I do use Spiriva every 36 hours, Albuteral inhalers and
Combivent inhalers daily. I have a nebulizer but try to avoid using that; only if I do have a cold and a lot of phlegm to get rid of. Doctors, especially in the USA are of little help. Here, they actually care and are helpful. It is also a lot less expensive, obviously, to buy medications because no prescriptions are necessary unless it is a narcotic. You can get medical consultations for $2-$35 USD instead of having to mortgage your home.