hi thank you for providing the brief history. A thorough musculoskeletal and respiratory assessment is advised. As your husband is diagnosed with COPD, and is gasping alot , means his lungs requirements are bit and the alveoli needs some help. Only oxygen therapy is not the long term solution. let us understand little about the pathophysiology of COPD Pathophysiology of COPD COPD is a complex syndrome comprised of airway inflammation, mucociliary dysfunction and consequent airway structural changes Airway inflammation COPD is characterized by chronic inflammation of the airways, lung tissue and pulmonary blood vessels as a result of exposure to inhaled irritants such as tobacco smoke. The inhaled irritants cause inflammatory cells such as neutrophils, CD8+ T-lymphocytes, B cells and macrophages to accumulate. When activated, these cells initiate an inflammatory cascade that triggers the release of inflammatory mediators such as tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), matrix-metalloproteinases (MMP-6, MMP-9), C-reactive protein (CRP), interleukins (IL-1, IL-6, IL-8) and fibrinogen. These inflammatory mediators sustain the inflammatory process and lead to tissue damage as well as a range of systemic effects. The chronic inflammation is present from the outset of the disease and leads to various structural changes in the lung which further perpetuate airflow limitation. Structural changes Airway remodeling in COPD is a direct result of the inflammatory response associated with COPD and leads to narrowing of the airways. Three main factors contribute to this: peribronchial fibrosis, build-up of scar tissue from damage to the airways and over-multiplication of the epithelial cells lining the airways. Parenchymal destruction is associated with loss of lung tissue elasticity, which occurs as a result of destruction of the structures supporting and feeding the alveoli (emphysema). This means that the small airways collapse during exhalation, impeding airflow, trapping air in the lungs and reducing lung capacity Mucociliary dysfunction Smoking and inflammation enlarge the mucous glands that line airway walls in the lungs, causing goblet cell metaplasia and leading to healthy cells being replaced by more mucus-secreting cells.Additionally, inflammation associated with COPD causes damage to the mucociliary transport system which is responsible for clearing mucus from the airways. Both these factors contribute to excess mucus in the airways which eventually accumulates, blocking them and worsening airflow. To make the rehabilitation plan better - along with oxygen therapy and medication your husband need to under go physical therapy. As the muscles of respiration are weak and are not able to support the lungs to perform normal respiration. In my clinical practice I have seen a lady aged 85, pacemaker, bypass and dyspnea. Cannot walk 10 steps either and get breathless badly. With the help of physical therapy the respiratory muscles were trained to balance the requirements of the lung tissue and the rest of the body. @ present she is much better and do not need oxygen therapy at all. Things can work better if a proper measurement is applied for rehabilitation of COPD. Medicines act only for symptomatic relief, and there is no long term relief. Making the body fit enough with exercise is the key for rehabilitation. For any further doubts/queries/suggestions you can t contact me an I will be happy to help you further. Regards Jay Indravadan Patel