I was diagnosed with COPD 2 1/2 yrs ago and have been on just Spiriva Respimat and occasional Ventolin HFA (this one as needed only). This past week my pulmonary doctor added Symbicort 160 to take 2 puffs twice a day since I was having a little wheezing on exhaling. No Spirometry or PFT was done at this visit, nor any x-rays or blood work. I also have Obstructive Sleep Apnea and have been on CPAP therapy for about 10 yrs already. I looked on my chart online after this last doctor visit and a new condition was added - "Asthma". Is this usually diagnosed with just breath sounds or should at least a Spirometry been done? Also, now that I am using 2 inhalers can they both be used at the same time in the morning? Before the Symbicort I was using 2 puffs of the Spiriva first thing in the morning. Should I wait a little bit after the Spiriva before using the Symbicort or use them one right after the other. The doctor's office did not specify. Thanks