My husband had a massive right-sided stroke four years ago. He is totally paralyzed on the left side. The last six months his breathing has been a bit labored, now 02 sats can be low (91-93), and he has much more shortness of breath. He pedals from his wheelchair daily, uses an incentive spirometer, and deep breathes. We have used aerosols and puffers as needed but breathing is getting worse. He often feels short of breath. Is there something happening to cause this and what treatment can be done? What are the long term consequences of this dyspnea for him?