British Lung Foundation
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DO I HAVE COPD OR NOT ?

I would really appreciate some help regarding a spirometry test result that I had done yesterday;but before that a very brief history. Ex smoker, very bad cough last month so asked for x-ray. X Ray result showed hyperinflated lungs consistent with COPD. (cough now gone) but because of x ray had the spirometry to cofirm or exclude COPD.

The nurse looked at results and decided I did not have COPD, so I should be happy. But I have concerns. Why were my lungs hyperinflated ? Could she be wrong about the test results ? Here are some figures from my test result

FEV1 108% of predicted (2.26 actual)

FVC 131% of predicted ((3.31 actual)

FEV1/FVC 90% of predicted (actual 68)

FEV1/FVC 100% of predicted after inhaler (actual 76)

Surely if I need an inhaler to bring my FEV1/FVC up to 100% of predicted then I must have an airway restriction/obstruction ? Don't get me wrong I am delighted and so very relieved to be told I have not got COPD but I question it. I would be SO pleased if anyone can help me

20 Replies
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Them numbers look good to me BUT i think FEV is load bull really REAL test is gas transfer test co2 & oxygen transfer.

You might have bad gas transfer but good fev thats could explain hyperinflated lung's or could be bad breathing ie breath in longer than you do out.

But numbers look good BUT if not happy and struggling go see your doc and ask for lung transfer capacity test.

A lot is down to age WITH lung disease AND its up to you to define what is acceptable not a nurse AS you live with it 24/7

She only dose 9 to 5 or near ass

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Thanks so much for replying Jeff. I have no idea what a gas transfer test is but thank you for the suggestion. I am delighted you think the numbers are good but do still worry that the initial result was 68 and only 90% of predicted. I am 68 years old but obviously that has been taken into account.

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Its not nice but the take age into account as thinking is something else will be issue befour breathing becomes one.

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yes I get that thanks

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Hi

If your FEV 1 is within normal range, 80/120

And your FVC is within normal range 80/120

Then you ignore the FEV/FVC ratio

In some cases, lungs may appear hyperinflated on X-rays for reasons unrelated to lung function. If you aren't experiencing shortness of breath, there's probably nothing to worry about. However, if it isn't clear what is causing the hyperinflation, your doctor may recommend additional testing.

Are you still seeing your GP, for a explanation.

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Thanks Stone I did not know that about ignoring the FEV/FVC ratio if those other nos are within the normal range. No I have not got an appointment to see the doctor but will make one and ask about the hyperinflation

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Hi, I'm new here and don't understand the numbers or initials, but I also had the experience of being told first that I did, and then that I didn't, have COPD.

I am an ex-smoker with well-controlled asthma, and developed a persistent cough (and lost my voice for a month) at the beginning of this year. X-ray showed "chronic obstructive (shadowing?) in both lungs consistent with mild COPD". My GP assumed I had it and sent me for spirometry to confirm - which it didn't.

GP surgery just told me "it's ok, you don't have COPD" and would have left it at that. I pushed to know what I had instead, as I still had the symptoms. That was in March. Last week (late August) I was diagnosed with bronchiectasis, which is apparently often mistaken for COPD at the beginning.

I don't know if this is relevant to you or not, but I'm so glad I didn't just accept the "no COPD" diagnosis and would urge anyone to keep asking the questions until you find answers that make sense in your situation.

All best wishes,

Rachel :-)

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Hi Rachel I hope you are well at the moment. Yes it's all a bit confusing isn't it. Is your condition treatable ? How is it different from COPD ?

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Hi.

Yes definitely confusing. I am very new to this and have extremely limited knowledge - there are people here who know much more. But my simplified understanding (so far) of the difference between COPD and Bronchiectasis is:

In COPD the airways are constricted and/or blocked - due to damage by smoking, environmental causes and other things. (Progressive.)

In bronchiectasis the airways are widened, make more mucus than normal, and can't clear it out properly - due to damage from infections, or other situations - so it gets infected. (My consultant said it isn't usually progressive as such, but can get worse due to further infections.)

There are such huge similarities between the two that it's hard to tell the difference, and bronchiectasis is much less well known.

Bronchiectasis is not reversible but is treatable by exercises and medication to get the mucus out and reduce further infections, and then antibiotics to clear them when they happen.

I know very little so far and am waiting for my first physio appointment. Please do not take anything I say as being accurate!

I am currently well thanks, and practising with breathing exercises that I haven't officially been taught yet. Glad to have found this community.

Wishing you all the best,

Rachel :-)

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Hi Rachel thanks for the info. Like you I am so pleased to have found this website All the best for the future

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All the answers that the guys gave now makes me doubtful if my diagnosis was correct. I am according to the Spirometry test borderline stage 1 or 2 Emphysema the Dr said. I however went for a CT scan as well and he mumbled " That's strange no sign of Hyperinflation or any scar tissue;. I never cough, I've got no phlegm and my breathing is normal. I do however as long as I can remember a post nasal drip and sinus problems - maybe I've got something else under the COPD umbrella?

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How old are you? In the UK? How much did you smoke for how long? Was the cough productive? How was it treated? Is it your first episode of a chest infection? Have you got the Fef 75-25 numbers?

I don't believe you can trust those headline numbers as my guess is your lungs are still showing signs of previously being over inflated - which can be caused by mucous plugging.

On the face of it, 68% Fev1/FVC is in the obstructed range - but that's probably a false positive; your lung volume (FVC) is too high which is why the ratio is just a little low.

I think it's a good call by your nurse - over time the stretch that over inflation has caused will subside, FVC will reduce and your ratio will improve to normal or near.

She can also see the prophile of your blow on a graph, the pattern of which the spiro machine uses to help confirm the diagnosis.

All guess work, but if they test you again in 6 months your numbers will probably be better, even though you couldn't really call them much worse than normal now.

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Thanks so much for your reply soulsaver. I think that once I give you the following info then you might not be so optimistic (oh but I am so hoping you will). I am 68yrs old and I smoked for about 50yrs until 3yrs ago when I quit. The cough was productive but cleared up after no treatment. I have a chest infection in the past (maybe once/twice). My FEF nos are as follows-as a percentage of predicted.

25 86%

50 60%

75 29%

After inhaler they were the following (again as a percentage of predicted)

25 108%

50 69%

75 51%

The nos look pretty bad for the FEF but I would rather know the truth about the test. Have you any idea why the lung volume was so high ? Many thanks for your help in all this.

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Could the high lung volume have anything to do with the fact that I am a runner and still run about 25mls a week on average ?

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Not sure but I was wondering if you were a swimmer....

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No not a swimmer just a runner for the last 25 years

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Yes I believe can be due to sustained fitness levels. Remember diagnoses are based on measures, graphs AND symptoms: If you're symptom free & don't get more out of breath than usual, I'd still be inclined to accept her diagnosis.

There appears to be a degree of reversibility with Ventolin in the small airways which may indicate a small asthma component? Possibly not enough to warrant inhaler but may contribute to bit of extra mucous which could attract infection? Just speculation.

Note, your Fev1/FVC ratio is borderline normal in many other countries' health associations and was in the UK until a few years ago when they lifted it from the previous 70%.

You're going to get some deterioration from age influences as everyone including the healthy does, but keeping fit & healthy weight and you'll live to be ripe. :)

What's the next step or are you discharged?

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Soul saver your name is very apt and I can't thank you enough for taking the time and trouble to respond to my post. I am discharged in terms of having no further appointments. I do have an inhaler for use only when my hay fever is bad and When it's really cold and I want to go for a run. I will continue my running for as long as I can as it allows me to eat cake guilt free!! Thanks once again

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Just keep an eye on things as you obviously are. I've had asthma since childhood and they diagnosed mild Copd 2 years ago. The asthma nurse kept trying to tell me that I didn't have Copd as I'd never smoked and the spirometer readings were just an elevation of my asthma due to my age (57 at the time). They're now saying it's at level 3 and I have constant chest infections.

Sorry to say at the end of the day you just have to look after yourself. I don't know why the medics try to minimise diagnosis - maybe a funding issue.

I really hope you'll be fine x

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Thank you yes I will. Interesting point re the funding. Keep well

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