Hello Sandy well when I was a child I had asthma. When I become a teenager I started smoking. We also lived next to a sand factory and all of the kids in the neighborhood would go there to play in it. I'm sure we inhaled a lot of it I am 70 years old now. In my 50's I was on drugs that I had to inhale Those drugs caused me to smoke more cigarettes. I have been clean for several years now. But before I quit using my breathing was getting really bad . The inhalers would work sometimes and sometimes it didn't help much. I decided to go to my Doctor. He schedule me for a breathing test. I must have failed it because that's when I was told I had COPD. I have been on several different inhalers. I was still working and very active up until last year I was really getting short of breath more so I started researching for other options and for new treatments that where out there. I had considered the zephyr valves then I was a little sceptical after reading the reviews. I then learned about the Dupiexnt and I told my doctor that I wanted to try it. He had to research it himself before subscribing it to me. This was the best decision I ever made. It's like I'm almost back to normal before all of the damage to my lungs. I am breathing much deeper and better and can't do more activities. I am still working 12 hour shifts. I read that most people that have COPD have high levels of eosinophils. This is caused Type 2 inflammation. I decided to look back in my patient portal to see how many years back I had this type 2 inflammation. Come to find out it was showing up on my 2015 blood test lab work. But the Dupiexnt is lowering my eosinophils level and this is helping me to breathe better and less or no flare-ups.