Hi everyone I have had asthma for many years and was diagnosed with mild COPD about 2 years ago and my question is

Should I have been offered a chest X-Ray or a CAT scan etc. when I was diagnosed to see any damage done to my lungs? I was diagnosed by my asthma nurse via a spirometry and peak flow test. She said my lung age was 89 which meant I was in the COPD range. I have never seen a doctor (for diagnosis) or a consultant. I also asked her if it was emphysema. She wouldn't give an answer and just said it all comes under COPD now. Is this true? Some web sites say they are different illnesses and some that they are not. Im confused!

The last X-Ray I had done was about 5 years ago and I really had to insist because the doctor said I didn't need it. I was told it showed hyperexpansion of my lower lung. But that was 5 years ago...

I have asked the nurse this and she said because my bloods are done every 12 months this would pick up any problems without the need for any other tests.

I have my appointment with her this Friday so I would appreciate any thoughts on this please.

Thanks Bev xx

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  • Hi Bev, A well used phrase around here is "everyone is different", and that applies to medical staff too.

    If you've had spiro and peak flow then that's obviously their diagnosis done. The tests say COPD, why do they need to go any further? Chronic bronchitis and emphysema are the two lung diseases grouped together as COPD, Don't believe all you read on the Internet, stick to the official sites like those clearly in the NHS etc.

    If you need peace of mind then call the BLF helpline and ask for one of their nurses to call you back. They can go over your questions and try to help. There's no need to go for x-ray or a scan if it's not needed. Insisting on one won't really tell them much more.

    If your condition gets worse then you'd go back to your GP and they'd no doubt do something else, which could be another test to show if there has been deterioration or send you to see a consultant or whatever they think is suitable. If they think you've got worse then they should be making these steps without any prompting from you.

    If you're unsure about things then the nurse should be explaining things to you, they should not leave you anxious or wondering if they've done enough.

  • My you are a late bird too Gordon...Many thanks for answering my questions.

    I feel much relieved now. And more knowledgeable. The reason why I requested a chest X-Ray 5 years ago was because I was getting a lot of chest infections and needed steriods to clear them for the first time. And because I was coughing a lot. It did show damage to my lungs. So I am not sure they would voluntarily do anything if my condition deteriorated though I hope they would. TThanks again.

    Bev xx

  • I'm often up until 3am, 4am, sometimes later. Takes me ages to get to sleep these days so I have to make myself tired. I play games, do paperwork, sort through stacks of music files. Eventually I go get my head down.

  • Bev I would suggest you ring the BLF helpline and discuss your symptoms and degree of difficulty as they can then suggest what you should be asking to get the right results. As to the blood tests - they should be testing the blood from a vein to check your red blood cell count (reactive polycythemia) and a sample should be taken from your artery to check the blood gas levels (oxygen and carbon dioxide).

    And don't let anyone fob you off when you need an answer.

  • Thank you auntymary. I only remember having one blood test done not 2. I don't understand the terms you use though! Whats reactive poly.... and what is the significance of oxygen and carbon dioxide please?

    Bev x

  • I was diagnosed with Asthma after hospitalisation with Pneumonia over 10 years ago, after a few years of monitoring and almost constant coughing the practise nurse asked me to have a spirometry and reversibility test then diagnosed me with chronic bronchitis (COPD) Around 3 years ago I started having chest infections almost every month so I sent for a CT scan this showed Bronchiectasis of the right lung . It is worth you asking your GP at least to put your mind at rest, the answers are not always what we want to hear but knowing is better than not knowing.

    Take care Karen X

  • Hi

    Its not unusual for an appropriately qualified nurse to diagnose mild to moderate COPD and for you not to be seen by anyone else assuming there are no other complications and that you are responding to your treatment.

    What I want to clarify however is that you seem to be implying somehow that the lung age forms part of your diagnosis. Its standard for most people to have a chest xray done at time of diagnosis which may be repeated depending on the result. Also you don't mention your smoking or occupational history. Please feel free to call the helpline either to speak to a nurse or receive a free dvd on living with copd

    Lastly blood tests would not normally identify a deterioration in lung conditions.

    Regard

    Vicky

  • Oh I am bit concerned now Vicky. I am not implying anything this is what I was told at the time of diagnosis. I was definately told that my lung age was 89 and that this put me in the range of COPD. That was exactly what my asthma nurse said at the time.

    I told her last time I was worried about lung cancer and she said that my bloods were done every year and that this would show up any changes. She was very definate about that! She said there was no need for a chest X-Ray. And I have never had one done at the time I was diagnosed or afterwards. When I had a chest infection and saw my doctor she agreed with this too. I don't seem to be getting any worse and the medication is helping.

    I am not sure what you mean by occupational history but I have a chronic cough and recurrant chest infections. I do smoke and keep trying to stop. I will succeed. I get the impression at my surgery that because I still smoke there is not much they can do until I stop. Individual guilt??

    I will ring up BLF to clarify my position. But I don't know now what to do. I can't fight the medical professionals at my surgery - I am not strong enough to stand up against them. My doctor otherwise is brilliant - but she also said I do not need the pnemonia jab as I haven't had pnuemonia before and they don't believe in it unless I have had it.

    I believe what you say but don't know how to proceed now. I just feel that until I stop smoking they are not really bothered....

  • Oh forgot - have asked the doctor about this and although she will explain she is keen for my COPD nurse to continue dealing with me.

  • Hi Bev,

    Please do ask for a Ct scan. Bronchiectasis doesn't show up on X-rays, for example, as my daughter found out. She was diagnosed with asthma at age 4 and despite years of deterioration wasn't scanned til she was 16 at which time she had widespread bronchiectasis because it hadn't been treated. I'm sure you wouldn't have reached that point, but better safe than sorry,eh? It's difficult to be firm when asking for investigations, I know, as I always feel intimidated by the professionals. But sometimes the patient's right!

    wishing you the very best of luck

  • Thank you for your reply bluemagic. Not sure what bronchiectasis is. Is it chronic bronchitis? And what would a CT be used for exactly?

    Bev xx

  • Thanks for your replies everyone. I am more confused than ever but appreciate the time everyone has taken to answer me.

    Bev xx

  • Hi Bev,

    Bronchiectasis is a sort of scarring of the lungs where the bronchi get distorted from infection. As the damage tends to be in the lower part of the lungs you need to do physio to clear them every day and to reduce the risk of infection. I mentioned it cos of my daughter's experience and I have it too. Apparently more people with COPD are being diagnosed with it now as we'll. As I understand it, the scarring doesn't show up on X rays so the CT scan gives a much more detailed picture of the state of your lungs. Blood tests are good but I don't suppose they can give the full picture.

    Best of luck - I know how frustrating it is when you feel you're not getting enough information,

    Patxx

  • Thank you Pat I appreciate that. I will ask about it next time I go.

    Bev xx

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