and then, if I can't tolerate it or if it doesn't work for me, a doctor can authorize the Flonase. I can't say that switching to Nasarel coincides with my breathing problems getting worse, but I think I was basically getting just fumes from my Flonase bottle the last couple of weeks. (I was trying to wait until May 1 to renew my Rx, because that's when my new Kaiser Medicare + CHOICE coverage started, and giving me at least limited coverage for prescription drugs. Before that, I had no Rx coverage at all.) It was during the last couple of weeks that I noticed my breathing problems coming back. So it's possible that the Flonase had been helping to keep it in check. In doing research on the Web, I found that both Flonase and Nasarel are intended primarily for control of allergic sinusitis and/or rhinitis, not asthma. I haven't really found much of anything about "minimal lung defect" and what, if anything, that may have to do with what I'm experiencing. However, I know a lot of people with Fibro also have GERD, and since I have both GERD and some mild swallowing problems (another fairly new symptom), I suspect that that I might have aspirated some acid, causing or exacerbating the lung defect and making the breathing problems flare up again. I was wondering whether anybody on the board has had any experience with Flonase and/or Nasare and can tell me how they seemed to compare for you. I noticed on the box for Nasarel that one of the inactive ingredients is citric acid--just what I need with GERD and the heartburn side effects I already get from so many of my meds. Furthermore, as a child I was allergic to citric acid. Nothing major, like anaphylactic shock; just skin rashes. But it still seems silly to force me to use Nasarel first when the odds are very high I won't be able to tolerate it. (In fairness, I have to admit I didn't tell the docs about the citrus allergy, mainly because I didn't know Nasarel used citric acid until after I picked up the prescription.) To top everything off, I find the Nasarel applicator relatively hard to use, especially when my MS is making my hands and fingers particularly hard to control. I never had a problem with the Flonase applicator. Sorry for venting with my latest sad story. My problems are really nothing compared with what a lot of people on this board are going through. But I really am hoping to find somebody who can tell me more about "minimal lung defect" and about the relative merits and weaknesses of Flonase and Nasarel. Thanks. --Laura R.M.