Quick ? about COPD

[beeperoni]

Ok...so diagnosed mod. COPD...COPD usually is composed of emphysema and or chronic bronchitis. Dr said both my cxr was clear and CT showed no acute abnormalities? Any ideas. I thought being stage II, something would have shown

[SeasideSusie]

I was diagnosed with moderate COPD two years ago after full lung function tests. Didn't have a fancy x-ray just a bog standard chest x-ray at local clinic nor did I have a scan of any sort. I wasn't told if I had chronic bronchitis or emphysema either. In fact I wasn't even told I had COPD, just that I needed an inhaler, only found out when I asked why I needed an inhaler.

[beeperoni in reply to SeasideSusie]

I was diagnosed by spirometey. But I wanted to know what was causing the airflow limitation cause I heard some meds work better for one than the other

[stone-UK]

Hi

X-Rays are normally taken to eliminate other causes.

Have you had a spirometer test which will confirm the cause and severity of your breathlessness.

CT scans show soft tissue, which could indicate you condition is more bronchitis

.have another word with you GP for more clarification.

[O2Trees]

Ok, I've looked at your previous post again where there's a typo so i though you were saying you DO have acute abnormalities.

If your GP is saying there are NO acute abnormalities, that could mean there are no infections or other things which need special treatment. Acute usually means that something out of your usual situation is happening that needs treating - some kind of flare-up for example.

But if you aren't sure what is being said, do ask for further explanation.

[ck101]

Firstly did you have a Hi Res CT?

X-ray only shows advanced disease and may be normal but generally shows Hyperinflated Lungs impacting on the diaphragm, CT is mostly conclusive for emphysema however does not show the small airways. Russell Winwood COPD athlete has 30% lung capacity ( whatever this refers to, FEV1 possibly ) and also has a clear CT.

Anything I have seen eludes to the the CT being the gold standard for emphysema however I believe in the case of mild Chronic Bronchitis & Asthma CT is inconclusive.

Spirometry with Diffusion on the other hand doesn't lie and will show a pattern of increased RV, TLC and a reduced FEV1, FVC and Diffusion in emphysema. In very mild disease both Spirometry and CT can be normal. In Chronic Bronchitis Diffusion is normal.

This truly is a sneaky disease, not only can it be elusive in diagnosis, it's insidious and creeps up on you. Add the fact there's no cure and it really paints a sinister picture.

Both the cigarette companies and government have a lot to answer for.

[beeperoni in reply to ck101]

I had a CT scan with contrast. My Dr ordered this because my SOB got worse after starting Breo. She stated that the scan was clear and showed nothing. She has referred me to a pulmonary Dr, I see him on 25th. I have not had any other PFT other than the spirometey. I just assumed the contrast scan would have shown emphysema if it existed. I have SOB, but no cough or mucus.

[Hidden in reply to beeperoni]

Hi the contrast is used to highlight blood vessels not airways. If your spirometry results were below normal i think you mentioned this in a previous post. The ct would definately have seen areas of emphysema, but may not show chronic bronchitis or asthma. A full lung function would be advisable. This will deterrmine volumes and dclo. Dclo would be normal or even slightly higher than normal. Also high in asthma with air trapping.

[Hidden in reply to beeperoni]

Previous post should have said in chronic bronchitis dclo is normal or slightly higher and higher in asthma due to air trapping. Sorry about that.

[rubyred777 in reply to ck101]

I have a fev1 of 60.Do not have increase in TLC or RD. FVC is 79 Fev1/fvc % Is 78. Diffusion of 67%. That sums me up. Thats what the spirometry test tells you. You can't just do the little test in the Drs. Office. Thats a starting point. If that's low, then you get the one done at the hosp. that gives all the other #s into your diagnosis

Rubyxx😊😊

[ck101]

Well if you have no cough or mucous not even first thing in the morning you likely don't have chronic bronchitis, they are the hallmarks.

I too would also have expected Stage 2 to show on the CT.

As you most likely have no baseline spirometry to compare you may never have had 100% of anything, the decrease then could be mild and the diagnosis not stage 2.

[beeperoni in reply to ck101]

I have never had a spirometey to compare this one to, and my GP said she half expected to see something on the CT also. I never had symptoms, just woke up one morning unable to take deep breath, which now I have SOB sometimes after starting the inhaler, which she just stopped

[ck101]

Not being able to take a deep breath in itself is not specific to COPD but many other things including Anxiety, heart disease etc.

Stop trying to take deep breaths and see what happens, if you find yourself going for one swallow instead. You may find they come easier.

You also don't just wake up with COPD but will have noticed symptoms for some time and ignored them. In my case SOB lying down, hacking cough and chest pain.

You really won't get all the answers you want until you see your Pulmo I'm afraid to say.

[beeperoni]

I was quite active until March. At that time, I acquired a really bad head cold...two days later, I noticed I couldn't take a deep breath during/after exertion??? Never noticed it before. I went to my GP and she ordered cxr, but that was clear...so she did spirometey, which said mod. COPD. My FVC IS 90%, FEV1 is 64%, and ratio is 70%. Dr said both restrictive and obstructive pattern.

[Hidden in reply to beeperoni]

Sounds to me that your doctor doesn't know much about spirometry. My nurse said that most training on it is done by nurses and that they are better at that sort of thing

[ck101]

With an FVC of 90% I think your doctor may be incorrect on the restriction element.

To diagnose Restrictive disease you really need two values TLC and and Diffusion or DLCO, these tests are not performed in General Practice surgerys although there is a new brand new machine for this on the market that is aimed at GP's.

[Offcut in reply to ck101]

I was first diagnosed from my GP spiro with RLD by the fact that the salbutamol did nothing to change the second test from the first. It was the hospital one in the plastic box that confirmed RLD. Plus a test when on my back of a further 12% lose of lung function.

I am allergic to Iodine so I cannot have the contrast tests

Be Well

[beeperoni in reply to Offcut]

There was no change in my post test either. I'm just still so scared about the whole thing (diagnosed 4 wks ago). I see the pulmonary Dr in three days. GP just took me off Breo and put me on Spiriva only, but I don't think Spiriva has an anti inflammatory component, just a bronchodilator. I get the feeling of inflammation a lot, but the Breo made my throat extremely soar and a burning sensation in my chest. But not being on the Breo, a feel like my airways are closed off. This disease is so horribly 😫

[Offcut in reply to beeperoni]

The one thing I have learned is it does you no good worrying about something that makes you feel worse by worrying. A lot of the time it can be stopped or slowed so much that it is an inconvenience and nothing else.

It might be a lot of trail and error to find what suits you but never be afraid to ask as many questions as you can.

Be Well

[beeperoni in reply to Offcut]

Thanks Offcut. I'm trying to remain positive. Everytime I look at my 11 yr old son though, I get depressed and wonder if I'm gonna be around to watch him grow. My uncle died with COPD (got pneumonia), but he was 75 and smoked 2pks day of camel non filters for 55 yrs. Was still smoking when he passed and never needed O2. I'm only 41.

I've been trying to learn as much as possible about this disease, but it's hard when you don't get answers. I have heard that most meds work best for the asthma and bronchitis diseases, and not so much for emphysema. Plus, a lot of the information on COPD seems contradictory depending on where you get it from.

[Hidden]

I think you need to see specialist and get the correct diagnosis.