In advance of the Monday release of his book, Steve Jobs: A Biography, Isaacson told the CBS News program  60 Minutes  that Jobs said he initially felt the surgery would be too invasive.
The HandiHaler device is an inhalation device used to inhale the dry powder contained in the SPIRIVA capsule. The dry powder is delivered from the HandiHaler device at flow rates as low as 20 L/min. Under standardized in vitro testing, the HandiHaler device delivers a mean of 10.4 mcg tiotropium when tested at a flow rate of 39 L/min for 3.1 seconds (2L total).
Do not use extra Spiriva to make up for the missed dose. Spiriva HandiHaler is an anticholinergic medication approved for the long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD) and for reducing exacerbations of COPD.