I have emphysema. My insurance has refused to pay for symbicort so I asked my doctor to put me back on spiriva inhaler. I have been taking the spiriva for about 10 days and wheezing and SOB have increased. I had taken spiriva capsule inhaler before and seemed to ok. I was doing very good with the symbicort and did not have to use my rescue inhaler often (combivent). This past week I have had to use the rescue inhaler 6 times a day and I am still wheezing. What is the difference in the 2 medication?