I started using a nebulizer when the rescue inhaler no longer helped. Your Spiriva is a preventative which you should use every day as it helps with your breathing. It is important your primary care Dr know you've been told you have COPE. Once it gets to where he's done all he knows then he should recommend a pulmonary Dr. COPD is a bitch & only gets worse so you need to take it serious and use the meds they tell you plus exercise as much as you can & for as long as you can. Good luck to you.

I have nebulizer at home and portable for emergency in my car I pd co pay get Dr to fight for u medically needed

You gonna come out of denial when the hospital put you on that High flow oxygen and you can't leave till they set up 02 for you at home. it is a big lifestyle change but you can live longer if you do what you have to do. You can always talk to me I'm available

Get a pulmonary care doctor. Your lungs are too important to trust to anyone else. I love my pulmonologist, he really understands what is happening and is happy to explain.

im on Advair now two times daily I go for a lung function test on friday I have cut down on smoking to one or two a day. Sometimes two or three dys with none. Im using the patch and e ciggerette to try and quit. Its hard to do. I quit drinking cold turkey after a daily habit with some side effects and cravings I quit smoking weed with little problems, I still crave it but I quit cold turkey no problem. These cigerretes are the worse thing Ive tried to quit.