I still do not have a definitive diagnosis yet (seronegative), but here are my triggers:

#1 Surgery - I have had several surgeries. I do not tolerate the anesthesia well and end up sick for month with exhaustion, weigh loss, and fatigue. It takes me a year to recover from even a simple endoscopy surgery like gall bladder. After the last surgery, I think I will need to be dying before I ever consider another surgery for the rest of my life.

#2 heat !! Heat bring on immediate exhaustion. I set my winter thermostat at home at 64 during the day and 58 at night and I feel so much better. Unfortunately I cannot afford to set my summer thermostat to the point where I feel good - 67 degrees.

#3 stress - arguing with my teenage daughter can bring on an exacerbation so fast, and especially the breathing and choking symptoms.

#4 not enough sleep - I try to get 10 hours every night. 10 hours is the point where I feel good. On the weekend, I get around 15 hours a night to recover for the workweek. As the work week progresses I fell worse. My symptoms are all down hill from Wednesday on.

thanks
kathie