My M-I-L is 70, she was apparently diagnosed with Emphysema about 2-3 years ago. She is telling everyone that she was diagnosed with Stage 4, however, she is not on oxygen, not barrel chested, not losing weight, doesn't cough much (from what I can hear). She does get winded, but I've seen her go up and down 2 flights of stairs w/very little huffing/puffing. I question the stage 4 diagnosis as I watched my grandmother with stage 4 for 2-3 years before she died and it was not pretty, and she was on oxygen 24/7. I do not believe my M-I-L is that bad, I'm figuring between stage 2-3. She also does not eat right (basically once a day (long story) - her diet consists of candy and diet coke), does not exercise (even though she does say she walks at the park, but not sure how true that actually is), and basically doesn't really do anything (she lives with us). Is it possible to have stage 4 and not need oxygen? How do you know when you cross over to stage 4?