Inhalers / should I ?

[Healthy24680]

Hi ,

Since I was diagnosed April 9th with mild COPD I went and saw two other doctors - that’s just me being normally hypochondriac-

First doctor put me immediately on two inhalers Symbicort two puffs two times daily , and Soiriva 18mg that pill popper inhaler.

I have no symptoms no SOB and frankly I don’t feel any difference after taking them except for the heart pounding for couple of hours after Spiriva

Second doctor told me to drop the inhalers

3rd doctor with second spirometer test also told me not to use them

I frankly don’t know the use for each and stopped since 15th April , and I don’t know if I should use them while I’m mild with no symptoms , are they going to improve my next PFT and that’s why the first doctor asked me to take it and come after one month to repeat the test (sounds unreasonable) (I know also doing two spirometer tests in 9 days window and expecting different results is unreasonable too 🤦🏻‍♂️😄) , second doctor asked me to come after 3 months to repeat the test ..

So confused

Anyone was put on those inhalers while with no symptoms and mild COPD FEV1 95% , FVC 118% , FEV1/FVC 68.6

Shall I get back on it for the next test

Thank you all and god bless

[Shazza59]

Hi Healthy, I was diagnosed with moderate COPD about 10 weeks ago and put on Spiriva (the same capsule one as you) and doctor told me this would strengthen lungs in the long term and to get another spirometry test in a year. Had to go back as thought might have start of infection but hadn’t and seen a different doctor who told me to stop Spiriva as didn’t need it and gave me Ventolin (which I haven’t used in the 2 weeks I have had it). I kept taking Spiriva because of what first doctor said. I will go back soon when can get appointment with first doctor as she is my regular gp and discuss. I get some shortness of breath on excertion e.g. stairs and walking briskly and the odd ache in ribs which could be gerd. Doctors seem to have different guidelines to follow and end up confusing the patient!!!

[Healthy24680 in reply to Shazza59]

True that , it’s very confusing , add to that we don’t want to miss any chance to get in better conditio ..

Wish you best of luck for your next doctor appointment , please write again if you get to know from them

Thank you

[Superzob]

There is a view, at least amongst some consultants, that inhalers do reduce lung deterioration. In fact, some posters on this forum have actually reported improvements, which is amazing considering the fact that lung function degenerates naturally with age. I think what tends to happen is that, if you have no symptoms, then medics will operate on the principle of "if it ain't broke, don't fix it". However, if you catch it early before symptoms, then there may be an argument to treat it anyway, particularly if the effect of doing so is beneficial; if you react badly to the medication, then that might need to be reviewed - in the end, it's your choice, based on the best medical advice you can get, and that could well be BLF.

[Healthy24680 in reply to Superzob]

I’ll check again with doctor in a month time . Thank you

[Schmicter]

If you didn't have any symptoms, why was a spirometry test done? Just a guess but those numbers generally shouldn't result in medications. If you want to stay on inhalers for your next test to see if the numbers get better, and whether or not it is even worth it, that is up to you. So what if your 95% goes to 97% is that significant enough to take drugs for you? It is up to you not your doctors.

[Healthy24680 in reply to Schmicter]

I was doing medical Cannabis for a while to treat other health issues and normally the use increase sputum (frequent throat clearing) and couple of coughs a day and usually when I don’t smoke for 1-2 days these symptoms subsided and that’s what happened also this time , went to doctor to check out those symptoms and even before he examine me he’s asked me if I’ve heard of COPD which I didn’t at the time. Then he put me to spirometer and before spirometer he put me on symbicort and after spirometer he added spiriva ..

[Healthy24680]

I guess you guys said it all , it’s really up to personal decision .. I will try to understand the different needs for both inhalers and maybe choose the one that works on the long run

[Symes]

I honestly believe inhalers do work and help. Well, I think they’ve certainly helped me anyways.

I’m on Tiotropium, and AirFluSal Forspiro - basically a mixture of 50 micrograms salmeterol and 500 micrograms fluticasone propionate twice daily. As well as the Salbutamol as and when.

I’m not hugely better, but I am definitely slightly better than when I was first diagnosed 5 years ago.

Every individual is different though I guess.

[Lleech]

Your Spirometry is normal if the figures are correct. However the ratio should be 80.5% on those numbers . If you have mild symptoms are they triggered by anything ?

Inhalers would not really help unless you get breathless episodes and you certainly don’t need an inhaled steroid (symbicort).

If you are still concerned ask for a full king function test at the hospital.

[Healthy24680 in reply to Lleech]

This is what I was thinking , however because the ratio is less than 70% it has to be diagnosed (even without symptoms!!) small airways disease was written on one the test papers.

Need to clear throat multiple times a day is only symptom I can get , only trigger I know is when I smoke weed which I stopped also

Since I don’t have shortness of breath I thought I don’t need inhalers. But I’m still thinking Spiriva might be beneficial , I read in couple of posts here that it’s long term and might have increase lung function on the long run , I don’t want to miss a chance of improvement if there is one

I did full study PFT two times with lung volumes and all the other numbers of breathing .. what is the full function test ?

[Lleech in reply to Healthy24680]

That should have read full lung function. This looks at more than lung Capacity. Your ratio is wrong as it is worked out by dividing fev1 by fvc. Spiriva assists in airway inflammation but should be used alongside salbutamol or similar short acting bronchodilator as this opens the airways . Although you have smoked weed in the last I’m not convinced that you need this unless symptoms worsen to limit any exertion.

[Healthy24680]

What should be the right way to read the ratio ?

Here are the numbers they gave me : all after dialator : and all as oerfentage it predicted. I can give in liters if yuh want

FVC: 112.5

FEV1: 95.2

FEV1 % VC max: 85.9 of predicted , while FEV1 % VC max: 68.58 (hence the copd diagnosis)

PEF: 106.6

MEF75: 86

MEF50: 56.5

MEF25: 42.8

MMEF75/25: 55.9

MVV: 79.1

Following calculations pre dialator - % of predicted

R tot: 60.6

FRCpleth: 119

ERV: 122.6

RV: 116.4

TLC: 112.7

RV%TLC: 95

DLCOc/VA: 99.1

[Lleech]

They are all normal . You don’t show VC reading . The ratio does not mean much with out that . What were the readings before bronchodilator??

[Healthy24680 in reply to Lleech]

These are the number pre

FVC: 118.5

FEV1: 93.2

FEV1 % VC max: 80.5 of predicted , while FEV1 % VC max: 64.29 (hence the copd diagnosis)

PEF: 106.8

MEF75: 70.7

MEF50: 48.4

MEF25: 42.7

MMEF75/25: 49.3

Following calculations pre dialator - % of predicted

R tot: 60.6

FRCpleth: 119

ERV: 122.6

RV: 116.4

TLC: 112.7

RV%TLC: 95

DLCOc/VA: 99.1

[Healthy24680 in reply to Lleech]

There is no Vc reading .. how strange is that !!

[Healthy24680 in reply to Lleech]

Just figured out how to add picture. Please have a look on the full report if you like , when you said normal number you mean normal for COPD or normal for normal PFT report without COPD.

Thanks

[Healthy24680]

That’s all the numbers in the report sheet. I wish I can post it here so you can have a look. Pre measures were just slightly lower that post.