Recently diagnosed with copd very confused about results of test. Nurse says mild gp says moderate what questions should I be asking to find

[thomasdoyle]

Out more about my condition. Thanks

[Hidden]

have you been given any inhalers,as mild is early stage, moderate it 2nd stage,did your gp explain your results to you,but the answer to your question would be ,go to see your gp again, to explain correctly what level you are,and if your smoking please if you can stop,lot of us members have or still smoke and no 1 will judge you,but stop if you can,xxx

[ellc]

your gp may or may not want to treat you with inhalers, i think its moderate onwards you will have inhalers as mild doesnt often cause problems, are you experiencing problems breathing etc?

[thomasdoyle]

I stopped smoking 9 years ago. First sign was breathless after being on exercise bike for 10 mins and a cough for about 3 months. Was given blue inhaler to releive cough. Got cold in Feb and ended up with fever, very breathless so had 5 days of steroids and antibiotic had flu jab and ended up 2 days later on antis and steroids again given spiriva inhaler had pneumonia jab ended on steroidal and anti again fine for a couple of weeks then waking wheezing so given brown inhaler due to see doc in 2weeks

[thomasdoyle in reply to thomasdoyle]

All happened very quick have had chest x rays and bloods and these are fine. Went on bike tonight for 2 miles and was breathless but had inhalers and recovered ok I seem to produce alot of mucous that makes me cough

[Hidden in reply to thomasdoyle]

if you have no meds for the mucus, drink plenty of water,ring your gp, in the morning, explain your producing loads of mucus, but cough and spit it out,dont swallow it,if you have inhalers to hand use it, but don't worry you will be ok,and ring gp 1st thing,and don't be fobbed of with 2 weeks seeing gp,you tell them now,i need to see gp,,all the best,xxx

[Hidden in reply to thomasdoyle]

I would if I was you, get over the cold and fever proper, then exercise again on the bike, but only if your up to it,and take your inhalers,until you see your gp again, did thay tell you your spiro read out the gp,as with all the goings on with your health might not be a correct 1,dont worry in the mean time,and getting out of breath is good for us,keep on the forum ,get some vitc , and manuka honey,plenty of fruit veg ,let us no how you go on,all the best,xxx

[ellc in reply to thomasdoyle]

sounds more moderate than mild!! im on 4 diffrent inhalers every day constantly getting lung infections, colds you name it! the brown one i have too, clenil? that is a steroid one! i am going to get linched when i say i dont get the flu jab as any time i have had it i end up ill!!

[Daisylacy in reply to ellc]

Me too. Refused to have flu jab as, like you, caused what I can only describe as Flu. Medical profession dispute this but have had 3 times on random years and each time, it's been a problem so worried about taking their advice again. Obviously, it helps a lot of people, but for some, it doesn't

[initial]

I think the first thing to do is to get clarification from your GP with regards to you FEV1 % reading from your spirometry test. This will give you a more accurate picture on how well you're lungs are performing. Mild is 80%, moderate is 50% up to 79%, severe is 30-49% and very severe is under 30%.

Everyone with COPD reacts differently, since we are all individuals. It is a slowly progressive condition, so please, keep fit with exercise, eat a good balances diet, stay away from air pollutants, and most of all keep a positive attitude. Take care, and best wishes x

[Mibs in reply to initial]

Hi initial, can you tell me what these % mean as mine is 47.8%. Is that lung capacity, % of lungs working???? I've never been told.

[initial in reply to Mibs]

Hi Mibs, what a good question. However, I'm not really sure, is the honest answer. All I know is that the FEV1 is forced expiratory volume, and indicates how much air you blow out in a second. (Healthy lungs can be nearly emptied in a second!) That figure is then divided by the FVC, forced vital capacity, which is how much air you blow out in one continuous breath. The readings are calculated on your height, weight and sex. Don't ask me how, because I've never made that enquiry LOL! I assume it lets the doctor know how well the lungs are performing, or not, as the case may be. My last spirometry gave an FEV1 reading of 19%!

[Mibs in reply to initial]

Ok, thanks for that. So basically my lungs are only running at less than 50%? What I don't understand is why is it so important that we can empty our lungs, surely inhaling is whats important...Or am I being a bit thick? Lol.

[initial in reply to Mibs]

Aha, now I do know a bit about that, but only a little bit LOL. It's just as important to empty the lungs of the carbon dioxide, as it is to breath in the good air. When we don't empty our lungs, there's less room for the good air to get in. My lovely surgery nurse told me that when we first met a year ago, breath in for a count of 2, and out for a count of 4. I was having terrible panic attacks, and couldn't get any air into my lungs. Since then, I've followed her sound advice. Hope that helps Mibs x

[Mibs in reply to initial]

Hi Initial. Thanks for that. Very helpful. That explains why sometimes when I breath in it feels like it's not enough. Thank you. So if I can take a few minutes out & do what your nurse suggests then that'll get me back on track. Ta everso for your help. Nice meeting you. Take Care.

[initial in reply to Mibs]

Pleased to meet you too Mibs x

[soothsayer in reply to initial]

Its very confusing because your FEV naturally starts reducing at about the age of 35 so someone in their 50's who may have given up smoking or not, a figure of 80% would be considered normal , which is what mine is, yet i can just about walk up the hill and cant do any strenuous physically activity for more than 5 mins. I did used to be very active and only 15 years ago used to do survival courses/3 peaks challenge that kind of thing! i find their understanding of it all very limited. And their explanation ebven worse. I cant hardly do anything for any length of time.

[droo32 in reply to soothsayer]

Predicted lung function is based upon observational population based studies in healthy never smokers and therefore accounts for parameters such as age, weight, race, and height. Thus, a healthy 50 year old with normal lung function has 100% predicted on all parameters across the board. A given cohort in a population will however present as a normal distributed bell curve and therefore the general range of normal for any cohort is between 80-120%. 95% of the healthy people will fall within this window.

What's important in diagnosing lung diseases is looking for patterns. Is your FEV1 85% and your FVC 110%? This would be mild COPD. Are both your FEV1 and FVC 80%? This would be boarder-line restrictive lung disease - such as IPF or Pneumoconiosis for example, or it could even be something far more complicated like concurrent emphysema and fibrosis. An 80% FEV1 does not mean one has normal lung function, it means one has a FEV1 in the range or normal, barely. In order to have normal lung function, all of the various parameters, especially diffusing capacity, would have to be in the range of normal. Even if all the parameters are in the range of normal, this still doesn't mean one has normal lung function as the lungs could have be damaged to a degree that is not detected on standardized tests. For example, someone who never smoked could normally have a FEV1 of 115% however if they smoked for 10 years, their FEV1 could be reduced to 90%. Even if all other parameters were equally reduced to the same extent, and all their numbers were within the range of normality, they still lost 25% of the predicted lung function they had as a result of smoking which would mean that their lungs were diseased to some extent however still within the range or normal. In other words, they are normal on a population based scale, however not normal for them as an individual.

I know many 60 year olds that hike regularly and even some 80 year olds. Shortness of breath is never a normal phenomenon. With the scenarios you describe, I would wager that your diffusing capacity is reduced. Unfortunately, this is a very common occurrence in smokers and former smokers or in people who develop COPD otherwise, and at this date in time there is unfortunately nothing anyone can do about it other than oxygen when things get very bad.

[Jake364]

I'd say your moderate because your GP knows you better than your nurse and also look at the test results

[droo32]

The confusion often arises from the varying definitions of COPD. Historically the British Thoracic Society NICE definition of COPD has been considerably more lenient that those of the rest of the world, including the European Respiratory Society's definition. Whether you are mild or moderate, what really matters is how you feel and how you treat your condition. The doctor is the one with the special degree however and he would be the one prescribing the medications so I would listen to him over a nurse.

[FarmerD]

An important thing to know is that the lungs are designed to breath OUT and not in.Air pressure allows us to breath in,the muscles in the lungs let us breath out.A lot of my problems with Copd are not clearing out the lungs therefore no space for more breath.The body thinks there is not enough oxygen(although there usually is) and reacts by making us gasp for breath which is frightening and leads to panic which of course makes it worse.Once we learn to recognise and control the panic it is a lot easier,well that is what I found anyway.Copd is a very individual disease and we may react differently.Try to stay as calm as you can and take your time,good luck.D.

[Mibs in reply to FarmerD]

Thanks, this was useful information.

[Hidden]

Looking at levels is less important than managing the condition

Ali

[thomasdoyle]

Thanks I will ask the questions of my GP I have just been for a 30 mon walk and all ok. I am fairly active most of the tome as I have horses that I ride and dogs that I walk. Very rare that I get breathless and as has been said I may still be recovering from the virus I had in Feb, if they last that long?

[hopetorun]

I think this will always be a difficult one to answer as some days are better than others my lung function varies from between 42% at best and 27% at worst without an infection. We all talk about moderate or severe, I dont think it makes much difference. it is how well you are able to cope with the lungs functioning on that day. you will generally find if you are getting more tired that is a good indication that your lungs are not working so well on that particular day.

I am breathless every day to some degree or other.

just try and do all the things we should do like healthy eating at regular intervals. getting exercise and not smoking and staying away from pollutants or fumes. Look after yourself and try not to worry.

[AnneGodolphin]

the help line should be able to clarify most of your questions