Hyperinflation of lungs

[d0ttysslave]

Hi,

I have (almost) been diagnosed with COPD - emphysema has been mentioned. This is the result of tightness in chest, increased breathlessness, and a chest xray which shows hyperinflation of the lungs . I also have a sore pain in the left side of my chest, and I have had this for a long time.

The doctor said that any COPD is likely to be mild, which is reassuring. However, I do get very breathless, I have had these symptoms for years (a chest xray was done and lost about three years ago) and they have got worse over time, and I feel sort of full most of the time.

I had hoped the Dr would do a spirometer test to see what stage this COPD was at, but this has not been mentioned yet.

I am a bit worried because in many sources (and I know we should not trawl the Internet for information) hyperinflation occurs at a later stage of COPD (possibly stage 2) because the lungs can no longer empty themselves fully.

I do not want to pester the Dr, but I am worried that the symptoms are not being taken seriously, and my breathlessness and the pain are not been 'treated'.

Am I just overthinking things?

[Hoobs]

Hi, to put it simply , your doctor cannot diagnose you with COPD without a spirometry test, it is impossible. Unless of course he is that good he can tell that your breathing is obstructed ( the ''O'' in COPD) just by looking at you. Given that he clearly doesn't know the correct procedure for diagnosing a common condition I probably wouldn't put him in the ''good'' category.It would be like diagnosing somebody with Diabetes without running all the tests, it simply wouldn't happen.I would insist that you get a spirometry test and let him know you are aware that he shouldn't be diagnosing you without one. Good luck.

[Davegt in reply to Hoobs]

Spirometry tests are not being done at the moment. That is why you have only been almost diagnosed.

[Karenanne61 in reply to Davegt]

I've had recent lung function tests at my local hospital, even during covid. Sadly my gp surgery is very poor. It seems a lot of gps are using covid as an excuse.

[Davegt in reply to Karenanne61]

Not an excuse. The BMA give guidance for GP's to follow. Please don't blame GP's for following guidance from the British Medical Association.

But joint guidance from the BMA and RCGP on practice workload prioritisation in place since January lists spirometry as a ‘red’-rated procedure, meaning it can be postponed until the end of the pandemic.

The guidance said the ‘red’ category represents ‘lower priority routine work which could be postponed in the event of a high prevalence of Covid-19 in your patient population, aiming to revisit once the pandemic ends, ensuring recall dates are updated where possible’.

[JulyAugust in reply to Karenanne61]

Yes the GP surgeries are all empty except for the staff. My son has been unable to get an appointment for some important medication he can’t be without which he was getting in the USA for the three years he was working there. He spent an hour on the phone in a ‘queue’ only to be told no appointments. He went in personally and was told he would receive a call the next day but not even given the courtesy of an approximate time (morning/afternoon). I agree that Covid is being used as an excuse and has little to do with BMA guidelines in many circumstances.

[Karenanne61 in reply to JulyAugust]

I agree. I hope your son has managed to get his meds.

[Katinka46]

I am not sure if the GP practices are doing spirometry. I think they stopped during the Covid crisis. It is certainly a test that could show up problems in your lungs. Your concerns should be addressed. COPD is too often an automatic assumption by doctors because it is the commonest lung disease. I have a little device at home that does FEV1 and peak flow, so the results are limited.

Push for more information.

All the best

[d0ttysslave in reply to Katinka46]

Thank you Hoobs and Katinka.

I will call the surgery today and explain that I am still experiencing the breathlessness and chest pain, that the X ray showed hyperinflation, and ask for a spirometry test. I know they are being done because my son has had them recently with respect to asthma.

Thank you.

[Hoobs in reply to d0ttysslave]

Please also ask for the reversibility test, if the first spirometry test shows obstruction they get you to take a few puffs of an inhaler, wait for 15 -20 minutes and then re-test. This will test for Asthma also. This should be done anyway but given the poor care people with lung problems receive in general , they may not bother or even know they are supposed to do it.

[Davegt in reply to d0ttysslave]

journals.rcni.com/primary-h...

[Biggles550]

You dont mention any inhalers , if your out of breath with COPD an inhaler can help. Perhaps asking the doctor for some relief of being out of breath , maybe one tack to try.

[B0xermad]

Hi hopefully you will be reffered by the gp to a consultant who will do all the spirometry, lung function tests and a ct scan.I waited 6mths ,8yrs ago before covid kicked in , for the complete tests then you would be called yearly from then on

[0282749m]

I suggest you change your doctor. That is how my COPD started. Now I am in the final stage - Stage 4,

[d0ttysslave]

@0282749m I am sorry to hear that. It also concerns me. I am considering asking for a second opinion.

[watergazer]

If you haven’t already had a referral to a consultant I would say push for one x

[Patk1]

Welcome to the forum.i hope u can get a definite diagnosis soon and relevant treatment.fo u have history of asthma,like son? If u smoke,do stop asap x

[d0ttysslave]

Hello Patk1, thank you. I stopped smoking about 20 years ago, although I smoked for 25 years before then. I do not have a history of asthma.

[CDPO16]

Hi and welcome d0ttysslave, hope you get some answers soon.

[JonathanPittsCrick]

Many people with COPD are much more breathless than they need to be – this is because the less-flexible lungs gives your brain the sensation of needing to breathe. What you need to know is how good your lungs are at getting oxygen into your blood, and you can easily test this yourself if you buy a finger pulse oximeter (e.g. amazon.co.uk/Saturation-Mon.... Just walk up a long hill and limit your breathing to one breath every 6 steps (in on 3, out on 3) and see if your oxygen level drops below 90% at your maximum exertion. If it does, then you do have significant COPD and should see a respiratory physician / pulmonologist, If not, your lung function is not the limiting factor and not the main problem.

[Hidden in reply to JonathanPittsCrick]

I have to disagree with your comment. Many people with grossly abnormal spirometry and significant lung damage requiring specialist input have SpO2 within acceptable parameters, even when they push themselves. The body can learn to compensate and maintain gas exchange. It also doesn’t follow that exertional desats prove COPD. All they prove is that oxygen utilisation is being limited by some mechanism: it could be the result of any respiratory condition, but you can also experience desats purely as a result of dysfunctional breathing, which can and does occur in the absence of any underlying lung disease. The OP needs spirometry to help determine what’s going on.

[JonathanPittsCrick in reply to Hidden]

Spirometry is useful to identify the nature of a lung problem, but if the O2 sats are normal on exercise the lungs ARE functioning adequately in their job of oxygenating the blood. “Learning to compensate” cannot manufacture oxygen – if it’s in the blood, the lungs got it there!

I’m not saying that desaturation proves COPD, just that it means that there IS a problem that needs sorting out.

[d0ttysslave]

@jonathanpitttscreek Thank you. My son has a finger pulse oximeter and I will try this test.

[DreddR]

Hi, I have hyperinflated lungs, most likely due to 30 odd years of smoking, and I had chest pain & breathlessness as you describe. This all came about during beginning of pandemic. I also think I had covid early on but no tests then so will never know. I gave up smoking. I am quite healthy, physical outdoor job. I discovered my chest pain was costocondritis (may be spelt wrong). Was given Sabutamol inhaler, used rarely since I was prescribed it. I take lungwort, NAC and tumeric, started at the gym doing cardio and weights. Unbelievably I feel fitter than I have done for years. Climbing hills, cycling and my job is way easier. The breathlessness has really reduced unless doing exercise (whichis normal to an extent) and I have minimal mucus with no coughing in the morning.

COPD was mentioned but despite asthma nurse making noises about spirometry test, nothing has come of it. I know the damage is done but I have confidence I have done all I can to mitigate this.

Yes its possible to overthink and I spent many a sleepless night wondering if I was going to leave my young son motherless but with a change of lifestyle, habits, diet snd exercise I am hopeful I will live a lot longer! I am 46. Hope this helps.

[Anonymoustoo]

Keep pushing the Dr your body your health ask for it to be done

[Taurus74]

I have the same issues at the moment COPD emphysema hyperinflation of lungs , the chest pain isn’t Goin away it’s quite painful .. I was stage 1 a year ago and go back on the 31st for another lung function test ..