Possible COPD?

Hi there

I was diagnosed with Asthma in 2013 it was a very quick diagnosis I remember being bewildered at how simple the test was. My symptoms were persistent cough, with and without phlegm, wheezing (but not persistent), shortness of breath, out of breathe during exercise.

I believe since then I have continued to have these symptoms, they have gone on for so long that I have got used to them, however people around me notice the cough a lot and have said they dont no me without a cough.

I guess this struck a light bulb and I started looking into COPD before i try to get my doctor on my side, I would like some advice and information of what everyone else experiences and if im actually just overreacting.

Thanks

[Minushabens]

The first thing to take on board is that COPD is often something of a generic term used to describe a range of lung problems. Traditionally, the difference between COPD & asthma is reversibility. What that means is that asthma symptoms can be improved through the use of a bronchodilator whereas COPD can't.

In a sense though, that doesn't necessarily help you! So the first question needs to be whether or not taking a blue inhaler makes your breathing better. If it does, then asthma is probably at least part of the issue. It may be that you simply need a better management plan/medication rather than it being something more complicated.

Beyond that, there is a range of things that you could look into. Your GP could take sputum samples, run a spirometry test (you might already have had this as part of your original diagnosis), arrange chest x-rays/scans & so on. If any of these show up particular problems, then they would be likely to refer you to a specialist, but that's a bit down the line.

For now, I'd simply book your appointment & explain that you are coughing constantly & want advice on next steps. If your surgery has a specialist asthma nurse, you might be better speaking to them...I did that a few years ago when I thought I had a never-ending asthma attack & it was the nurse who really steered through everything to the point that I got a more specific diagnosis (ABPA in my case) via a consultant referral.

Good luck & I hope that things move forward for you.

[Chip_y2kuk]

COPD as i understand it is very similar to asthma tradironally . It is also often used to describe a range of conditions including more severe persistent asthma... however COPD nearly always has some element of none reversible damage

I wouldn't try to self diagnose asthma or COPD as there are lots of reasons to have a persistent cough and there aren't many I would like it to be (including asthma and COPD)..... I my self have undergone tests on my heart (which luckily showed nothing interesting)

But it can also be that your asthma management isn't where it needs to be for example last year I had a persistent cough all winter, cold and damp are a trigger for me.... so it wasn't surprising however this year after jumping up and down for a trial of montelukast (apparently very good for people with asthma and allergies, I have both).... I have no winter cough

A lot of gp's aren't aware of the additional add-on medications or are reluctant to prescribe them (usually because of cost, sometimes because of potential side effects).... I've had a gp tell me i can double my intake of tioptropium bromide (spiriva) however I've had another gp, the pharmacist and a specialist asthma nurse tell me that this is very dangerous and spiriva lasts 24 hours and needs to be taken at the same time of day only once per day (very frightening)

[Hidden]

Do your asthma meds help with your shortness of breath?

What is your peak flow when you have SOB does it drop much?

[Hidden in reply to Hidden]

I have the blue and brown pump and when I am out of breath, using the blue doesn't actually give a relief.

[Hidden in reply to Hidden]

You should invest in a peak flow meter, they are very cheap online.

If your PF doesnt drop much when you have shortness of breath and the fact the blue inhaler doesnt give you relief then you possibly dont have asthma.

Persistent cough and SOB are major symptoms of silent reflux, also known as laryngopharyngeal reflux (LPR) or extraesophogeal reflux.

If your PF is stable look up the symptoms of LPR it might be a possibility.

[Matman]

A very high % of Asthmatics suffer from a type of Asthma called Eosinophillic Asthma. The symptoms can be very similar to COPD, to the extent that Doctors frequently misdiagnose COPD, whereas this Asthma phenotype can turn out to be the issue.

Obviously, no one can accurately say what you’re suffering from without a thorough review / diagnosis, starting with a chat with your GP.

If you’ve not seen a Respiratory Consultant in some time (or never seen one) suggest you ask your GP about the possibility of a referral so that more ‘in-depth’ testing can occur. NHS Waiting time in most areas for such a referral appointment date is likely to be 6 to 12 Weeks, unless your symptoms have worsened to such an extent that your GP considers a priority referral is required.

If you want things to move faster you could consider a Private Consultation, but that’s likely to cost a few hundred quid, plus quite a bit more if the Private Consultant feels Imaging and other Tests are also necessary to asssist with a clearer diagnosis. (Get a Cost Estimate from any Private Consultant before proceeding if you decide to go that way).

Hope you feel better soon.

[Lysistrata Administrator Community Ambassador in reply to Matman]

I'm not sure how much direct correlation there is between asthma clinical presentation and the underlying phenotype (eg eosinophilic, allergic, non-eosinophilic). The relationship appears to be very complex based on what I've read, and I know that as a (mainly...I rustled some up during my last admission but had many admisisons with none) non-eosinophilic severe asthmatic, I share many features of clinical presentation with people who have confirmed eosinophilic or allergic asthma, as do other asthmatics across different phenotypes (for example, asthmatics with many different underlying types can regularly present without a wheeze during attacks).

I think many types of more severe asthma might be confused with COPD by doctors, especially in patients who are older or have smoked (sorry don't know how old you are.WorldofThought or if you ever have smoked!) and some types of COPD can also be associated with eosinophilia and may respond to the same medications as some types of asthma, which confuses things more. Minushabens has mentioned that reversibility is one of the key differences - asthma is also more variable. I do have a completely unproven belief that many doctors don't really 'get' the variability of asthma and subconsciously expect it to be more reliably present eg on spirometry etc., like COPD. People with COPD do not generally go from 30% FEV1 predicted in an attack to 110% predicted when well, whereas at least one friend with severe asthma does - if you got her at the good point it might be hard to pick up, and if you got her at a lower point COPD might be suspected.

I agree with Matman that more tests are probably needed ans a referral may be in order as your GP might not be able to offer the in depth testing.