Asthma/COPD... Unsure?

[Ami40]

Hi All,

Firstly I'd just like to say how great this group is and how we all support each other!!

Secondly, I'd like your opinion/thoughts please if possible?

I have been for multiple chest x rays and they have been fine. Was still feeling ill not long after and Dr's sent me for another one and then referred to chest clinic/consultant. He stated that they think i have Asthma/COPD issues. Very likely to be COPD (not definite!) they said they can't get me in at the mo for tests at mo due to backlog of people, no spirometry is available either. They say the 'pragmatic approach' would be to give me a combo inhaler (LABA included). However, I've had major side effects off all LABAs I've tried! I spoke to an Asthma nurse and she has said that this may only be Asthma related and that I may only need an ICS to tackle the inflammation which may be causing the problem!

I I feel i need a diagnosis to confirm what I have so I know which way to go, but no tests at mo!!

Is it best to ask for an ICS now due to the above issues. Could this be just asthma related and I'm being prescribed a LABA just in case it's COPD?

Has this happened to anyone else at all please? Let me know if so please?

Thanks

[Lol1944]

May be helpful if you could please elaborate . You feel ill. In what way?

[Ami40 in reply to Lol1944]

Of course yes, sorry I forgot to mention that, I have shortness of breath on exertion or when using force, there's no cough, no mucus really and sometimes I can breathe ok, but my chest is dry and back hurts on either side of spine and ribs ache at times too. Wheezing on a morning sometimes and tight chest etc. Feel tired and fatigued sometimes too. Get a little dizzy sometimes but again that might be meds, the pains may be to do with the different inhalers I've tried and come off as LABAs do not agree with me.

[Superzob in reply to Ami40]

I have a problem with the aerosol propellant in inhalers, so a dry powder one might also work better for you. Also, as you can't get spirometry at the moment, it won't be possible to confirm whether your condition is reversible (the definition of asthma). However, if you were to use a peak flow meter before and after a couple of puffs of Ventolin, that would show whether you have asthma, in which case you could change to a single ICS if that suits you better. However, I have both COPD and late onset asthma, and I benefit more from a dual inhaler (because it has a long-lasting bronchodilator).

[Ami40 in reply to Superzob]

Thanks, I'm ok with the aerosol as thats what the blue ventolin is isn't it? I think it may be just the LABAs that are causing issues with me...but not sure. So yes if I do my PF and monitor it daily, if it increases after blue ventolin inhaler does this mean it's more likely to be Asthma related? I'm going in for a Full Pulmonary Test in April, I'm guessing this will have spirometry involved? Reversibility option is written on the enclosed form but I think I will ring them to ensure that I need that too, what exactly is the reversibility aspect for? I heard before but forgot now lol

[Superzob in reply to Ami40]

Oddly enough, I’m fine with the Ventolin aerosol, but not those used in Dual inhalers - no idea what the difference is! Asthma is a reversible condition because the alveoli in the lungs are perfectly capable of collapsing on exhalation, but the immune system prevents them working properly (it’s an autoimmune response); on the other hand, COPD is fixed irreversible actual damage to the lungs.

It sounds from your experience with Ventolin that there is a distinct asthma component, in which case a corticosteroid inhaler would certainly help; to confirm this, I would expect you to be given a reversibility test during your spirometry. But it would be unprofessional for a consultant to ignore any fixed breathing obstruction, but you could argue that LABAs give you more problem than their worth. There are so many inhalers on the market that I imagine it’s possible to keep trying until you find one that agrees with you; alternatively, you could continue to use Ventolin together with your steroid inhaler, though I suspect most medical professionals would prefer a more long term bronchodilator.