There are some thoughts that need to be said in this thread, in my opinion. I have severe COPD (Emphysema), Alpha-1 carrier and am a patient at Mayo, Rochester. My Care team is Dr Niven and me and my wife. I mention that because if you look at your Dr as one provider alone you are making a huge mistake, after all Mayo is staffed and run on a team concept. It is a two way street, not one way. Your friends and family and fellow patients and COPD Foundation can also aid in your mental aspect of this condition.... how you handle it mentally is just as important as the physical aspects. Another thing to keep in mind is clinical trials, after all discovering new treatments and cures start with data and research.