Well bit of a mixed bag was my consultation today but I came away with hope as there were still other options to explore. This year so far I have had 20 flare ups conclusion oral antibiotics no longer working and the long term azithromycin is not either so he stopped the azithromycin. Next port of call is a 2 week IV antibiotic using a CVC line. I apparently have pseudonymous in my lungs and he is aiming at zapping them if that does not work it is hospital for two weeks IV again with a different drug. COPD is no longer scored on a 1-4 or 1-5 basis now I at 32% am classed as severe. At least the confinement is during the cold period when I am not really keen on going out. I will get an appointment with the nurse practitioner possibly next week and then she will go through things with me and when I have to go into hospital for the day to have the CVC lines put in, from there it will be up to the community nurse to check my drips and line in. Will keep you all informed as things progress and how I am going on.