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British Lung Foundation
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Emphysema losing battle

I hate to be negative but if you honestly think about You go to the Physican. You get your CTScan you then go to Pulmonary specialist and your tested and diagnosed with COPD/Emphysema in its mild or early stages and after all the hoopla and medicine, exercise, diet etc your progress to severe eventually anyway. So is it that big of a deal to be diagnosed early ? While you’ve done everything correctly you still struggle mightily into your 60s . I for one was so much happier without an early diagnosis as I would have quit smoking and been much less depressed and much happier in my inevitable decline . I really would like to know if there is actually anyone who is truly still “mild” years after their diagnosis!

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I will be interested in any reply’s. Had asthma all my life diagnosed with copd 2002 I’m 76 now yes I’m severe now but reckon I must be doing something right

Take care

Dorothy

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You've probably got adequate magnesium which most people don't have.

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You would have quit smoking without the diagnosis RedSox? Really?

Everyone is different obvs in the way they deal with their diagnosis and having a progressive condition, but early diagnosis is important as it gives the chance to make life-style changes you mention which delay progression - exercise, pulmonary rehab, a good diet.

I was diagnosed in 2000 at moderate stage. Im 72 now and borderline very severe but the years in between have been great ones despite the condition and although I've had serious spells and currently a bad time with the pollen, there are still really good times. Who knows how long Ive got? Or any of us. But Ive always been determined that it wouldn't ruin my life. And it just occurred to me that life itself is a long term condition.

Im sorry you're feeling so bad about it all, depression can be such an awful thing to deal with. I wonder what support you have as I know my life has been immeasurably better due to wonderful partner and friends. Everyone here will want to support you RedSox, and Im sending you very best wishes.

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Honestly you are probably correct I Pro would not have as it probably was the major contributor To cessation. Yet I was recently entertaining the thought for more economic reasons

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How right you are O2Trees! Strange how these things occur to us - in January 2012 having been diagnosed with cancer by my consultant - I was too stunned to feel anything I wasn't worried, frightened or even 'bothered', the only thing that bothered me was how abnormal it seemed to feel nothing while knowing that I had cancer. I had an appointment to see my doc a couple of days later, he was going through what the op' would involve and I heard myself saying "life is a terminal condition anyway and at 72 I'm not sure it's worth it". I had no idea where that came from, it had never occurred to me before but I had the op because my doc assured me that 'this wasn't a nice way to go' and that 'there better ways'. Now, I find the thought of life being a terminal condition strangely comforting, illness is less worrying because now it's only a reminder of how precious life is - even if it doesn't feel great when I am ill.

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We are all suffering from a terminal, sexually transmitted disease. It is called life.

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Haha I’ve never heard it put that way . That is great Katinka46 can I use that in my everyday conversations? Haha that is golden

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My consultant also said to me if we all lived to 150yrs EVERYONE would have COPD - lungs deteriorate with age.

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Brilliant!!

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Great way to think of it Magpuss - you've been through such a lot. You seem to combine a pragmatic and a philosophical approach in such a good way. I hope you're in a better phase right now. :)

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Pragmatic and philosophical🤔 - funnily enough I've struggled a bit with that over the last few days. My son finally moved into a new supported living facility very recently, there's been some 'difficulties' to sort out, partly (I think) because it's new - and some are ongoing but he and the three other residents are getting along well with each other. So, last Friday when I went to a meeting with the staff it was just to air one or two concerns and iron out a few wrinkles. I wasn't anticipating any problems and things were going well until a staff member took a call from the local surgery where my son has been registered and out of the blue told us that the call was to let them know that an appointment had been made for this Thursday for him to have an endoscopy. To say I was shocked is putting it mildly and I definitely wasn't thinking pragmatically or philosophically for a couple of days after that. I was angry that an appointment had been made without anyone contacting me, angry with the doc and frightened for my son. Having stood back from it a bit since then I've 'gathered my wits' cancelled tomorrows appointment and made an appointment for us to see his doc this Friday instead. If an endoscopy is needed I want it to be at our local hospital- not one that's extremely difficult for me to get to and - if possible, I want him to be anaesthetised. He'd panic if anyone tried putting anything in his mouth, it would be far too distressing for him and may make him reluctant to admit to any other problems in the future? I'm still hoping that it won't be necessary but I know there's a possibility that he could be heading for Barrett's oesophagus and given my recent history I can't ignore that. So - I'm in a 'better phase' than I was last weekend, not quite out of the woods yet but feeling better for doing something about it instead of just whittling. Fingers crossed for my lad though.

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Goodness, that's a heavy thing to cope with Magpuss. Id have done exactly the same - how insensitive to book an endoscopy without telling you and giving you some choice in where it should be, on a day you could go too. I have barretts and have regular endoscopies and they are never nice even with sedation - possible but not nice - so I can see why you would want him anaesthetised. Awful to think how not doing so could potentially destroy his trust. Words fail. Well done you for taking it in hand. Im crossing fingers too.

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Thank you. You're right sedation 'just about' makes them tolerable but I wish there was some other, less intrusive way of doing it . If I could have it done for him, I would.

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Of course you would - if only life were so simple.

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Ive had two endoscopies earlier this year both with sedation-I have to say it was really ok and didn’t remember a thing!

Hope it will be the same for your son and all goes well!

Janzo

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Oh dear Magpuss,with your back ground of esophageal cancer you know more than most how unpleasant and frightening endoscopy's are and to even attempt to proceed without your knowledge and also your support to subject your lad (i know that word makes you laugh for some reason)to such a procedure is both unprofessional and uncaring,go bite their bums and put your foot down young lady as you always do when required...........love and best wishes Ski's and Scruffs

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Thank you Ski's - and Scruffs. Hope you're both 'enjoying' this lovely weather rather than suffering it.

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All the best to you and son hope all goes well xx

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Thank you 👍🏻

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I love that. Life is a terminal condition

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I know what you mean Magpuss . I also thought I would forgo transplant. After all it's buying time, not a cure. Children are grown, my duty fulfilled. Yet, life is precious and maybe I still yet have some duty to myself.

How very upsetting re: your son. I'm sorry . I can understand how hard it must be for you.

Thinking of you. xx 🍀

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You're definitely due some 'you' time Cas - time to meander through all that lovely cherry blossom with Chom and to wander round taking photographs of your beautiful country - then posting them for us to see of course😊

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*BIG HUG*

I will remember that Magpuss . Thank you. xx 🙋🐕

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You are also a great support and encouragement to the rest of us hear, Cas. A real treasure.

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And you are too Ergendl . xx 😘

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O2 no wonder I look forward to reading your posts and replys.I'm sure there are times life is physically tough but you get on and aren't afraid to challenge but in a caring and supportive way,strong woman,huge respect Ger

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Everyone’s different RedSox, that’s the way with most diseases I feel. You’re not being negative but some days it just hits you and knocks you for 6.

As I’ve said before Pete has COPD (bronchitis diagnosed 8 years ago) and we have no idea what stage he’s at. He’s probably moderate but who knows.

Focus on day to day and keep coming on here to chat. Great people who listen and give great advice.

Love to you xxxx 💖😘👍😘

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Hello RedSox . 👋

I have Bronchiolitis Obliterans and not Emphysema, but for what it's worth, I thought I'd offer my two cents anyway.

By the time I was diagnosed my lung function was already in the 30% range. Very severe. It is believed that I may have had lung issues stemming from having Rheumatoid Arthritis for many years. And the decline was so slow that my body kept adjusting and "coping". Before diagnosis, I ate healthily and exercised and did all the things I thought I should. Now whether that contributed to the slow decline I will never be sure. But I feel like being physically very fit did keep me moving, thus keeping excess weight off. That served to keep breathing easier, my heart strong and my body to a certain degree, able to function. But again, I will never be 100% certain.

Even with the exact same disease, each person's progression varies, in my opinion. I know only a handful of people with Bronchiolitis Obliterans. I am nearly four years into diagnosis ( yet I may have had it much longer than four years) and in need of a transplant. I know a lady who has had the disease for eight years and still works, no transplant planned. Another young woman who also has this disease, declined at lightning speed. These things are so hard to predict, nigh impossible perhaps.

I have read on this forum, of people who stay stable for a long time. And those who don't. it seems to be such a case by case situation.

It is EXTREMELY hard to try and look forward and not to sink into the depths of the sea of depression. In fact at the best of times, staying positive can be harder than managing the actual disease itself. Yet, for many of us, it has kept our heads above the waves thus far. Even then, we all sink sometimes. 😊 I'm sorry it's hard for you at the moment. I really hope things improve. We are all here to listen anytime.

Have a lovely week.

Cas xx 🌞🌷

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Thanks Caspiana .... God bless!

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Hugs to you Caspiana and 🌹🌹🌹🌹🌹🌹🌹🌹🌹🌹

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😘😘😘

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hI Cas_-I havent been on here for a while--Nice to see you and that you are holding your own--Been a rough summer--MmeT

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Hi there madametobacco49 . I've been carrying on the best I can. It's really nice to see you. Hopefully autumn with it's crisp, fresh air will bring easier breathing. xx 🌿🍁

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Marvelous answer Caspiana

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That was a lot of paragraphs. It wore me out. It is great to know you are here. Look after yourself in this hot weather x

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Sorry. 😑 😊

And you take care of yourself too. 🌞

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As with all things lung related the information about COPD is sketchy and not really helpful in any way. This forum certainly gives the impression of 5 to 10 ish years to go from mild to severe.

I am only 42 and was diagnosed as mild, despite having a FEV1 of 79%, moderate,not mild. I was also told by my consultant that my progressive disease wouldn't progress as I had stopped smoking, it either progresses or it doesn't, if it doesn't, stop classing it as a progressive disease.

I certainly have no plans made for still being here or of any use by 50, I can't find one single positive post regarding this disease and it's progression, so I believe that unfortunately its a case of having to get used to the idea of not being here long.

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Again Rory I agree with you wholeheartedly. I always hear posters saying “there are many who haven’t progressed “ my simple question is If so who and where are they ????? Unless they remained mild and felt they left the forum or needn’t reply. Personally I never hear from them.

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Sorry Roey my spell check had you as Rory I do apologize

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Really glad you posted this as I still feel the same as you and Very scared x

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Please don't be scared. Just do every day and see the beauty. Write a book, paint a picture, sing a song, hold a hand. Please don't be scared. You are frightening me now x

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Thank you for your kind words x

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We will be alright x

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Me Too Vonnie--I worry every single day--I dont know how to live my life now--and so many things I want to do and cant--MmeT

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Don't worry, I've been called worse ha ha

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I was diagnosed with severe emphysema in 1999 when I was 56yrs.. My diagnosis in 2018 is still severe emphysema. Shortness of breath has worsened over that time and I was given O2 last year (concentrator) and then portable O2 as well earlier this year. I'm still puffing along! Last year the Respiratory Consultant added pulmonary hypertension to diagnosis.

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Dear, dear roey123 .

I am two years your senior. My FEV1 is less than half of yours. I know that doesn't sound very helpful, but please, please don't give up. Honestly, you may decline, but in the mean time please give it a jolly good run for it's money. Use that 79% as best as you possibly can. Our lives are like a camera. Focus on the things that make it worthwhile, keep the pictures in your heart. We are all here for you anytime you need us.

*Hugs*

Cas xx 🌞🐳

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More hugs and 🌺🌺🌺🌺🌺🌺🌺🌺🌺🌺

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Thank you, you are a very brave lady.x

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Car, that was a beautiful comment.....simply beautiful.

Meg xx💕💕💕

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Everybody has a progressive decline in their lungs as they age. If you take great care of yourself there's no reason why your lungs shouldn't decline at the same rate as someone without copd, that's what my doctor told me and I'm sticking to it. It's alarming that you feel you will deteriorate to point that you will be useless or dead within 8 years, try to stay positive and not think in those terms and live your life to the full. In 20 years time you don't want to look back and wish you hadn't wasted so much time thinking your time was nearly up and affecting the way you lived your life. I'm at exactly the same stage I was when diagnosed 5 years ago.

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Honestly I was not being negative with my post but rather, just like to bring some issues to the forefront.

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That's what the forum is for RS :)

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Whatever. I just walk a bit slower and enjoy every minute. It is frustrating but it doesn't stop me having a laugh x

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Again great love and support from the members of the forum but not a single one who remained mild . I love the members sincere wishes but I’m a staunch realist and all I ask is there any one that has remained mild . I’m only asking what time it is not how to build a clock

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I'm guessing the ones that remained mild after 20 years do not spend much time here if at all. The realist must realise the BLF posters are not the total sum of the whole.

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So true Bkin there is definitely truth in your summation

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The possibilities in life and health are endless.

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I also think that the reason you never hear about those who stay mild for years, is, because their lumg disease is having no detrimental effect on their life so, they are just getting on with their lives.

The was a post on here, a few years ago, where the poster met a man on a train who said he had been moderate for twenty years.

I've read on other forums of people who are still mild after 14 years.

Most people come on here because they are newly diagnosed and afraid of the future, myself included.

People who don't feel sick, usually, don't go on health forums. xx

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I think I'm correct in saying that Hypercat has stayed mild. Hope she comes along to agree with me. Sheila x

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Id like to know what time it is too--MmeT

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Dear Roey,i am 65, many years your senior,my emphysema progressed because i didn't take heed of warnings or adapt my life style but i cruised through my 50's and my glass is even less full than Caspianna's with an fev1 of 22% but it is still a glass that i intend to drink from as long as i can still lift it and i manage quite well on a day to day basis,please think positively as it is to a certain extend your mindset that will also stop things progressing and let you enjoy all life has to offer you.....regards Ski's and a cat that will live even longer....... xx :)

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Cheers ! Ski school drink up !

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Thank you ,I do the right things , I don't smoke, I eat healthily and I run on my treadmill and do press ups everyday. It's just hard reading some of the posts by the more severe members, knowing that's what I am heading for. Thank you for replying to me.

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i am here where you fear to reach,if i get any more severe i will drop of the scale but life is still worth living and enjoying,so dump that fear and breathe :) xx

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Do positive my love. We are all different. Press ups are very different! OMG, I can hardly pull my socks up! x

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makes me so sad to hear that stamford--hugs,MmeT

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Look at my reply roey. x

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Rosey I was last diagnosed with 44% I'm still here 5years later and haven't stopped smoking, I'm probably very severe by now my copd nurse is useless I'm was only on Ventolin and still walked about most days just fine, I'm starting to struggle a bit with breathlessness and am trying to give up the cigs,I wish I did 5 years ago as I believe if I had I would have had a lot longer before I progressed. 79% is only just moderate, lung function can improve when stopped smoking for women, by up to 10% even with copd, people are still alive 30years later at less than 79% try to be positive.

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God bless but I feel as though Roey123 as well as others and myself included are constantly hearing of folks having had The condition over 20 years , 30 years etc but where are they ? Where are the internet links ? Saying things like being positive and everyone is different is understandable and kind but where is the proof ? that is what is so frustrating not even medical websites can be found that has any concrete evidence . Call me stubborn call me callous but my original post was clear and concise. I didn’t mean to ruffle feathers I just wanted to know who is hear or actually knows one here who has progressed slowly into their 70s and or 80s without the aid of o2 or other ailments

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My copd nurse showed me a chart showing how long you can live after you stop smoking if a 40 yr old stopped smoking with mild cops which is 79/60 % they can live til gone 75

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Haha with those calculations than I would tell your COPD nurse that RedSox quitting at 64 has about 2 Days ir maybe 3 Lol

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Lol I ment mild but I put moderate % oops being diagnosed at 64 is a lot different to 42 I doubt a lot of people got 30years after that age. I edited the post☺

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This I believe is called the Fletcher -peto chart, it has been proven to be inaccurate and is only really used as an incentive to give up smoking/

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I am 68 and 7 years in - I take it slowly. You know the worst thing for me is you look okay ... and people don't appreciate that ... you need air. I get very embarrassed

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I was diagnosed with mild copd in 2011 aged 47. I think i’ve had it s long time...i’ve Had asthma as a child and when suffering from allergies and hay fever by smoked from being s teenager to when I gave up in first weeks of pregnancy aged 34. I am now 53 and run parkrun most weeks with the odd walk...i’m always towards the back but I don’t care. I still work but am considering changing job as I am a teacher and in contact with lots of snotty kids so catch lots of viruses that trigger exacerbation. I am still very much alive and kicking , and whilst I notice I have less energy and stamina than s lot of people my age...I live a full life. The future scares me a little but I am definitely nowhere near dead xxxxx

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Thanx ..... God bless

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mmmm nothing is cut in stone and COPD may or may not be the reason for a persons death.

Some people will die having lived with COPD, into old age. Some people die before COPD reaches advanced stage, perhaps of something related or unrelated to COPD. Sadly some people die at a young age.

COPD doesn't progress rapidly if we can do the best we can to preserve our lung health and yes being diagnosed in the mild stage is a bonus so that all the Edcuation and exercise ongoing learnt at PR can work to our best advantage.

Stopping Smoking

Regular Exercise

Avoid those infected with Cold or Flu virus.

Keeping lung infections to a minimum and at best infection free for years

Good diet, looking after our wellbeing in general, mentally, emotionally and physically.

If one is foccused mainly on the worst case scenarios in life, its not going to help much to achieve an improved life enhancement and slow down progress of COPD.

Diagnosed early 50s mild to moderate

Now mid 60s mild to moderate to severe, Very severe when I get a lung infection with 3 different lung issues not to mention the rest.

I am aiming to achieve and hope to maintain mild to moderate across the board into my 70s, but there is no guarantee, I will just keep up all I can do to help improve lung health and general wellbeing overall.

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I think you have nailed it there - thanks

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RedSox, I was diagnosed with mild emphysema and lung cancer 5 years ago and I lost my upper left lobe to the cancer. I have since lost the upper right to cancer. I have no idea what "stage" my emphysema is currently, I guess I will find out when I see my new pulmonologist in November. But I am now down to 3 lobes, so I am on oxygen when sleeping and when active.

There are no guarantees in life, you could step off the curb tomorrow and get hit by a bus. But if you spend your time worrying about the future, you are missing out on the present. My dad smoked after his emphysema diagnosis, he didn't quit until he went on oxygen. But the emphysema didn't ultimately end his life, the dementia did (he was 75). My mother lived well into her 80's, she lived about 30 years after diagnosis. I am now 61, but I refuse to let myself dwell on what might happen in the future. I would miss out on too much of the present. I have no idea how much time I have left, but I intend to enjoy life while I can. Please don't let yourself dwell on the what if's for too long, you might miss out on the here and now. Remember; Life is a crap shoot, it is by nature terminal, none of us are getting out alive. Try to enjoy each day.

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I think their are quite a few on this site who are still mild after many years. They don't come on so often as they're busy living their lives . I've heard a positive attitude helps. Perhaps you're one of the unlucky ones

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Why is he a unlucky one ?

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Great question Vonnie I’m still trying to figure that out too? Unlikely about maybe being a realist !

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Think we are all unlucky to get this disease is all I can think. But if doctors say you should just progress at a normal rate why are so many now severe ?

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To be honest, I've never, ever had a doctor attempt to predict progression to me. I've been told what may help slow progression, and besides, for everyone a "normal rate" means something different.

I really try and concentrate on the rate of my own progression rather than try to monitor the rate of the masses. I know that sounds rather selfish, but to be brutally honest, that's all I have energy for, keeping up with myself.

I am on a lung transplant group. People share there daily. Unfortunately, most of the posts talk about rejection and the myriad of problems faced by transplant patients. The patients who are doing very well, hardly post much at all. I used to be discouraged by this, but after reading and researching and being in contact with people, I discovered there are many post transplant that do amazingly well. I realized, I may run into difficulties too. But no two experiences are ever totally identical. I have my own unique story. Good or bad. And you probably do too. xx 🌿🌸🌿

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I am sure with your spirit you are going to be great even if you have a bump on the road. Keep up doing so well 💖

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I'm guessing you hear more from the severe ones than the not so severe ones :)

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I agree as milder probably find it quite scary as I do at times and they are living there lives too 🌸

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Well Im near to beginning of very severe. Dxd well into moderate stage and that progression has taken 18 years. So I must have had copd much earlier, at least five years but the asthma masked it. In relation to your question I wish I had known back then. I also have asthma and bronchiectasis. I have had bad times but rapid recovery from recent double pneumonia and respiratory failure (the hospital seemed to think I might not make it at one point) seems to indicate that my body is in good shape, apart from the lungs of course lol.

At dx I asked my then GP what the prognosis would be. I was talking about symptom progression but he just replied that I would probably last to 75 which was 20 years from dx. I felt very upset and went home and thought about this. Then I reckoned that that figure must have been an average figure so it was probably the mid point of a wide span and people would live both longer and shorter lives from dx. I now have three years to go to 75 lol. Anyway I went back and told him that he shouldn't have told me that and he actually admitted he was wrong and apologised profusely. He was (is) a professor of general practice and he should have known better.

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No he should not of said that at all. I wondered why you had not been on this forum recently. So glad you are back on here and you are very much alive and will be for many many more years ⭐️⭐️⭐️⭐️

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Hoping so Vonnie, cheers :) Not great at the moment but it will pass (see my Prisoner of Pollen post). Re the forum, I go through phases - mostly to do with whether I think I've got anything useful to say. Some queries, about benefits for instance, I know nothing about and I find the questions seem to come in phases too so I have absences lol. Thanks for your nice reply and hope you're ok at the moment :) :)

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Oh bless you I am off to read it ⭐️

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Great to hear O2 now I finish the day on a positive note

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Cool :)

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Did you smoke O2Trees ??? I went from what nurse said was 59% moderate although I believe that's the start of severe, To 44% severe in 18 months not years I'm too scared to ask what my function is now, even though I had a review last week, she didn't offer to tell me them .

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I think 50% is the start of severe Lizadam, not 59%. Anyone?

Yes I smoked, 10 a day from age 19 to 40 so quit 15 years before diagnosis. Not that much but definitely enough to cause the damage. But as a photographer I was working in badly ventilated darkrooms with toxic chemicals before digital, and I was forever doing building jobs at home without a mask, so lots of damage potential. I was suggesting a medication review to you below, but just seen you had a review last week. Did you discuss medication then?

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I was 50% lung function when diagnosed, I thought that was moderate. My overall lung function now is just under 70% but the gas exchange is now under 50%, so many different areas to determine what is what. I was told originally can't improve lung function but I proved em wrong :D

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I believe that they didn't stop smoking, maybe still around polluted environment (work chemicals, other smokers, pets, ) it comes on slowly you don't notice until you have a excubation then wham, my peak flow went from 350, to 200 after my last chest infection and will not go any higher and I use my nebs 10x as much all in 3months i m at the frightened stage now possibly permanently disabled.

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Oh no how long have you been diagnosed are you still smoking? Sure you can improve x

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Doctor said if I stop smoking I wouldn't get worse if I kept smoking I would be 1/2 59% in 5 years but I went to 44% in a 18 months my first post said I was first diagnosed at 44% I ment to say my last diagnoses was 44% lol my fingers type quicker than my brain catches up.I was diagnosed originally at 59% 5years ago and haven't been told a reading for over 3 years although I was told it's critical I give up smoking last year. I've tried everything to stop but because My symptoms wasn't too bad I kept telling myself I will give up soon,then I had an excubation a few months ago now I'm extremely breathless and trying my hardest to stop with not much success I have mental health problems and the fact I'm dying is not sinking in. I'm probably in the very severe stage now will I improve IF I stop smoking or is it too late??

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It's never ever too late to stop smoking.

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Please quit you can do it ! You can . I know it’s cliche but honestly if I could anyone could I mean that ! You can do it roey123

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I was replying to lizadam , I haven't smoked for coming up to two years

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Oh Hun it is very hard to quit I did 4 years ago but still have to chew nicotine gum constantly. Mental health issues are the worst I suffer too from anxiety and a bit of ocd I am here to talk Ifyou need too. I think if you quit it will help you tremendously and you will breathe so much better plus help yourself to keep healthier. Please keep trying to give up 🌸

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It’s never too late to stop. When I had my initial diagnosis I was told I had the lungs of a 100 year old and would never get better. It took a really bad experience (thinking I was suffocating and going to die) to make me stop. I am now 38% but feel so much better and do so much more - this is 20 years on. I grade myself by my symptoms not by a number -and yes, if I am sick with a chest infection I am quickly reminded of my crappy lungs. On the whole I am convinced that giving up smoking was the start of me living a near normal life (I won’t be running anytime soon though !)

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Hello Lizadam,

Stopping smoking at any stage will help you to breath a bit better and the a big plus is that you will have more oxygen in your blood as smoking/Co 2 steals that! Try going to the NHS stop smoking clinics theres so much help out there and its free! Dont give up giving up! You will get there but you have to want to.

I do hope you can feel motivated to try- we wont judge but are here to support!

Good luck,

Janzo

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Never too late Lizadam. I had my worst winter 2016/17 I never thought I would recover, I went down to very severe with the lung functioning, flu, viral bronchitis pneumonia, flu, from Dec 2016 to end July 2017, it takes time to recover from bad infections that don't respond to treatment and also from pneumonia. Just give it time and start doing some exercise each day and build on it. Ask your doc for referral to PR. Stopping smoking will be the very best thing you can do to love your lungs back into feeling some better. Changing mind set is the way to go.

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My resp nurse said today that you can flood your receptors with too much nebulising - I tend to nebulise salbutamol as even with a spacer it has no effect at all. Sounds like yours aren't working too well - should you ask for a medication review Lizadam?

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Hi o2trees what do you mean by that is that dangerous as my doctor said to much nebs can be harmful as it masks the problem I use a spacer but like you had no effect unless I have 5or 6 puffs could that cause me more damage ??! I am on anora but it makes my legs hurt a lot so only take it when I feel desperate havnt told nurse that yet though at my review she suggested a x Ray but she's been saying that for the last 3 times I saw her and she still hasn't done it (about a year) is she putting it off because I smoke do you think ?? As she thinks it's not worth it maybe ??

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I was diagnosed mild copd 10 years and my lung function hasn't changed in 10 years despite only packing in ciggies last year. I don't ever expect to get to the severe stage so I don't see that sort of decline as inevitable. Unless I live to 120 I only see myself progressing to moderate maybe but no more.

I think a lot of it depends on luck and some good genes as well as healthy living etc. I obviously have the former as I don't have a very healthy lifestyle. x

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That's brilliant, I was going to mention you as being the only one I know on this site that has remained the same over a long period of time, but thought you would answer if you saw fit anyway.

I think like me, a lot of people are told by their consultants that they won't progress as long as they do the correct things, mainly not smoking. These are the professionals so surely there must be some evidence of this for them to say it, they must see hundreds of people a week. Or is this a very best case scenario that rarely happens but they don't want to cause more anxiety?

People then come onto forums like these and it paints a very different picture, most on here that post have all got a lot worse over the years, this then puts doubt into peoples minds about where these consultants are getting their information from.

Does this site show a fair representation of progression , I think that is the question.

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Mild COPD but is it Mild Emphysema? To many it is not a difference but to me it is as I’ve established I don’t believe in the whole Umbrella theory

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I agree red Sox my doctors won't tell me if I have emphysema or chronic bronchitis, They keep saying they're both together to have chronic bronchitis diagnoses your supposed to have it 3 mnts for 2years in a row , I haven't had that happen to me, and I believe if I have got emphysema I only got it last year, as that's when I started to feel like in can breath in fine but can breath out fully and I've got swollen ankles and get exhausted. I was diagnosed copd 5years ago after going to doctors regarding panic attacks. And it's only the last 6months I've had distressing symptoms,as I didn't give up smoking I know feel like I've left it too late,The sad fact is that my COPD diagnosis at 39 made my already fragile mental health a lot worse causing me to smoke 3x as much I became a chain smoker. As everything I've read about emphysema says 5years is average life span.

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5 years is average? I just don't believe that. I was told something very different, see above. I think we all want to know how long we've got when we are first diagnosed, it's such a shock, and looking to find out on the net doesnt help. People here will tell you a very different story - I would think 5 years is unusual.

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My doctor told me to stay off Google lol I'm starting to see that people can have relatively normal lives I just wish I could've give up smoking but because I believed at first I only had 5years left I thought whats the point, now I've damaged myself alot more now I'm going doctors tomorrow last time they wouldn't give me champix because of my MH, stupid I could die from copd but didn't want to make my depression and anxiety worse

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That must feel awful, but now you have a plan. So go tomorrow, and let us know what happens. Ask for something that won't interact with your MH stuff - there must be something because you won't be alone in having to deal with MH difficulties. And in case no-one has mentioned it, there's a good Quit forum here where you'll get a lot of support. And we are here for you on our forum. Sometimes people post each day that they've given up - "My first day without cigs" or something like that, then "My second day . . .etc".

Dont regret, don't look back, just do it, NOW!! Best of luck Lizadam :)

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A side effect of champix is psychosis and anyone with existing MH problems could be a lot more susceptible. That's the main reason they won't often prescribe.

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No that's totally wrong. I have been on this site for a lot longer than 5 years and there are some folk on here who were severe and very severe then and who are still very much with us.

A lot does depend I think on what stage you are diagnosed at. I was diagnosed early coz I also have asthma and had a check up every year. It was picked up at one of my annual reviews. Others aren't diagnosed until they are severe and their prognosis obviously isn't as good as those diagnosed at an early stage, but even then 5 years is far too low.

It is never too late to pack up the ciggies unless you are very severe and then it might be too late to make much of a difference. But at your stage you can help stop it progressing as quickly as smoking can cause massive acceleration. This is the reason I stopped the fags - fear. I didn't mind dying tomorrow but didn't want to live 20 years on oxygen and in pain maybe as well.

If you wait until the ciggies give you up instead then you are in deep trouble. I know coz I have seen it a few times in my real life. x

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I remember you telling me this and you gave me hope keep up great work x

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Wow but you say COPD but it is Emphysema?

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I haven't a clue as my doctors and nurses consistently refuse to tell me and insist angrily that it's all copd. I don't think they know to be honest. If I had to guess I would say primarily CB with a bit of E as well. x

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Whatever it is stay healthy!

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Am trying to. You as well! x

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Hi I am 70 not diagnosed yet but FEV1 is 69% and although no symptoms at present have had horrendous 4 months coughing sob day and night was scared till I met a woman of 79 who has had Copd for the last 20 yrs and she told me she never bothers with yearly test anymore just gets antib if she gets an infection and never really thinks about it certainly doesn’t spend her time on the internet looking it up like I do

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Thanks for asking the question I’ve wondered most about in the 10 months since my diagnosis. I don’t often post here but do read a lot and in different groups, but I find you guys here especially inspiring. I‘ve come to the conclusion that some people seem to stay at the mild level for a long time despite not making the lifestyle changes that are supposed to slow down the progress of the disease. (Just like some lifelong smokers never get ill)

In other groups I’ve read about people who’ve made the lifestyle changes and have actually improved as a result. To a relative ‘newbie’ like me this gives the impression that anybody can do that if only you try hard enough. But given that we probably all have different variations of the disease, how can you compare. It’s impossible and only adds unnecessary pressure in my opinion.

The frustrating thing for me is that I seem to be doing all the right things, I look after myself, exercise when I can, have always eaten healthily even take lots of supplements that are supposed to help. But still I seem to encounter one problem or setback after another. Occasionally I wish I could turn the clock back to a year ago when I didn’t know what i know now.

But mostly I try hard to stay positive despite knowing that neither luck nor genes seem to be on my side.

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Ah but would you have quit smoking without your diagnosis ? When I was diagnosed with asthma and then COPD ( I'm now severe and on oxygen) I didn't get very upset or depressed about it. I just regarded it as a natural result of smoking and aging. After all there are worse diagnoses we could have. I regard myself as lucky compared to some people and somethings got to get me in the end. I have no desire to live to be 100. Sheila x

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The above reply was to RedSox ! Sheila x

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Hi mskpjb thanks for the reply and I do not want to live til 100 but I will take 99 lol is it my understanding that you continued smoking or did you quit ?

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For a few years I kept giving up but having the occasional one. I finally saw the light and gave up permanently. Not easy though ! Sheila x

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RedSox.....I hope this helps you.... being from the US, I'm hoping.....While Nelson is 85 years old .....has had emphysema since he was 41....that's 44 years....Leonard Bernstein emphysema from 45 passed away at 72....never quit smoking, his physicians told him to...all the time. Barbara Stanwyk...actress.. started smoking at age 9, diagnosed in her 40s, passed away at 82....Leonard Cohen...had COPD since his 40s passed away from leukemia was a contributing cause....died age 82....First Lady Barbara Bush COPD....and lots of health problems passed at age 92.....President George HW Bush...cigarette and pipe smoker...COPD...and now Alzemizers....age 94 still going....and I always looks at it like there are cures that happen everyday....for diseases they aren't even trying to cure!! And, they are just now starting to research towards hopefully a cure and advancements....for many lung diseases...it's liken to if they cure say CF....it could cause a domino effect in cures for other lung disease.....

Hope this list made you feel somewhat better!! Sure hope so....and Maybe it helped someone else to....

Take good care!

Meg xx💕💕

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Thank you megshafer sadly I’m old enough to remember them all lol and of course there is Pablo Picasso whom we all know (although not clinically diagnosed) had lung problems and he lived until like 91 and worked up until he was 91

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Don't forget to mention Leonard Nimoy (Spock in Star Trek). Ok he did pack in the ciggies back in the 80's but he was in his early 80's when he died from copd. Apparently he wasn't even diagnosed until a couple of years before his death which I find completely bizarre. x

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Hi! hypercat!! I was not a Star Trek fan...but it was always on at someone's house growing up....and then the movies...if you watch Leonard Nimoy in all those movies, after the show went off air.....you can tell his breathing was not normal. I agree with you....he had to have known way before, he would have had the best medical care, too...I think he worried it would hurt his career.....that's my thoughts on it.

Take good care!!

Meg xx💕💕

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No apparently he had been to the doctors and they didn't know what was wrong. It wasn't a case of he didn't admit it because of his career. He was 39 when Star Trek aired so by the 80's he was around 60. He would have been at the tail end of his career then anyway. x

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I did not know...his age at the times. Thanks for information...

We just had a horrible thunderstorm, some of my plants look very wind blown and out of sorts! My ferns are blown down....and it's still raining pretty hard.

Thanks again!! Stay well!!

Meg xx💕💕

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Applauding you for a most wonderful and uplifting post--Hugs and more hugs--Made my day----MmeT

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And, many....many more....and many who have not a clue they even have it!! There are more undiagnosed, than diagnosed.

Again, take care....enjoy the beautiful weather as we are to have a 5 day heat wave here, starting Friday so they say. Booo....I never did like heat!! Ever.

Meg xx💕💕

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Hi again Meg--I knew you had to be in US when I seen that weather forEcast--I am there too--I also I lost my wonderful cat recently as I believe you did too and my support person died 5 weeks ago--He had a double lung transplant 10 years ago--so he got 10 extra years--Happy to meet you--MmeT

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I can see your point 100% but the one thing that is a given is we all have an end date! Even those that appear healthy can be taken at an early age. I have had a few times that they have told the wife I was not going to see the night out but still battling on. I live with what I have with what I can get away with?

Be Well

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I have coughed nearly everyday since I had double pneumonia 24 years ago....I was diagnosed with asthma then COPD....but I am still here. Ok my peak flow has gone down, but I am 71 now and it does decline with age.

I have a number of friends who have similar lung problems and we are still enjoying life albeit with a few grumbles now and then.

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Oh yes I realize their are many but if you read the original post it says Emphysema not Asthma as I explained yesterday no umbrellas for me . I still am old fashioned and believe there is a distinct difference. In the meantime I’m glad to hear you are well and battling !

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I don't ask for copies of my annual test results or know what stage I am at with COPD. I have to take emergency meds at least once a month and so long I can get out more days than not I'm happy. Feel sorry for the members are so much worse than I am.

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Only diagnosed 20 months ago. Made changes and do not intend to hide in a hole feeling sorry for myself. Life is about living. Like most when first diagnosed I had the same anxiety about how much time I had left. My conclusion was it's not the length of time but making what time you have as much a quality experience as possible.

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The one thing I’ve learned is that the classification means nothing. When I was first diagnosed approx 20 years ago I was ‘mild’ - I couldn’t walk and talk at the same time - in fact I had trouble doing anything. Fast forward and I’m in my 60s with ‘severe’ emphysema and I walk about 5 miles a day and rarely get out of breath. It was a hard road and sometimes a chest infection will remind me that my lungs are not healthy. I started walking as a therapy just a short one to start and it increased as time went on. I avoid smoke and dust which seem to have an impact.

I am a ‘use it or lose it’ person - if I hadn’t been I really think I would be housebound and on oxygen.

Don’t be defined by your illness !

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Hi red Sox ,I was diagnosed in early 2004 .I have managed my condition without any problems , except when I get an exacerbation , but it is progressive .I'm now at very severe stage and I'm approaching 71 years old .Have just been told I'm having a lung reduction operation on 10 th September so I'm hoping afterwards I go back to managing my condition like in the early stages . I have never let my condition rule my life and it's basically an attitude of mind how you cope with it .Good luck

Live Babs♥️

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Thank you for your advice Thank you Alfiebax2 and very best of luck to you. When you were diagnosed in 2004 what stage was it ? If mild that just proves my hypothesis on many of my posts that slowing the progression is just a medical term they use . Yes it is a progressive disease and I understand that but why does the medical community feed us the whole non treatment treatment spiel ?meantime good luck on your lung reduction . You have so much to look forward to

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Mine was severe from the start but manageable until as you say it is progressive , I couldn't manage it anymore . Hopefully after my op things will be better .

Love Barbara xxx

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God bless !

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At the top of the dusty, creaking stairs that lead to the furthest point of my mind there is a locked door. Behind the door is a tiny attic room. I don’t keep a portrait in there ( I could wish) or a mad woman ( that’s me anyway). Locked away in the darkness there is the boggart of fear, frustration and despair. At a very early age, so early that I cannot truly remember, I must have realised that I would have to confine this boggart to a place where he could do least damage. If I allowed him free range in my life his babble would prevent me from hearing the birdsong, his poking prevent me from doing the things which I needed to and the damage that his destructive presence did to me would render me incapable of achieving the life that I wanted to lead.

Mostly he squats quietly in his attic, but occasionally he beats on the door until it rattles and screams and screams to be let out to plague me. Sometimes I put one foot on the first step of the stairs, but always manage to turn away: take the dog for a walk,put the radio on, email a friend or take myself to my wonderful volunteering job. Leaving the boggart to turn his fear, anger and frustration on himself.

Love to all of you.

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hiya Redsox, you are doing so well. Don't give up. Read a nice book or put some music on. Water your plants and make a nice cup of something ... be careful out there

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We are here, we are talking, we are Alive, we are all Different. It all depends on how YOU look after Yourself, You have been given the Tools and Advise by the Professionals. I was told in 2013 That I can extend my Life by helping myself............2018, Yes, had a Gift of Valves as an interim whilst waiting for Double Lung Transplant now 2 years on List., Some days feel so Low, but kick myself in the butt, I'm Here, I'm happy, I'm a loving Human being, I love everyone, I go to the Gym, I exercise, I love my Lippy, regardless of age which does not mean we are "Old" so Listen to your self and your loved ones.

TODAY, I have received a Post saying that a young Friend of 23, Jordan, Died of Sepsis, He wasn't even ill, he was a Market Trader at work, he finished work went home and became poorly, ONE hour Later he had Died...No Warning, No Illness, Happy and Carefree was Jordan.....makes us all stop and be Grateful that due to our Meds, Doctors, and all our friends on this Forum....We are Alive.......RIP my Young Friend. XXXXXX

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Hi. I have inly been in here once before but felt I would like to add my penny's worth on this one. I gave up smoking about 21 years ago after smoking 40 a day for about 30 years, and to be honest I didueven get a cough whilst smoking! Nor for 10 yesrs afterwards - I started getting a bit breathless about that went to doctor and was immediately diagnosed with COPD simply because I had smoked! I was treated for COPD for about 10 years when they decided I didn't have COPD at all but Bronchiolitis Obliterons I was given that diagnosis in July last year and have got steadily worse since then. I now find I can barely walk or even make a cuppa and get very depressed. Doctors say it was caused by my Rhuematoid arthritis. The thing is I have no idea what my 'score' is or what my condition is, although my doctor said moderate/severe. Is my condition basically panic attacks? Maybe my sats range for 88-92 on a good day but the do not feel I need oxygen, when I went to rheumatology/lung clinic first time she said she hoped she could give me 5 years good life - don't know where that went it feels like I have only bad times recently I sit around all day because if I move I can't breathe and when I try to get up I have wobbly legs - I am going on pulmonary rehab next week though so fingers crossed! BTW I have never known what level my condition is just ince I was told my ling function was 50% that was about 4 years ago no idea now. Sorry to go on for so long but I really feel nobody understands and if the doctors do then they jyst can't do anything about it

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I wasn't diagnosed with COPD in 2015 until the moderate stage, 69%. Following all the advice o this site, I am still at the moderate stage, 69%. Whatever tomorrow brings, I'm living today as best I can.

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I try to stay away from Doctors. At my age, I really don't want to know what they might find. Lung function as well as many other things decline with age. Take those percentages with a grain of salt. If an otherwise healthy, non-smoker...no COPD, 70 year old has 50% of a 25 year old.. just from age, and I have a 50% of a normal 70 year old....shouldn't I already be dead? :)

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Try 'The Salt Cave' therapy if you live in England there a re a few places, the same in the USA. It helps asthma, COPD, emphysema.

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Well at least you are being monitored and still relatively OK so why not go with the flow and do your best and never give up.

Dan

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I was diagnosed as severe at about 35 i was i hospital every couple of months now about 20 years later with the help of briliant gp,s respatory specialist, pulmonary rehab, singing, the help of some wonderful people at breath easy Norwich. Oh and the nurses i am still sever i dont en

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Hi RedSox I'm a mild one! Diagnosed with COPD 12 years ago FEV1 67% now FEV1 60% I am a retainer of O2 and that has worsened but there is very little I can't do - pushing 14 stone disabled husband up a slight hill helps breathing!!! Yes I do go to a gym twice a week, walk a forty minute circuit taking in an incline, keep weight stable and eat a balanced diet - never say no to a custard cream though! Have smoked on and off when totally stressed out (should take up alcohol instead!) but rarely. Was really scared at the thought of not reaching 60 now well on the way to the big 70! What will be will be as they say!

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Thank you Jillybaby you have made my day . God bless and stay well

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Thankyou for such a nice comment. Keep checking in and let us know how you get on.

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Thanks again Jillybaby but and I wish you the best yet after reading all the responses I realized many replies were a mix of COPD and emphysema (which I separate) and it seems you were diagnosed with COPD and not Emphysema which may be why you seem to have been successful over the years . I don’t believe anyone with Email could say as much but hopefully I could be wrong.

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Try to stay positive.

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I'm 62 seaver stage bronchitis and emphysema an I still smoke they only give me medicine now test at this point aren't gonna change anything I'm gonna be here till I'm gone me COPD still changes me all the time I weigh 77 pounds my feet are so swollen they burn but I'm still here

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Normal lung function decline for healthy people is around 20/30 ml annually. COPD stable will stablize the decline 30/40 ml annually (after stopping smoking 1 or 2 years) might be a bit more if you have emphesyma . If you keep smoking that number might increase to 60ml or more annually

Given that stages are calculated to predicted number and hence the percentage, if you manage to keep your decline ratio close to normal declining ratio you will keep the ratio high or stable that's why people stay at the same stage or ratio for long time while the absolute FEV1 number will decline

Keep an eye on FEV1 absolute number and ratio and that will give u good idea of there is any progression at all

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Thank you Healthy but your reply confirms exactly why Emphysema and COPD should be separate. You state COPD stable decline and Emphysema decline are different therefore giving credence to the fact that each condition is an separate entity and in my opinion should be treated as so .

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Totaly agree i had a dodgy chest for years but drank smoked danced travelled ect ect i also had horses i know now it wasnt asthma like they said it was COPD but has soon has i was diagnosed in 2013 with COPD ! my life felt like it was over and i became so depressed and my breathing terrible with anxiety ,So yes im glad i wasnt diagnosed in my early 40s i enjoyed my life to the full i feel for the people who are now being diagnossed so early in their life x

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Hi RedSox - Ten years on from being diagnosed with severe COPD (mostly Emphsema as no cough) and needing oxygen for sleep and activity, my 'numbers' (FEV1, FVC etc) have not declined - in fact FEV1 is about 8 points better than at at diagnosis, and FVC is about 15 points better. I achieved this by stopping smoking on diagnosis, and building up my strength & endurance through regular walking and swimming. It didn't happen overnight & I didn't expect results as Doc's all acted as if we could only deteriorate. I still need the oxygen just as much, and truth be told my lungs are still permanently damaged - but the way I see it is that I have strengthened my diaphragm & all muscles, and that the 'good bits' of my lungs are working at their best. There are people around the world who have improved their numbers in this way - some swim, some run or walk, some cycle, lift serious weights etc. The way I see it is that as long as there is no cure and little the doctors can actually do for us, the ball is in our court to fight our disease as best we can. I wish I had been diagnosed early - you cannot believe how much I envy you! BTW just realised it's 11years now - I was diagnosed aged 53 and I am now 64. I aim to live until at least 85 - hopefully longer!

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Thank you vansmith your words are so inspiring I thank you so much for taking the time to explain your condition and your encouraging will power driven therapy. You have truly inspired me and hopefully others as well. Again thank you and God Bless you for fighting the good fight. Good luck to you .

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Hi vavsmith , not to be too pushy and if you don’t mind me asking , what was your (FEV1, FEV1/FVC 10 yrs ago in comparison with today ?

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I was diagnosed at FEV1 29% post ventolin inhaler. I was then prescribed 2 more inhalers -Symbicort & Spiriva - and after 6 months of use my FEV1 had increased to 39% which I expected to be the max I could ever expect. That first year I couldn't do much but I did do pulmonary rehab - it made no difference to my numbers of course but it got me fit enough to do more ie. I treated PR as a starting point not an end point. I had read of a woman in the USA who, like me, was on oxygen and was speed walking half marathons - I figured if she could do that then I could at least build up to walking a few miles, so I got a treadmill for daily use but also walked as far and fast as I could outdoors in good weather. My FEV1 inched up over a couple of years from my previous best of 39% to 40% and I added regular swims to the mix. As with the walking I gradually built my swimming up from doing widths to doing lengths until I was doing 40 lengths/1km 3 or 4 times a week. At this point I had a bigger increase in my FEV1 & I started recording my FVC too. Over aprox 18 months of swimming and walking my FEV1 reached 46% and my FVC climbed from 80 to 91% as I recorded in a blog a few years ago copdinfocus.blogspot.com/20... Since then I trained even harder with the walking until I speedwalked the 'Great North Run' a few years back copdinfocus.blogspot.com/20... My FEV1 has settled since then at 48% and my FVC at109% ! I still struggle and get breathless, my 'speedwalk' is a healthy persons average walking speed, and I still need oxygen 24/7. But I feel way better than those early years and as I said before - 11 years from diagnosis I am in better shape - not declining.

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PS. This is fellow COPD'er Andy - he was diagnosed at 50% - he dipped below that once and panicked so took up walking etc. I think his last reading was 53%..

copdinfocus.blogspot.com/20...

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Wow you have made me believe in the power of walking thank you God bless

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That is awesome . Thanks for reply

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Wow that is a fabulous story and very inspiring even though I cannot swim and do not like the water , other than look and listen to it your story is amazing and very inspiring thank you

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I totally hear you on the swimming--I try to go at least 4 days a week--the walking is hard on me tho--MmeT

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Thanks for your inspiring message. You help me see that I must keep a record of my lung function figures which I have never really paid much attention to, probably to avoid thinking about the whole thing..

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. The Dr told me I had COPD I come home my husband said it means different lung problems witch one do you have.. I don't know I told him.. I went to the asthma clinic last week .. She said I don't have it .... I feel my allergies cause my lungs to weaken from all the lung infections every year.. I"m sixty they told me I have a lots of scars on my lungs.. The CT report they did for over a year because my lumps they said didn't grow there 5mm and inflammorty.. And it said small airway disesase.. The asthma clinic said I have asthma not COPD.. But they have never heard asthma when I ended up in the hospital .. They tell me to quite smoking the Dr in emerge and I don't smoke........I finely realized this summer every summer I get infections from allergy's ..... I told her I feel because the lumps which stayed for a year in all three CT scans is beging of COPD..... I told her that it might be at O stage of COPD . She said I could of been in a asthma flare up I said the lumps didn't go down. I couldn't of been in a lung flare up over a year.. .Then she walked out on me... Every DR gave me medication for COPD and the asthma clinic takes it away.. ..... . I think most people are in stages 1 or higher when they ended up at the asthma clinic and she never had.a patient that is getting worse and she has to blame me even though I did what she wanted me to...............Depressed over this She started treating me awful the pass five years because I"m getting worse.... Then I found on line .. Allergy's can lead to asthma leads to small airway disease.... Dr's never connected the two problems since I was a young kid... They said I had a small nose and that is the reason I can't breath through my nose and wanted to do a nose job..no allergy testing they never thought of that . So all my life thought it was because I had a small nose ........I finely put the dots together but a bit late......Fifty years of lung infection every year and one turn into pleuisy for three months walking pheumonia ... Is all due to allergyies and not one Dr asked why I get lung infections every year.. My husband never had one lung infection...... Some times we are left on our own figuring things out ... Sorry for the rant on this site people know what your going through with Dr's and clinic''s... But for me 0 stage... Have an appointment at the end of this month..... Find out more....

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That is a remarkable story and I am sorry you needed to be ran through the umbrella mill which to me is a ridiculous way of reaching a disease to an opinionated condition. Good luck to clamdigger and breathe easy .

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It's not for me to question your feelings, but I am confident that but for my diagnosis I would not have stopped smoking and would have quickly progressed to a wise position than I am now. I hate the restrictions COPD places on me, but that's how it is. I strongly suspect that the accompanying depression can be more harmful to the enjoyment of everyday life than the direct physical impact of COPD itself.

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should read "worse position" above

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