Hi bobarb, I don't have e a pulmonologist yet , I just spoke to my gp the one time about this copd diagnosis and she told me if I felt breathless to come and get a faily inhaler . So after my vacation where I experienced breathlessness while walking around a farm I told her and she gave me this spiriva . Ya maybe I'm.not sure what I expected. Miracle lol ? It does make me feel less breathless , just a lot of phlegm coughing and throat clearing . My gp isn't seeming to be making much of a big deal about it , just told me if I have a lot of shortness of breath to go to the ER .