I suddenly feel I may be wearing out my welcome with my questions concerning my recent diagnosis and the initial prescription of Spiriva but what the heck hopefully I can play it forward later. Initially Spiriva made me feel a whole lot better until it didn't. Now I feel a somewhat sore throat and lower sinus area and a raspy voice even though I am sure to thoroughly gargle after use. The mucus has certainly decreased although my cough is markedly huskier and deeper and the produced mucus seems to be coming from deeper in the lung as opposed to bronchial in source as before Spiriva. My bronchial passages seem to feel noticeably irritated and my deep cough today is producing scant mucus (comparably) that is alarmingly accompanied with small amounts of bright fresh blood. Not streaked but rather small clots. I do have a CT scheduled for two weeks out and I certainly am not jumping to catastrophic conclusions as I feel the blood appearance is related to the deeper cough and the sense of irritation I am recently experiencing after starting Spiriva..Has anyone else had unfavorable reactions to inhalers? What have been your experiences in finding the "right" one? And are these inhalers "always" necessary in the treatment of COPD? .