I have had one exacerbation that I am aware of. I was in the hospital over night and was diagnosed with COPD. I have been to a pulmonologist since and it was confirmed having moderate COPD. I'm doing a nebulizer twice a day and am on breztri. Before this, I was walking 1 to 2 miles at a fast clip every other day. I also cycled often doing 10 miles at a fast clip. When I was walking I had a hard time getting my heart rate above 110 BPM. I just got done walking a mile. My heart rate was in the 126 BPM range at a slower pace and I felt like I never have felt before.(like I didn't have the lung capacity that I had). I'm 77 years old. I have exercised all my life since I quit smoking 45 years ago. I am at a lost that I have gone down hill so fast ? Any comment that would help please ?