He really is a complicated
case, he has several things going on....Have the doctors done anything diagnostic to him such as a CT scan, xrays, pulmonary function tests? His scoliosis creates a restrictive defect along with his COPD...I wonder if it has gotten so bad that he might need some help with his breathing. Nebulizers will help his COPD but not the breathing problems from his scoliosis.
Does he have anything cardiac going on? Maybe a cardiologist along with the pulmo might help....