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Asthma and/or COPD

Hi, I'm 74 & have mild, well controlled asthma since 7. I have been on a preventer inhaler since my 20's. In 2015 I developed a chronic cough and my breathing problem became more of a concern. (no asthma attack but often breathless, & wheezy). My Dr said I now have COPD & added Spiolto Respimat inhaler. I thought it made me worse so stopped it, he says it's the best. I had to see another Dr. one day when mine wasn't available & he said asthmatics can't get COPD. Articles on internet say asthmatics should not take Spiolto Respimat inhaler. Some articles say an asthmatic cannot have COPD, others say they can. What is the truth?

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I wish I knew! I am in almost exactly the same position as you.

As far as I am concerned I have life long Atopic Asthma, I am using Symbicort 100/6 and Oxis 6 when needed, sometimes when out of doors I use Ventolin but only very seldom.

I am sure I do not have COPD after reading about it on the web..

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Hi Pete

Picked up on your ref to Oxis 6. Looked it up (very briefly) because had not heard of it. Impression I got was that it’s only constituent is a form of Formoterol (Formoterol - as far as I know - being a LABA).

I thought Inhalers containing LABAs had to also include an Inhaled Steroid due to earlier perceived safety risks, so was surprised Oxis 6 did not appear to have one?

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I was concerned when I started using it as I had read about some deaths. When I was on Symbicort 400/12 I was OK but when I reduced to 200/6 and then 100/6 I needed more Ventolin so I worked out it was the formoterol that I needed. The Gloucestershire Pulmonery nurses recommended adding Oxis 6 - BUT - local GP's wouldn't allow me to have it. A later casual conversation with a locum GP and she allowed me to have it!

It's worked OK for just over a year now, I only take 1 puff in the morning with the Symbicort 100/6 and I never require Ventolin when at home. Pete

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Cheers Pete. Interesting.

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Hi what your doctor told you is absolute rubbish. It is common to have asthma first then to also get copd. It happened to me and to many others I know.

Having said that I was smoking so maybe the doctor meant it was unlikely to become copd unless you smoked. Around 85% of copders are smokers or ex smokers. The remainder is probably because of second hand smoke or working in certain trades ie the rag trade or construction etc.

A spirometry test is the usual tool to determine if you have copd or not. Have you had one? If not then I would ask your doctor for it. A CT scan will also be used on occasion.

If you have had a spirometry test do you know your lung function (FEV1) x

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No, I don't know lung function result but I had several spirometry tests that's when I was told I had COPD. I will try Spiolto Respimat 2/5 by 2/5 again. Maybe I imagined it made me worse because I was pretty bad at the time of taking it but I can't help worrying about all the internet reading that says asthmatics must not use it. I also saw a lung specialist who said he couldn't do anything for me, but I did only see him about the chronic cough not breathing problems. I believe the 2 are connected. I didn't mention to my Dr I had been on the internet as Dr's don't like you to do that.

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Hi I am not sure but think spiolto respimat is one I was prescribed. If so it wasn't a case of not using it if you have asthma but more a case of it doesn't treat asthma only copd. My pharmacist explained all this to me and my respiratory nurse said when you have both asthma and copd only the main one ie copd gets treated. She also said there is a big overlap between the 2 anyway. x

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Ive been reading a lot too lately and according to what I read COPD is a label for a group of diseases and Asthma is one of them. So I think Drs say it wrong. Your asthma can eventually cause you to have permanent damage and making airway obstruction worse. I dont think they ave a term for that really except COPD.

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I think the definition of what exactly the term copd covers depends on what country you are in. In the UK it isn't generally included in copd as it is reversible with the right meds. The only things which are included is emphysema and chronic bronchitis as these are both irreversible and are treated the same way. x

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In New Zealand it is referred to as CORD - Chronic Obstructive Respiratory Disease.

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I can only tell you what I'm on as an artistic, firstly duoresp spiromax 2x daily,spirits response 1x daily then montelukast nightly and uniphyllin 2 X daily and my symptoms are controlled hope this helps

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That should read asthmatic not artistic

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I have late onset asthma and fixed small airways obstruction which, to all intents and purposes, is COPD by any other name. Doctors are reluctant to diagnose COPD if you've not smoked, but smoking simply causes the lungs to deteriorate faster, though there can be other smoking-specific damage. If your lungs started life at a lower than average performance then, like mine, their performance over time will drop to a lower level than those whose lungs started at a higher performance level, and you will start to get symptoms (usually around 53/54% lung function). I can't comment on specific medications, only that I use a dual purpose inhaler which took me 5 attempts to find; there isn't a "one size fits all" medication, which is why there are so many on the market - you may need to try a few before settling on the right one for YOU. I wish you well.

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Eosinophillic Asthma has often been wrongly diagnosed as COPD because symptoms and spirometry test results are frequently similar. Respiratory Diseases often overlap, and treatments can be quite similar. The important thing is to get an accurate diagnosis from a qualified Respiratory Disease Consultant, who can then give accurate guidance on the right Meds.

Don’t think you mentioned a Consultant but your GP should be able to refer you to an NHS one at the Hospital if you so request. Failing that you could get a Private Consultation Referral, typically for around £300 to £350, but that’s without the added costs of Tests or follow-up visit to discuss results, both of which will increase costs.

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Thankyou for your reply. I'm in Australia. I have seen a lung specialist but it was about my chronic cough, he changed my asthma puffer 4 or 5 times without any change happening so he said he couldn't help, at that time I wasn't looking for an answer for my sudden onset of breathlessness and wheezing but of course it's seems obvious now they are connected. At one stage I struggled on stairs and slight hills, even getting out of a chair. Since stopping S

piolto Rerpsimat all of that has improved. Of course it could be sheer coincidence it's all settled a lot (still use Ventolin if I go for a walk sometimes)

Anyway I will take a couple of puffs of Spiolto Respimat and see what happens but I'm still worried.

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Basically - the 'experts' don't now the answer to this question. I've been asthmatic since 5 years old and a few years ago was told I have COPD as well, and that asthmatics can develop COPD. However, my hospital consultant said I have NOT got COPD and it should be struck from my records. But, my doctor is (I am told) an asthma expert and he still insists I do have COPD. So, as the Americans would say - Go Figure!!

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Hi Elaine asthma and copd are 2 different things hope this helps

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