I was diagnosed with moderate copd on the basis of a breathing test last summer. X-ray at the time didn't show anything.
Neither my GP nor the respirologist I had one appt with said I need a CT scan done. (GP is worried about radiation exposure)
How do you know exactly what you have if you dont have a baseline scan done of your chest? I see people talk specifically about emphysema, chronic bronchitis, bronchiestasis, etc....all under the umbrella of copd. Sorry if this is a silly question, but wouldnt it be important to get a ct scan done to see exactly what your condition is, or are is everything under the copd umbrella treated by symptoms? I am currently on spiriva respimat and cough up phlegm at points during the day (I exercise a lot and use an aerobika and huff breathing to clear it out).
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Tuathana
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Bronchiectasis does not come under the copd umbrella and definitely needs a ct scan to diagnose. If you have problems with mucus production you need to be referred to a bronchiectasis specialist who can diagnose you properly with whatever condition you may have. GPs and general respiratory consultants do not have enough training or experience in this condition.
Thanks for the reply. I actually don't know what I have except that they said it was copd based on the breathing test alone. Just wondering if I should go for a CT scan.
You need to be referred to a respiratory consultant who also specialises in bronchiectasis. They will give you a ct scan. There is no point in going for a scan through your GP because they cannot interpret them properly. You don't seem to have had any kind of sensible diagnosis of copd or any other condition. Only given the wrong information that bronch comes under copd. The 'respirologist' certainly wasn't thorough either. It may be that you do have copd but it needs to be diagnosed properly and other conditions discounted. We do need to be proactive in our own interests. I suggest that you insist on a referral as you and your GP will not know what you have and how to manage it unless you have a proper diagnosis.
My understanding is that it’s ‘normal’ for COPD to be diagnosed purely on the basis of spirometry results for many, many people in the UK. But as you point out, COPD is an umbrella term, and one that covers more than just chronic bronchitis or emphysema, although as Littlepom has already told you, bronchiectasis is not part of it and requires significantly different treatment. For any respiratory disease, the only definitive way to diagnose is usually CT scan, although I believe I’m right in saying ct can be clear in the earlier stages of chronic bronchitis. It’s a bit of a sweeping generalisation, but from what I understand (and have seen with my ex, and more recently my mum), those that know their specific subtype of COPD are usually those that have had a ct scan as a result of being particularly unwell, or the GP finding them hard to manage so sending them (or referring them to respiratory) to make sure the diagnosis is correct.
Because it is a common condition, and it is predominantly managed at primary care level (meaning by the GP) for a majority of patients, and because the treatment is broadly similar regardless of which it is, ct is not routinely requested if spirometry shows non-reversible obstruction and there are no question marks that it could be something else. Whether that’s right or not is another matter entirely, and open for quite a bit of debate, but the tack taken seems to be that as long as the symptoms are managed and progression controlled, the subtype doesn’t really matter.
If you smoked at any point in your life and have breathing problems leading to an obstructed spirometry result the Dr will say you have COPD because of the smoking history. If you have a gut instinct that it is not COPD then insist on a referral to a Respiratory Consultant as our gut instinct is often correct
I did smoke for 22 years, bit I had a lot of bronchial infections as a child (and adult even before smoking). I suppose that's why I I am wondering about scarring on the lungs. I appreciate your input!
It seems your two areas of concern i.e. that you cough up phlegm every day and That you have had numerous chest infections as a child, have been ignored. I feel you need to be referred to a bronch specialist who may refer you for a scan. There seems the only evidence of your condition they have is spirometry.
Btw many of us here have had numerous scans for lungs and other stuff, so according to your GP, re radiation, we are lucky to be here!
I wonder if the GP is worried about the cost of a CT scan. The amount of radiation is teeny tiny. I’ve lost count of the number I’ve had in the past twelve years for various problems and I don’t glow in the dark! I would ask for a referral to your hospital respiratory department. Good luck!
Despite being advised to have a CT scan by second opinion consultant, GP first refused to do so saying GPs couldn't refer for CT scans. Luckily said consultant had told me my GP should refer me for CT, so I told GP I didn't think this was true. Oh yes he said, so I can, but I don't think you should have one because the radiation levels are very high. I had to say..'I don't care'.... I needed this scan to confirm diagnosis of bronchiectasis, but GPs can make it so difficult if they choose.
I think at least you should be having repeat x rays, I had 3 before a CT scan showed I had bronchiectasis, but my xrays had a report of suspected bronchiectasis at the time.Hope you get the treatment you need. Stay well
I thought copd could only be diagnosed by ct. I've had lots of scans and xrays, never had any professional express concerns about radiation. It's about risk versus benefit. Nor do I have any super powers . . . Yet! 🥴
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