A 72 year old man presents to your clinic with a 10 month history of productive cough and wheeze on exertion. In the past 4 months the patient describes finding it difficult to keep up with their grandchildren. The patient is a current smoker, smoking one and a half packs per day for the past 18 years. On exam, the patient is slightly barrel-chested, has fair air entry bilaterally with a prolonged expiratory phase. You suspect this patient has COPD.