Minimal emphysema + Asthma

[jamieb977]

Have been suffering sob and general fatigue for about 18 months now, since I had an asthma exerbation then covid a few months after, I was having chest pain and palpatations last year so was reffered to cardiology and had an echo then a ct angiogram back last November.I recently registered on the my care nhs app and viewed my results from the ct angiogram and was shocked to see at the bottom minimal emphysema in the lungs. This was never mentioned to me by anyone and first I've heard of it. I have an outstanding referral to the respitory at hospital seeing as my asthma nurse ran out of treatment options for the sob, she did a spirometry on me though which was 88% fev1

Should i contact my gp to tell them of my discovery ? How can my asthma nurse tell me I definitely havnt got copd from my peak flow and spirometry but then a ct showed thus.

I dont know of anyone else here has asthma and mild emphysema but is that enough to give you sob all the time and effected your quality of life to how you feel and what you can no longer do that you used to like long walks, exercise etc

Thank you for any advice given

[vampress]

Hi! I'm sorry you've been dealing with this for so long. The waiting lists suck.

The problem with asthma and COPD is that the symptoms mimic each other. And sometimes patients can have both. Typically COPD is a fev1 of less then 80% and you said yours was 88%, which is probably why your asthma nurse said it wasn't. Your airways would be chronically inflamed too, again something that is also present in asthma just to a lesser degree. But COPD is a gradual disease and you could be heading that way....the respiratory team will be able to give you a better diagnosis and treatment plan once you can see them.

Minimal emphysema is still likely to be causing you to feel so bad though, as its damage to your lungs that reduces the surface area. Meaning less oxygen is getting into your blood.

I hope you see the respiratory team soon, to put your mind at ease and get you feeling better.

[jamieb977 in reply to vampress]

Thank you for taking the time to reply vampress.

I have good and bad days, the sob is always there though just depends how bad it is on that particular day, its scary to think this is just minimal emphysema though I can't imagine coping with moderate or worse which as it's progressive is going to come at some point.

My spo2 is usually 97 to 99 and my peak flow is good at 520 so it doesn't make sense how I can be so symptomatic with good stats.

I feel stupid complaining about symptoms when basically I've caused this myself from smoking cigarettes and weed for over 20 years.

I got referred to respitory back in January and the letter I received said average wait was 54 weeks lol so im probably about halfway there, feels like I'm living in limbo waiting for a diagnosis and prognosis.

I need to completely give up smoking, hopefully that will make me feel a bit better and maybe there is some medicines etc that will help more and try to live a good life for as long as I'm able I guess. That's all any of us can do I guess, breathing problems are horrible.

[Troilus]

Hi Jamieb. I have been on a similar journey myself - heart scans, angiogram and severe emphysema. (I was an x smoker but had smoked for many years - I stopped because of the price. ) At the end of all of the tests and monitoring all was fine. My final diagnosis was asthma.

I think if I were you, I would make an appointment with your GP to discuss your findings, in particular what exactly is it that indicates minimal emphysema. At a very minimal level it can simple be are trapping - this can happen in asthma, but as asthmatics have a good response to inhalers this tends to be transient.

In the meantime, you are quite right when you say you need to stop smoking as this speeds up the progression of emphysema and causes inflammation in people with asthma. It is not as hard as many people say.

Try not to worry. (Easier said than done I know.)

[jamieb977 in reply to Troilus]

Thank you for the info Troilus, must have been a scary one being told you have severe emphysema and relief when it wasn't, the fact this information for me was from a CT scan I thought it would be definite as its a detailed scan inside the lung even though it was seen of the ct angiogram rather than specific ling ct, so I will hold out a little hope on it, the thing that most matches my symptoms is hyperinflated lungs from what I've read, I don't cough or bring up mucus really just find myself sob and hard to inhale like my lungs are already full and there no space for new air is what it feels like.

With my gp they like us to contact them using an online form so I will do this and see what they come back with, but I think it's a case of waiting for the referral and proper pulmonary tests.

I have cut down smoking in preparation for the full push to quitting very soon.

[Ern007]

Hi - Minimal emphysema is not the end of the world so long as if you smoke then stop, and don't vape in their place.

Emphysema is not curable but looking after your lungs, you really should not worry - I would tell your GP. I think you R Nurse was going by 88% fev1 - COPD starts at 80%.

You had an Asthma Flare UP - That will have dampened your energy and mood.

I have Angina that was found on an ECG and Cardiac Rhythm problems found on a 24 hours ECG. I have had both for years. I have had COPD for many years. I think your flare ups are more likely from Asthma than Mild Emphysema.

You IMO need to see your GP, ask him/her to explain your Emphysema from a CT and ask hew about the pains you had in your chest. Your GP has probably been informed.

You need your mind clear about your Mild Emphysema but 88% fev 1 is mild and should not be causing "SOB"

Best of luck really get help from your GP - I do and get lots of help.

[jamieb977 in reply to Ern007]

Thanks for the reply, yes I agree I shouldn't be that sob with an fev1 of 88% but my symptoms tell a different story, the asthma exerbation and covid were both nearly two years ago so not recent I should have recovered by now. If it is asthma why don't any of the medications work, spiriva, montelukast I tried plus I'm on seretide 125 x 4 times a day.I'm feeling really sob all the time, walking up stairs is horrible feel like I cant breath 😫.

My chest doesn't seem to expand to bring air in, find it hard to inhale. Xray I had was fine, blood tests fine.

Regarding the chest pains they were last year and have stopped now i think covid really messed with my digestive system and was causing heartburn and palpatations. Had 7 days heart monitor, echocardigram, ct angiogram and was normal so doesn't look cardiac related. I wonder sometimes if my diaphram isnt working properly, I get bloated and breathing is way worse at the same time like its being squashed.

I'm at a loss with it all, doesn't make sense I was so active before now I feel like a stage 3 copd person.