Emphysema and chronic bronchitis affects 15.7 million Americans and COPD was the 3rd leading cause of death in the United States in 2014 according to data from Centers from Disease Control and Prevention. The incidence increases with age together with exposure to tobacco smoke and other household or workplace air pollutants.  These diseases  cause diminished capacity to exchange oxygen and carbon dioxide in the terminal alveoli (tiny air pockets at the airways’ end) resulting in strain on the heart, brain and other organs which depend on oxygen.  Airways become congested when the natural ability to move mucus becomes impaired and airflow is blocked due to permanent damage to the walls of the small and mid-sized airways. Cough and shortness of breath and poor tolerance of exertion are symptoms which often progress to complete debility. Simple office tests include oximetry to measure the quantity of oxygen in the blood and spirometry to assess the function of the lungs. These are useful to diagnose and monitor progression of COPD.