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For three decades, breathing troubles followed James Seymore as he and his wife moved from one place to another. In 1980, he received his first diagnosis of pulmonary sarcoidosis in Wyoming. The inflammatory condition can cause shortness of breath, coughing, fatigue, and joint pain. His first bout resolved after a course of steroids, but it returned seven years later after the Seymores moved to Oregon.

Chris Williams was a healthy guy. The 36-year-old bodybuilder worked out regularly, played basketball, didn’t smoke, and watched his diet. Yet, in January 2012, Williams could barely drag himself out of bed. And walking a few steps across the room left him gasping for air.