Those of you who have a lot of lung damage might want to look into Breo. I have started going to a pulmunologist and he has put me on Breo. It has really helped, at least for now. I've only been using it for about 2 weeks but my O2 levels have gone up by 3-4 %. That makes a big difference when you get down to the bottom of the barrel like I am. I have more energy and can get a little bit more done than I could before.