Kim, I was on Spiriva, Alvesco inhaler and another inhaler which I cannot remember the name of right now, before my husband lost his job, and yep, you guessed it, our health insurance. I've had to "improvise" since we lost the insurance, and have been using a Primatene mist inhaler to help with my breathing. It does help, not nearly as much as the prescriptions did, but it's better than nothing. I've been reading alot about ephedrine use with MG patients online this week, and am going to ask my dr about it at my next appointment. Also, you might want to stock up on the Primatene tablets. I read somewhere that they are taking the Primatene inhalers off the market after October or November 2011. Not sure about the tablets though. I'm sure you can get ephedrine by prescription. I'll let you know what my dr says after my appt next Tuesday.