Hi everyone,
I've made a few posts on this forum, trying to figure out of my obstructive lung condition is COPD or asthma. I'm 28 with a 10-year smoking history (5-10 cigarettes per day, sometimes more) between ages 15-25.
Initially my spirometry results showed FEV/FVC of 70% which went up to 77% post bronchilator. The pulmonologist thought it was COPD.
I have now gotten a second opinion. In my followup spirometry test (4 months later, after a strong corse of Breo ellipta inhaler) my FEV/FVC is at 68% with only a 1-2% change post bronchilator. My diffusing capacity is normal/healthy sitting at 110%.
I also had a AATD blood test (negative) and a CT scan (no signs of abnormalities). Essentially everything is normal except problems breathing and the FEV/FVC.
I have been struggling with GERD which could be making symptoms worse. My pulmonologist also went through any potential workplace exposures, and we do not think that it is work related.
Frustratingly, they said that it is probably not asthma, but they have not diagnosed me with COPD either. They did however, put me on a COPD LABA/LAMA inhaler (spiolto).
I'm pretty sure its COPD, but I suspect it will be years until I get the diagnosis (and there is still uncertainty in my mind until a doctor confirms it).
I'm having a hard time understanding what this means. I understand that a doctor might be hesitant to diagnose someone so young but I'm left with questions and not really sure where to go from here (I tried to clarify with the pulmonologist, but could not get clear answers).
- Does a lack of reversibility strongly point towards COPD diagnosis?
- If it is COPD, can I still work in a lab with chemicals (i.e. is the risk worth it, should I quit/switch careers?)
- If the CT scan is clear, does that mean that it is unlikely to be early COPD? Can you have chronic bronchitis with a clear CT?
- Do people generally start experiencing symptoms at 70% FEV1 with normal FVC?
- Should I treat it as COPD, how should I start?
- Are there any resources for young people living with COPD?
- Is it worth getting a 3rd opinion now?
Thank you in advance, I really appreciate the advice and knowledge of everyone here!
David