[AB25]

I am 46 and smoked from age 14-39. I recently had shortness of breath and severe fatigue. The doctor did an EKG and sent me for an ultrasound stress test on my heart. Then he did a Spirometry test. All these were normal. Next he ordered a chest x-ray. The radiologist sent back a sheet that said COPD

This site says a x-ray is not a good way to diagnose COPD, so I am concerned about the accuracy of the diagnosis. He said the COPD was mild since they didn't order a ct or other tests. I was given albuterol and offered a daily inhaler but I decided to wait.

I am wondering if I should see a pulmonology specialist. Since there really is no treatment I don't know that it matters.

[Davy9]

You tell us that they did a spirometry test that was 'normal'. There are a range of pulmonary functions studies entitled 'spirometry'. Some are simple screening studies done in a physicians office (or even a shopping mall) while others are quite involved. That also means that some are more sensitive than others. A typical complete pulmonary function study involves the forced exhalation/inhalation exercise before and after using an inhaled bronchodilator. They also do a sustained maximal ventilation study (MVV) and they should should do a simple assessment of watching for O2 desaturation under mild exercise (especially since you presented with exertional dyspnea). A nitrogen washout or closing capacity study will for subtle signs of COPD.

These full studies are compared to normal populations of similar results for people your age and gender. If indeed you had a complete study and were found to be 'normal' then you should have no immediate concerns.

On the other hand If you were normal I do not know why you were offered medication for treatment. If they suspect an asthma (a type of COPD) component they need to look for that with testing. They will try to provoke an asthma attack as part of a study.

Using Xrays to diagnose COPD is less specific but not to be ignored. There are new MRI studies using exotic helium gases which show very early smoking related obstructive changes not seen on any pulmonary function study or Xray. Understand also that as we all age we naturally work our way into degrees of COPD.

[AB25]

The doctor just did an exhale test in his office. I don't know if I should request the more extensive testing.

I also have heard contradicting information on weather my COPD will get worse.

[Davy9]

The study done in the doctors office was called a pulmonary screen and they're not very definitive. If you feel that your shortness of breath is a problem then you may want to get a full study completed. As to whether COPD gets worse you need to understand that some parts can be treatable they do get better whereas the process is progressive and inevitably worsens. A full study will provide a clear baseline of your current status and a treatment approach. It can be helpful now and it can be used for comparison in the future if the need should arise.

[AB25]

Thank you.

[gailc]

Yes, ask for further tests. I didn't understand what the doctor was saying at the time because I would have preferred to ignore the situation. Believe me, it'll put your mind at rest.