Help with confusing PFT results

23F, 123lbs, 10 years daily smoking marijuana. For 3 years I've had chronic daily phlegm - like hocking up a loogie. I started getting chest pains and some shortness of breath after quitting smoking 2 months ago. I have been on Flovent inhaler for 2 months but nothing before this. My PFT seems indicative of copd (chronic bronchitis) but I have been told it is "probably" asthma. I am so confused and unsure what to think. I am trying to get as many opinions, knowledge as I can on this because I have had the worst anxiety thinking I could have chronic bronchitis. IGE, eosinophil, chest CT all normal. No allergies. I have made a pulmonology appointment but it is not for 3 months.

[sassy59]

Hi, sorry I can’t really help but I would say my husband was diagnosed with COPD (chronic bronchitis) in 2010. He’s 70 and still doing pretty well. He also has asthma plus other health problems. Please don’t be anxious as you can live well. Stopping smoking is a good thing.

Hope you get a definitive diagnosis soon and maybe try and get your pulmonary appointment brought forward. Take care xxx

[peege]

Thank goodness you've quit the smoking and marijuana the best thing you could possibly do for yourself and future health. My son smoked a lot of marijuana and its really affecting his brain function. I'm afraid I can't help with the lung function test results , they might have suggested possible asthma if there was an improvement after taking the broncodilator.

Healthy diet, weight and exercise will be your best friends lung along with avoiding colds & coughs plus getting regular flu & covid vaccinations while you await the consultation and probably for evermore. Lots of exercise for pulmonary heath on youtube Good luck

[Hidden]

With the caveat that I’m not remotely medically qualified. My understanding is that it would be very difficult for any medic to draw meaningful conclusions on your diagnosis from spirometry when you’re only two months post stopping smoking. I say this as a former smoker who never had any breathlessness or cough when smoking, but was frequently breathless and constantly hacked up a (revolting) lung for almost 9 months solid after stopping. It took almost a full year to get completely back to ‘normal’, and all the literature states that many people have significant respiratory symptoms when they stop. This is because the cilia in our respiratory systems destroyed by smoking gradually start to regrow and then clear all the tar and rubbish from our lungs, all of which takes time.

In terms of your spirometry results - and I reiterate, I am not medically qualified - unless I’ve missed something, the only result that is marginally below the lower limit of normal is your fev1 at 77% predicted. The cut off for normal is 80% or above. Your fvc is good. Your fev1/fvc ratio is also within normal. To have a diagnosis of COPD, the criteria required is a ratio that indicates obstruction (usually taken as below 70% here in the UK) that does not reverse with a bronchodilator. This is because COPD is a group of diseases that feature non-reversible obstruction. In comparison, asthma is considered a reversible obstruction, so from the results you’ve posted, I think the increase in peak flow demonstrated post bronchodilator is why they’re saying possibly asthma. However, you would expect to also see a change in ratio or fev1: the fact that you’re not obstructed pre inhaler would make an asthma diagnosis slightly unusual unless you had no symptoms at all that day. Did you get the inhaler before or after these results, and if before, did you use it on the day of the test?

In all honesty, from those mostly normal results, and considering you’re in the smoking recovery cycle, I don’t think you can draw any conclusions at all. I know it’s easy to say, but I would concentrate on staying off any kind of smoking (or vaping), wait a good few months for your lungs to come through the other side, and then repeat the test.

[Hidden]

Thank you everyone for your advice and kindness! I think I may have been looking at the results wrong, as I thought my ratio was only 66 but I dpeidn't even take into account that percent predicted results are my results, not what they are supposed to be? If that makes sense. Thank you for explaining this to me! I think I will redo the test in a few months even though waiting that long is hard for me with my anxiety. I will definitely try to stay off the smoking as this has scared me straight haha!