Hi, I might be in denial but something seems weird to me. In september 2021 I had pretty nasty covid. My oxygen levels were always good and I didnt have any super big problems with breathing, however I had nasty cough that lingered even after covid was gone. I had a chest xray that showed some scarring and a nodule in left lung. Since recovering from covid I have sob. It manifests itself as being unable to take a deep satysfing breath. Not a deal breaker but super annoying. I can run on treadmil and do other stuff and it almost feels like it helps sob. Bending over or wearing heavy clothes seens to trigger sob. Just few days ago I had breath test and was diagnosed with severe COPD . My fev1/fvc is 64% of pred. I am only 42 years old and before this test I would never suspect this diagnosis. I have hiatal hernia for a while now and I was wondering if that could be it? My gp doctor said no. Iam waiting for a visit to specialist. Meanwhile I am starting excercise regime to see how much I can do. I would greatly apprecieate your input.
Is it reallyCOPD?: Hi, I might be in... - Lung Conditions C...
Is it reallyCOPD?
Hi Adam8,
I am not medically trained and am only speaking from my own experience. I have a very large hiatus hernia and have recently seen a specialist consultant, after a CT scan to confirm the diagnosis. He did say that a large hiatus hernia can affect my capacity to be able to breathe correctly and your problems with getting short of breath with bending down certainly resonate with me.
I would just be careful of any abdo exercises until you have spoken to a consultant or at least a physiotherapist. I have just seen one who is advising my on diaphragmatic breathing exercising and I am seeing her in two week's time for advise on exercise. Mind you, I am a lot older than you are 🙂.
Good luck.
Thanks for response. I had my hernia diagnosed few years ago and it was small at the time, but for some time now, even after medium sized meal I feel like a beached whale and sob kicks in. I am not a doctor either but I would imagine severe copd would not permit me to use a treadmil without getting out of breath. I am new in this and really count on some input frome people with experience.
When you you are sob, is it harder to breathe in or breathe out Adam? Ive often read that if its harder to breathe out then its copd or asthma. If its harder to breathe in, its more likely to be reflux. Ask your specialist what s/he thinks. Hope you get a solution which feels right.
It feels like I can breathe in but not all the way. Its not like I am strugling for air but just really annoying feeling. Usually I manage to breathe in fully in a minute or two. I am wondering about it because I expect to have breathing problems after 30 minutes on threadmil which doesnt happen, but happens if I am wearing coveralls and winter jacket or if I use my core muscles lifting etc
While the reflux sounds like a possibility, my understanding is that COPD can only be definitively dxd with a CT scan. I dont know if you smoked but if you did GPs often go to that as their first diagnosis. To be at severe stage of COPD your fev1 would need to be between 50%-30% - Im more familiar with that than with the ratio of fev1/fvc %, but I am at severe stage (fev1 is 35%) but my ratio is way below yours. Did they do a reversibility test when your had your spirometry? That's when they ask you to take salbutomol after the test, wait 20 minutes then do the test again. Reversibility indicates asthma rather than COPD.
But your saying how hard it is to take a satisfactory breath IN does fit with the possibility of a hiatus hernia so Im glad you're seeing a specialist. And if you were to (also) have severe COPD I agree that you would be likely to get short of breath using a treadmill. You could also ask about the impact of the fibrosis they have found. Please let us know how your appointment goes. Good luck! 
Stage of COPD is normally diagnosed from the Fev1 did the GP give you, your full results or just the Fev1/ FVC ratio result?
With the caveat that I’m not medically qualified. Your fev1 is pretty low in relative terms. Anything above 80% is considered normal, and the threshold generally taken for a normal fev1/fvc ratio in adults is 70% or above. However all those results are really telling you is that you have an obstructive pattern to your lung function, and spirometry is actually quite technique (and practice) dependent, so results should always be taken as ‘x% or higher’, rather than ‘only x%’, if that makes sense? That’s not to say you could have normal spirometry, as that’s unlikely with the figures you’ve had so far, just making the point that the values can quite frequently come out lower than they are, particularly in those that have never or only infrequently undertaken testing before. We also know that a variety of factors including tiredness and having eaten can impact on spirometry results on the day, or even nervousness or what you were thinking about at the time. False lows are commonplace.
With regards to whether it could be something other than COPD, a couple of things sprung to mind, but the short answer is yes. If you have severe reflux or a large enough hernia, that can absolutely impact on breathing and spirometry. Could it impact enough to give you the fev1 and ratio you have? That I don’t know, but it could definitely be bringing the numbers down to some extent. The other thing is that my understanding is covid doesn’t typically give rise to COPD-like permanent lung damage. I could be wrong, but everything I’ve read to date indicates it leaves behind scarring (fibrosis) rather than obstructive issues. Regardless, what you need is a CT scan: that’s the gold standard for diagnosing most respiratory conditions, and will also pick up a hernia in most cases, so should give some indication as to what role - if any - the hernia is playing in your respiratory issues. I don’t have a diagnosed lung condition myself, I’m a member for my daughter, but I do have a 4cm hernia, which is considered small and not in need of intervention, and find I can’t breathe properly if I bend forward. Chronic reflux arising from that also has me coughing when it’s not well controlled, even without any other typical signs of reflux or acid indigestion, and I do get bouts of shortness of breath. Is it a respiratory doctor/team you’ve been referred to?
Thanks for your reply. It is very informative. I will definitely try to get CT scan. So far I have been seen by my gp, I asked him about hernia being to blame he said no. Gave me sybicort and chest xray refferal and send me to respiratory doctor. I question COPD diagnosis because I dont feel like my breathing problems are so severe. Its been going on for about a year on and off. It gets better for a while than comes back. Never gets worse at least not yet. My hernia is ongoing issue at the same time. I dont have reflux but quite often a feeling of lump in my throat. After every regular sized meal I feel super full. I started to do 24 hr fast once a week and those days are great except lump in the throat feeling happens more and so is shortness of breath. Another thing I do not understand is the fact that physical activity doesn't seem to matter. It almost seems the more active I am the less sob I experience. My spo2 levels never go under 95, usually around 97 98. Thanks again for all the replies. It defienetly helps to develop a gameplan.
It’s always worth keeping in mind that GPs are jacks of all trades: they know a little bit about lots of things, but not a lot about much. The only respiratory conditions most will know a reasonable amount about managing are asthma and COPD, but even that is only to an extent. With most of the conditions I have, none of the GPs at my surgery know anything about them beyond the fact they exist, and if I ever try and take my daughter to see them for anything, you can almost see the panic on their faces. That’s not to say they’re not qualified, or shouldn’t be trusted to make diagnoses or medical decisions, but patients with chronic or unusual conditions often end up knowing as much as some specialty doctors in hospital. They have to to ensure they’re getting the right care.
Even though I’m not medically qualified, I am supremely confident in telling you that you do have reflux. Absolutely. That’s what that lump feeling you’re talking about is being caused by. It’s called globus, and almost certainly a result of acid entering the oesophagus. It’s a very common symptom of reflux, which is very often just part and parcel of having a hernia. Acid also fits with why you’re worse on the day you don’t eat: we often produce more acid with an empty stomach than we do when we eat regularly, so the lump and breathlessness are worse because your acid production is higher. Are you currently taking a PPI like omeprazole, pantoprazole, or lansoprazole? If not, you need to be, and if you are, it either needs increasing or changing! That should help the lump feeling, but potentially also help with the shortness of breath: reflux doesn’t always come with obvious symptoms. It can be what’s called silent. But whether it’s silent with few symptoms or feels like raging burning in your chest and you’ve got acid coming out your nose, it can affect the lungs, particularly if the acid rising into your throat due to reflux is entering your lungs and airways. This is an NHS document on silent reflux which you may find helpful both for your own information and to go to your doctor with:
dbth.nhs.uk/wp-content/uplo...
If you’ve told a GP about the lump feeling etc., and they’ve not done anything, then they’re not a very good doctor and you absolutely need to go and see a different one. With a known hernia, globus is an obvious sign that you’re (probably) experiencing silent reflux. It really is very basic medical knowledge. Putting you on a PPI now will give it an opportunity to properly take effect before you see respiratory, and you’ll get some idea of whether your sob or other symptoms has significantly improved.
what is son?
Hi Adam, I have a FEV rating of only 32% and I can use my treadmill without getting out of breath if walking at 3.4 km ph (at 3.8 km ph or above I start to get breathless). Using a treadmill whether walking or running is a lot easier than doing it outside where walking causes me to get breathless…I think because treadmills are sort of ‘cushioned’. Do you get breathless running outside? If you have COPD keeping fit is very important, otherwise SOB gets worse. If your FEV is 62% then I guess it’s not really ‘severe’. My oxygen levels have always been normal as well. I had Covid a few months ago and my breathing was badly affected and it took a few weeks for it to get back to (my) normal. Maybe your breathing will improve with time. Of course the specialist will be able to confirm whether it is COPD and he or she will probably request a CT scan (mine did on my first appointment). I don’t know anything about hiatus hernias so my response is entirely from the COPD perspective. Best wishes, Jan.
Perhaps try eating smaller meals,but more often,if hungry.worth reading up on breathing technique - controlled breathing with pursed lips.breathe in v slowly,thorough nose,hold,then expire vv slowly through pursed lips - bit more to it but that's basics.its great to practise and use for sob x
Yes, I meant to mention silent reflux but you've got the info now. With silent reflux (which I have) you often get few if any of the classic reflux symptoms, heartburn etc. But you could ask about being referred for an endoscopy which will check your oesophagus to make sure your reflux hasnt damaged it. Its important to have a check as there's a precancerous condition called Barretts oesophagus which actually has a low chance of progressing to cancer. But its a good idea to know about it. There is a lot online about foods which trigger reflux and you could see which ones are hard for you to manage - everyone is different.
Hey Adam, by now i hope youve found semblance. But i wanted to ask you a few questions: 1. On a PFT, did you have reversibility over 12% on your “post” test? If so, that indicates asthma more than chronic bronchtis aka copd. Also, what was your DLCO score? That’s a measure of diffusion capacity and indicates emphysema if low. You can have just chronic bronchitis, or emphysema or both. I have never smoked in my life or been around it, never had breathing issues- was always fit and healthy but after ONE simple bronchitis, its parting gift was irreversible airway obstruction. My fev1/fvc is 65-67%. Sometimes lower. No alpha 1 gene deficiency. No asthma bec i test negative for the markers and i passed the methocholine challenge. They dont understand.
Go by just the fev1 reading.
dlco is your gas exchange. 40% and lower is considered very severe.
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