Is there any certain tests the doctor performs to diagnose COPD? I guess I'm a little paranoid. I was diagosed with asthma about 2 years ago and at times I just feel like my medications are not working. My peak flow stays good at 450 but at times I just can't exercise or work like I used to without getting winded. For those of you with COPD, what kind of peak flow do you have (or does the doctor even measure?)
Cindy

I have severe COPD (emphysema) and can barely get the peak flow meter to 200--but peak flow is more useful for asthma rather than COPD. To determine COPD, you need complete PFT (pulmonary function testing) to know if you have obstructive (COPD) or restrictive (asthma) problems.

Since your peak flow is so good, I doubt you have COPD-- I don't wish to be offensive, but could it be that you are just de-conditioned or slightly overweight? Are you a smoker?

Thanks for your reply. You are not being offensive when you suggest my being overweight. I am about 60 lbs. overweight and know I need to lose. I am pemenopausal and it is just so hard! I have had numerous PFTs and my doctor says it's asthma. But even taking a steroid inhaler daily, my airways are not what they should be. I also have GERD, which I have heard afffects the airways. Thanks for responding. I just wish I could lose this weight.
Cindy

[QUOTE=hypatia]To determine COPD, you need complete PFT (pulmonary function testing) to know if you have obstructive (COPD) or restrictive (asthma) problems.[QUOTE]

Asthma and COPD are both obstructive conditions, however in asthma the obstruction can be reversed (by inhalers). So you need to have PFT's with reversability testing, you also need to monitor you peak flow for variability

I've had several PFTs; I don't know if they were complete ones or not but they were performed by asthma and allergy specialists. My tests were shown to be of an obstructive nature. I do have reversability with albuteral, but it is not a whole lot. I monitor my peak flows and they are always around 400 to 450.

Oh, and I have never smoked.

You're absolutely right, Cat--Asthma is obstructive. Must have been having a senior moment.

I know how hard it is to lose weight, Howitt, and I wish you well. It took me a year to lose 40 lbs, but even with severe COPD, it helped my breathing immensely. I started by walking (half a block was all I could do at first and am now doing 5 mi. a day). Try it--you'll like it.

Five miles a day? That is great! Think of all the health benefits in addition to the breathing. It sounds like you are doing better than the average American if you can walk five miles a day. What is your prognosis? Can COPD be stopped in it's progression by dieting, exercising, and good healthy habits?

Well, i'm 65 with emphysema, on oxygen 24/7 and 43% lung function. Also have a severe diffusion defect which requires the 02. I haven't lost any more lung function in 3 years, but even healthy lungs lose some ground as years go by. All of us with impaired lungs/airways need to be very careful of infections, pneumonia, etc., and get flu shots every year.

p.s. Walking 5 miles doesn't seem so bad if you do 2.5 morning and 2.5 evening. But i probably have a lot more free time than you do. Now if i could only give up chocolate!

My father passed away at the age of 49 with cardiac arrest. He had severe emphysema and was an alcoholic. He never took care of himself and even smoked in between the oxygen. My allergy doctor thought 49 was too young to have severe emphysema even in a smoker, so he checked me out for the inherited emphysema just to be sure. It was negative. I have never smoked, so my diagnosis is moderate persistent asthma. I have some irreversability, which is probably a result of not getting treated for asthma until my 40's. My PFTs are actually pretty good with my FEV1 at around 90% but my small airways at 50%. I use Advair daily as my only med right now. I take a lot of supplements that I feel help me, though. I'm sure it would help to lose weight. I need to lose about 60 lbs. Unfortunately since I am almost 50, most of my weight seems to be around my middle! IT sure is hard to lose when you get close to menopause. I love to walk and it is really the best exercise. So I better get busy and do it. Take care!
Cindy

Is there any certain tests the doctor performs to diagnose COPD? I guess I'm a little paranoid. I was diagosed with asthma about 2 years ago and at times I just feel like my medications are not working. My peak flow stays good at 450 but at times I just can't exercise or work like I used to without getting winded. For those of you with COPD, what kind of peak flow do you have (or does the doctor even measure?)
Cindy
Wow,450 on your peak flo test.I thought the average reading for a normal healthy male is 615?Well,I would love to have a reading of 450.Mine at good point is 125-150.Thats on a good day.
Take Care&God Bless you all,
:dizzy: Rod Nolungs in tacoma:angel:

My father passed away at the age of 49 with cardiac arrest. He had severe emphysema and was an alcoholic. He never took care of himself and even smoked in between the oxygen. My allergy doctor thought 49 was too young to have severe emphysema even in a smoker, so he checked me out for the inherited emphysema just to be sure. It was negative. I have never smoked, so my diagnosis is moderate persistent asthma. I have some irreversability, which is probably a result of not getting treated for asthma until my 40's. My PFTs are actually pretty good with my FEV1 at around 90% but my small airways at 50%. I use Advair daily as my only med right now. I take a lot of supplements that I feel help me, though. I'm sure it would help to lose weight. I need to lose about 60 lbs. Unfortunately since I am almost 50, most of my weight seems to be around my middle! IT sure is hard to lose when you get close to menopause. I love to walk and it is really the best exercise. So I better get busy and do it. Take care!
CindyI know eactly how you feel Cindy.My mom died in Oct. 1989 of emphysema and she smoked right up till she died.She was 49 also and I am 43 years old,I have severe emphysema,and I have an FEV1 reading of 12-14%.My O2 saturation level is between81-85% on a good day I can hit an 88%.I am on oxygen 21-24 hours a day.I try and turn off the O2 for as long as I can take it.My moms mom died of emphysema also so my pulmonologist sent me to test for Alpha1 Anti-trypsin Deficientsy but came back negative.So all I can say is,If you want to make this horrible disease stay at a non progressionary point,ANYONE SMOKING HAS TO STOP BACAUSE THE ONLY WAY TO STOP THE PROGRESSION IS TO STOP SMOKING CIGARETTES!!!!!!
Rod Tacoma Wa.

Dear Cindy,

I heard that Dr. Phil McGraw's book on losing weight is fantastic. I have emphysema also--from 45 years of smoking. I put the cigs down May 14 this year. That feeling like you are just not getting any air is so horrible. Am on oxygen now--that helps. I told my husband that I know that I look pathetic with the canula stuck up nose. He replied that it looked a lot better than my eyes bugging out gasping for air. I have a terrific, wonderful husband that is helping get through this. Dealing with Reflex Sympathetic Dystrophy as well. I was so sick there for a while that I went down to 92 lbs. After my pulmonologist put me on Predisone, I started eating everything in sight, especially Butterfingers. I was weighed at his office last week and was 115 lbs. Gotta stop with the candy because they pulled out a crown on a molar and 3 teeth have lost their fillings. But I've become addicted to the darn things. Today is the first day that I have not had a butterfinger in a month. I'm ashamed to admit that I have polished off a whole bag of the miniature ones in a day. Good luck and God bless. Last doctor's visit a few days ago has me weighing 123 pounds.

Sansy

I hope by all of these posts, the people smoking will stop. My sister smokes, but so far no lung problems. I am an asthmatic and I do have some reversability, but not total. I think exercise helps a lot and some vitamins to keep from getting sick. Luckily, since being on asthma meds, I haven't had a cough in 2 years!! Stay WEll!!

My husband was incorrectly treated for COPD for 8 months before being correctly diagnosed with a paralyzed diaphragm.

Holland895,

My husband was incorrectly treated for COPD for 8 months before being correctly diagnosed with a paralyzed diaphragm.

Why did he get misdiagnosed. What happened?

He had shoulder surgery and developed excruciating neck pain. Several days afterward he was very short of breath. He had bronchitis a couple of times in the past and thought that it was again bronchitis. At the time of course we would not have associated shoulder surgery (on the opposite side) as having anything to do with a breathing problem. He went to the ER, who sent him to the family doctor. They did a chest x-ray, tried antibiotics, etc. Finally after several trips to the ER and many trips to the family doctor he saw a pulmonologist, who did a breath test and told him it was COPD and mild asthma. After months on nebulizers and inhalers (none of which did any good), a full cardiac workup (to rule out heart problems), an upper GI (to rule out hiatal hernia), we went on our own to a second pulmonologist, who diagnosed him correctly within 10 seconds of looking at the chest x-ray. (the right diaphragm appears elevated). A "sniff test" (fluoroscopy) confirmed the diagnosis. Thankfully it is supposed to resolve itself (we've been told) but it may take years. I've read that a paralyzed diaphragm is more common than people know of (probably because of incorrect diagnoses). It's easy to rule out by a close look at the chest x-ray, and a sniff test. Usually there is just one number that's off on the breath test. The lungs are not the problem, just the phrenic nerve that runs to the diaphragm which makes them move. It's just very unusual, and 10 doctors missed it before this one caught it. Pulmonologist are quick to stamp "COPD" on problems...

Holland895,
we went on our own to a second pulmonologist, who diagnosed him correctly within 10 seconds of looking at the chest x-ray. (the right diaphragm appears elevated). A "sniff test" (fluoroscopy) confirmed the diagnosis. Thankfully it is supposed to resolve itself (we've been told) but it may take years.

Hi Holland895,
How were you so lucky as to find a good pulmonary doctor.
Was it just random luck after trying 10 previous doctors?
Was this pulmonary doctor through recommendation, a scan through insurance medical directory book, etc.

Is there a technique to finding one? What do you look for when picking out a pulmonary doctor?

I am not getting anywhere with my last 3 pulmonary doctors as to finding out whats going on.


I've read that a paralyzed diaphragm is more common than people know of (probably because of incorrect diagnoses). It's easy to rule out by a close look at the chest x-ray, and a sniff test. Usually there is just one number that's off on the breath test. The lungs are not the problem, just the phrenic nerve that runs to the diaphragm which makes them move. It's just very unusual, and 10 doctors missed it before this one caught it. Pulmonologist are quick to stamp "COPD" on problems...

Thank you for sharing your story.

My peak flow readings (on a good day) rarely reach 200. the rest of my family who have never smoked get 450 routinely. Consider yourself very lucky.

I have a question about the inherited emphysema. My da has it. And when I had my PFT's The resultsa were that I have restrictive and obstructive airways. Is the Test call Alpha 1 Antitrypsin Phenotype? I research it and all I come up with is emphysema or likely to get it.
Can someone explain this to me?
Thanks
C

Alpha1 Antitrypsin Deficiency (A1AD) is a genetic protein deficiency that leads to early onset of advanced emphysema in young adults regardless of smoking history. You can google Alpha1.org for more details and a simple blood test will determine if you have inherited this deficiency, which requires infusions to prevent lung/liver damage. If your PFTs were performed by a pulmonologist, s/he should be able to provide more info and testing.

We found a good pulmonologist through the advice of a friend, who is also a physician and suffers from asthma.

my mother and father have copd and are 64 moms on the transplant list finially! but because of her age she can only get 1 lung and my dad is not far behind pray if you do and gods blessings

I had the pulmonary function tests (where you breathe hard repeatedly into this thingamajig). The first time I did horrible with it, as I could not stop coughing to do it (this was while I was hospitalized with so-called COPD). Of course, when I got out of the hospital, and returned as an outpatient for a follow up test, I passed it ok. However, the diagnosis of COPD, as well as the "chronic recurring allergic asthmatic bronchitis" diagnosis still stood. My doctor knew, however, that I had a "calcium deposit around a heart valve". He discovered that when I was about 20 or 21 years old. Neither of us thought anything of it, even after repeated treatments with the electric pulmoaide did nothing to help ease my breathing, and me having to be on antibiotics for months on end and not getting better. This was several years ago. I now mention this to someone who thinks they have ahstma (however it's spelled) for the first time. I tell them if the breathing treatment does not help, and you find yourself sucking on that blamed thing too often, to ask your doctor if you could possibly be tested for a leaky heart valve. I realize that is NOT the solution to everyone's breathing probs..asthma is real and is debilitating. Oh yes, I was a 40 yr smoker, but have not had one single puff since Oct. 15, 2002! I'm still craving it at times, but am proud of myself for being off this long..and as high as those dang things are now, no way I'll go back on them unless I'm told I have x amount of hours to live...then may as well.

Moving right along, in 2002 I was hospitalized with what I thought would be colitis but was diverticulitis. While in there, I suffered a heart attack. Then when I was transferred to another city for heart care, they discovered my mitral valve was leaking badly, leading to the gurgling, wheezing etc. that I was always doing..and always coughing. Then finally, they decided I probably never had any of that, except an occasional bout of bronchitis...instead they "think" I was going or trying to go into congestive heart failure. (one of my best friends in high school was just like me...and she'd sit breathing thru a wet washrag to try to calm hers down...she died a few years ago...she'd had a heart attack, and had to have her valve replaced...then after a few years she died...again, I wonder about how well we can rely on so-called diagnosis? It also makes me wonder how long I have as I've now got another element added to the mix.)

Had the open heart (triple bypass and mitral valve replacement) in Oct. 2002. After that, it became difficult to take a deep breath, no matter what...unless I yawned! I figured the soreness etc. was from having had my chest cracked open and my sternum and rib cages removed and then wired back together (and did have numbness all thru the chest area for a long time after). I also had to have 4 stents put in 6 months after the open heart...and during that procedure I was bleeding internally afterwards. Caused some really freaky, bad pain for awhile until they got it stopped.

Moving right along to this year. I had asked my heart doctor if the shortness of breath was from still having blockages and she assured me no it wasn't...and ordered me to see a pulmonologist (spelling?). I saw him on Thursday. He looked at the nuclear stress test results I'd had done at that hospital (the one where I had the heart surgeries). He gave me a read out on it and it said nothing wrong with lungs, but small lung capacity, and elevated left diaphragm. He then said he seriously thinks it is paralyzed, but that I am definitely not dealing with anything really bad like cancer. In fact he seems to think my lungs are in good shape for the most part. I go I think next week for the pulmonary function tests and the blood gasses test and the sniff test..whatever that last one is. Oh, and I forgot to mention, that in Feb. of 2006 I had to have a total hysterectomy due to a "cyst" that turned out to be a benign tumor of some sort (yes, I'm a mess). After that surgery, she (the doctor) was very upset/concerned about upper bowel sounds not returning, even tho lower ones have. She admitted she had to cut into some of the nerves to remove everything from the abdomen or whatever. The shortness of breath HAS been worse since then, too.

Anyway, I've become rather chatty here, so to sum it all up, I really think 1. I was done more harm than good by being diagnosed as being asthmatic when I wasn't, 2. Done more harm than good to a certain extent, during at least ONE of my heart procedures/surgeries (I really think it's the first one, but the 2nd one could have been the culprit also). Then perhaps done even MORE harm by the obgyn who did the hysterectomy. I've a funny feeling it will turn out to be the fault of all the surgeries. Meantime, yes, I'm grateful I'm not dealing with cancer etc. However, I'm scared as to what life is going to be like with a paralyzed diaphragm. I always thought a human body contained ONE diaphragm, but he said the left diaphragm was paralyzed. Can anyone clear that part up for me? And does anyone know if this condition could possibly get worse? Is it life threatening?