I generally do a tune up one to two times a year (usually ends up being about 8 months. I would probably do it a bit more if I could afford to not work, but I pay all the bills sooo. I do always go in before I get real sick though, usually when I start having a lot of wheezing and some shortness of breath, before I ever get a productive though. It always goes in that order for me, I usually only get real productive if I am extremely sick, which has been a long time.