Is this asthma or copd?

[Dl98]

Age 65

Sex F

Height 160cm

Weight70kg

Race W

Fev1 45% pre Inhaler. Up to 50 after Inhaler. Hitting 56 during tests

Duration of complaint25 to 30 years

Location scotland

Any existing relevant medical issues COPD or asthma

Current medications trimbow ventolin

Include a photo if relevant. Not

She's got copd we think. But Im wondeing if she has it asthma instead..

I have asthma too

Diagnosed via pft only. She was hitting 56% during tests as it makes you do it three times. I thought an increase like this indicates asthma? Peak flow went from 130 to 180 as well. Otherwise she is really well. Works full time walks shops fine

[Damon1864 Volunteer]

Hi you are better off taking her to the GP at least you will get the correct diagnosis. We are not medically trained so can't tell you what it is .Sorry but please see GP or hope this helps and please let us know the results. Have a good evening and take care both of you.😊 Bernadette and Jack 🐕 xxxxxx 🌻🌻

[Hidden]

Hello again. I replied to a post about your mum previously, where the topic was whether she’d been misdiagnosed. As a reminder, nobody here is medically qualified and we’re therefore unable to diagnose anybody with anything, and I’d also say the replies you had on your last post still apply. However, we wouldn’t be able to tell you much of anything from the fev1, anyway: my understanding is that the main figure that determines copd from asthma is the fev1/fvc ratio. That fev1 does indicate something’s going on, though, as anything below 80% is considered abnormal, and being down in the 40s and 50s clearly so. Her peak flow is also low: even at the age of 85 and at 5ft in stature, ladies would be expected to have a peak flow of at least 300.

What I would say again is that asthma is considered a reversible obstruction, so if asthma was the only issue, you would generally expect to see the numbers normalise a lot more post ventolin inhaler. To be considered reversible, you need a 12% relative increase in either fev1 and/or fvc, however it’s the ratio that ultimately dictates a copd diagnosis. If that remains significantly under 70% (0.70) after using the inhaler, then a clinically significant increase in fev1 might well support that the person has both. It’s also important to recognise that fev1 doesn’t always correspond to levels of breathlessness. There are people that get very breathless with an fev1 in the high 60s, and those that cope brilliantly with a much lower level: some of it depends on the body’s ability to compensate and how well they’re utilising the oxygen they’re taking in.

Diagnosis of COPD on the basis of just spirometry (PFT) is commonplace in the UK. If your mum is coping well, and her condition is well managed, the question I would ask is how much does it matter what her underlying diagnosis is? She’s receiving treatment that’s clearly helping her to lead a normal life based on what you’re saying.

[sandravale]

I have asthma & bronchiectasis. Ventolin works well for me when occasionally get breathless or need to boost my steroid inhaler (e.g at night). The effect usually lasts about 4 hrs

[Bogart24]

I have nebulised ventolin for years it is a good thing if inhaler use with spacer

[Yourusername1]

My asthma , which is normally quite mild, got out of control a few months ago. My ventolin made no difference. Still doesn’t. I was shocked to see that I was describes COPD and was prescribed Trimbow and it made things worse. I went to see a specialist who said he would not have prescribed Trimbow for me. He dropped the ventolin and Flutiform, put me on a course of string steroids and antibiotics, and prescribed Seebri breezehaler and seretide 250 inhaler. It’s been great ever since. His diagnosis was that my asthma had just got out of control. My GP hadn’t picked up on that.

[Ergendl]

According to the NHS BMI calculator - BMI 27.3: she might benefit from losing a little weight.

[Andyfella]

Hello, your last paragraph tells me that asthma is more likely on the basis that she walks, shops fine, copd symptoms would be present most or all the time to some extent especially when walking or active.Your GP shoukd refer you to a respiratory specialist.

I dont beieve peak flows can be used to diagnose in and of themselves. With chronic asthma I can blow them to the end of the tube somehow.