Is it likely i have COPD?

[MivoUK]

Hi guys, guess i should start with some history.

23 year old male with Asthma since childhood. Smoker for 3 years as follows.

6 months (80-100 per day)

6 months (40-60 per day)

24 months (20-30 per day)

Around 6 months ago i started to notice cardiac problems. Chest pain, breathlessness and i would get episodes where my heart rate would go silly high. After ending up in A&E multiple times i eventually got diagnosed with a right bundle branch block. Some doctors would tell me i had a heart murmur as well, others would tell me i didn't. The doctors put this down to past drug use although i haven't used drugs in 3 years and my echo was clear. The cardiac issues seemed to last a few months then they stopped. I've not had any symptoms related to my heart for months now.

Then about 2 months ago. It started as i would smoke a cigarette and minutes later i would feel like my lungs completely shut down for a few seconds and i would get difficulty breathing. Eventually it got down to me smoking just 1-2 cigarettes each day but the breathing was getting worse with each cigarette. I was having to use huge amounts of my ventolin after each cigarette. The strange thing was my chest always sounded clear and i had no wheezing.

Quit smoking 2 months ago approximately and I'm still on patches now. In that mind frame currently of why the hell did i smoke! Any way after quitting smoking the inability to breathe episodes seem to have settled down and i only get them occasionally. But the breathlessness and tightness in my throat and chest has not subsided.

Nurse has switched my asthma inhalers multiple times to try and help but nothing seems to work for the tightness. I'm now on fostair 200/6 4 times per day and its greatly helped my breathing but something just feels not right, like a labored, tight breathing sensation all day, everyday.

Occasional clear mucus coughed up but thats only a couple of times a week maximum. The rest of the time its just a dry cough. Had a Pulmonary Function Test a couple of weeks ago and it showed that i had moderate airway constriction. Although i admit i didn't use my inhalers for 24 hours before the PFT as i got the instructions wrong.

Nurse has now said she believes its either asthma or COPD and she believes COPD is a real possibility. Apparently i have to wait a month before having a repeat PFT. A month!

Apparently my chest always sounds clear, no wheezing, oxygen sats are never below 95-97%

Can you all offer some opinions on this please? Do you really think its possible to get COPD from just 3 years of smoking?

On the PFT i found it impossible to breathe out as forcefully as possibly for 5 seconds. I could only manage 2 seconds or so. Chest x ray is clear.

I'm also having a few other problems. Mainly with swallowing food at random intervals in the day. Sometimes I'm fine then the next minute it feels like food wont go down my throat. I also seem to have an issue with water constantly going down the wrong hole when drinking leaving me in a fit of coughing.

[hypercat54]

Hi I think this is very unlikely but not impossible. The vast majority of smokers aren't diagnosed until after decades of smoking which usually means in your 40's and above. It is very rare to find this in your early 20's.

The definitive test is to have a spirometry test which will determine whether you do have copd and also give you your lung function.

Meantime well done for stopping smoking, it's not easy but stay stopped. x

[MivoUK in reply to hypercat54]

Apparently my PFT showed 68%. Asthma Nurse said she isn't sure if its COPD or Asthma.

[Sparkywoo]

I agree with Hypercat 54. Also when you give up smoking your body takes more than a couple of months to settle down and many people feel worse for a while in lots of different ways. I think you need to focus on staying calm - hard when your mind is thinking all sorts I know . Your problems with swallowing food etc are unlikely to be linked to your breathing issues but make sure you mention them to your nurse. It sounds like you’re really stressed by this. I would speak to your GP. And see if you can bring the PFT forward.

Your mind can talk you into or out of anything - I know!

[Ergendl]

You might have silent reflux in the mix, where stomach acid goes up into the oesophagus and can affect the lungs, so discuss your eating and drinking issues with your doctor too.

[Hidden]

Yes it seems extremely unlikely that 3 years smoking would cause COPD. Sounds like you have acid reflux which can cause breathing problems. Try not to worry in the meantime - good luck!

[donut43]

The main thing is you have stopped smoking. Keep in touch with the RESP team and GP. Good luck for the next test.

Dan

[Superzob]

I have a form of COPD called fixed small airways obstruction, which is not reversible and I have never smoked. I suspect this was due to my lung function being at the lower end of the spectrum since they were formed, and probably explains my legendary colds and poor stamina. I suspect when you refer to COPD (of which there are a number of different types), you are talking about emphysema and, I agree, you would be less likely to get it the less you smoke. As others have said, once you stop smoking, your lung deterioration curve goes back to that of a non-smoker. If you also have asthma (as I do), then a combined inhaler like Fostair is a good choice, but it tends to be recommended as it is one of the cheapest; there a plenty more on the market, and I've settled for Symbicort Turbohaler as I can't get on with aerosol propellant types. If Fostair isn't quite doing it for you, then see if you can trial an alternative; the advantage of a combined inhaler is that it helps prevent the COPD getting much worse and removes the asthma element which I find helps a lot with the symptoms.

[Lleech]

Hi firstly well done fot quitting smoking. That was the best thing you could do.

I agree with the other comments. You do not have COPD. This is not recognised in under 35 years. There should be more extensive tests performed, such as a full lung function with reversibility, as well as blood tests for alpha I/antitrypsin II, plus a referral to a Respiratory Specialist Consultant.

Being on such a high dose of inhaled steroid, could be causing you to have acid reflux. This does need tobe investigated as well, but the Respiratory Consultant would be able to assist with that. Ask for a referral!

[jackdup]

You mention a PFT, what were the results of that? If there is nothing wrong with your lungs I can understand you not being able to blow out forcefully for five seconds as you likely emptied them in less time than that.

[MivoUK in reply to jackdup]

Sorry for the slow reply. My PFT was just 68%. It should be about 110% for a healthy male at my age if i remember right?

But i didn't take any inhalers for 24 hours before my PFT. Which according to the doctor was NOT the correct thing to do. Do you think not taking my inhalers for the asthma could have caused such a low PFT of 68%?

[jackdup in reply to MivoUK]

I don’t know a lot about asthma but I would certainly think so. I’ve known people with asthma and their breathing can be quite bad, so I can certainly see it being reduced by that amount.

[stamford1234]

Well done for quitting cigarettes. Look after yourself and try to stick with a good diet and lots of exercise. Keep away from traffic fumes. It is all too easy to blame cigs

[Clamdigger]

I found out I had allergies in my twenties by the time I was thirty went to a allergy clinic they told me to move out west to dry climate did I listen .. Thought I could just take a pill clean a little more.. It seem to start in my forties on puffers lung infections during the summer I had so many lost count.. By the time I was fiftity told I had asthma .. Just a month ago COPD.. If years ago they would of told me one leads to another I would of moved and looked after myself.. I did smoke when I was in my teens did get lung infections didn't know I was allergic to it... I started with little mucus about ten years ago know its more often almost every day.. I have mild COPD ... Redoing my home putting in heat pump doing what I was suppose to do.. Allergies will cause COPD to flare up... I have the problem of not being able to swallow at times its from acid reflux .....