Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.Emphysema
is a genetic disease and your concerns are genuine. It happens many times the inhalers stop working at some stage. The best way to know the severity is to do a CT chest which will show you all the bullae.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
Wish you good health,
Dr. Srikanth Reddy M.D.