I have asthma as well as moderate COPD. My inhaler regime is Fostair on a MART regime. So I take 4 puffs per day and am allowed to take up to 4 more puffs per day as needed.
My SOB has always felt mild and I can quite easily ignore it. It does not correlate with O2 sats at all, though they tend to be around 98 and I notice when they go below 96. Fatigue or light-headedness will slow me down before SOB kicks in. Even when I was half dead in hospital with pneumonia I didn't really feel SOB.
My general life policy is to take as few meds as possible. If I can tolerate symptoms, I do. My doctor has persuaded me of the wisdom of taking my inhaler regularly. Previous doctors were quite happy to let me take a lower dose or stop intermittently. It's a wonder I'm not worse, but that's another story!
I know inhalers are not curative - but I also know the steroid element of my inhaler helps with inflammation. Is it the case that keeping the inflammation as low as possible is beneficial in maybe slowing progression of the COPD? When I get an onset of mild SOB is it better to take an extra dose of inhaler to cut inflammation even though I don't really feel uncomfortable enough to "need" the medication?