Asthma or COPD?

Hi, I was a very heavy smoker for 30 years. Quit 3 years ago. Never had a problem breathing till a few years ago. I am 53 yr old female. Went to pulmonologist and had PFT without inhaler. They said my lung function is fine (although it said lung age 70 yrs), that I had asthma and am now on Advair 250/50 2x with rescue inhaler. I also have always had allergies but not to where it affected my breathing till now. I use the Advair but it doesn't seem to do much unless I 'd really have a problem if I wasn't using it I don't know. just recently started using my rescue inhaler pretty much daily. It doesn't seem to do much either. My chest hurts most of the time. I don't feel like I am sick. no fever etc but it's like a band is around my chest most of the time. Have had a physical and a cardio work up everything fine. They want me to get allergy testing but I figure even if I have allergies I can't afford to improve my home at this time and I know it needs new carpeting but owners won't replace it. I've been back to pulmonologist but he just increased my Advair which didn't seem to do much. Just really kinda confused about the whole asthma thing. Think it probably is copd and they don't want to tell me that but I wonder if there are any different meds that could help or is this just how I got to live now. thx for reading, Stephanie

[David Tinkelman, M.D.]

The lung age of 70 years suggests that you may have lost some lung function but your doctor's having said your "lung function is fine" suggests that whatever lung function has been lost is or should be clinically insignificant.  I suspect that you have COPD but that it may be in the Mild category of severity.  You may also, as the pulmonologist suggested have asthma.  If you do,your lung function should improve in responsie to the Advair and the rescue inhaler, but there are no guarantees.

You stated that your "chest hurts".  Chest pain is not a symptom of chronic lung disease, be it asthma or COPD, so your doctors should try to determine what else might be causing your pain.  Chest pain that feels like a band across the chest is usually associated with coronary artery disase but lung diseases other than COPD can also cause such a pain.  If you've not had a chest X-ray, that should be done.And, you may want to consider gettingt a 2nd opinion about the chest pain.

The information you provided doesn't suggest allergic disease,  unless your doctors suspect that your asthma, and it's apparent resistance to Advair are on an allergic basis.  In that regard, it is too bad that you can't remove your carpet.  The most common allergens to be found in carpet of any age, but especially in old carpet, would be dust with the house dust mite, animal dander, cockroach (dead or alive) and mold.  Mold can, of course also often be found in bathrooms.

If you aren't able to persuade the landlord to remove the carpet, you might suggest to him or her that it be professionally cleaned, at his/her expense and, once cleaned, vacuumed often with a good vacuum cleaner, preferably by someone other than yourself and that you remain out of your place during and for at least four hours after vacuuming, ideally with the windows open.

As for other meds, there is an alternative to Advair called Spiriva,  deemed by some to be more effective in COPD than Advair. In my opinion these drugs are usually equally effective but, for a given individual, one may be more effective than another.

The good news for you is that, after smoking heavily for 30 years, you still have a lot of good lung function left.  It must be discouraging to have a chronic lung problem and also to have the worry of chest pain.  Your history suggests that you have treatable disease and, if your doctors are unable to provide an effective treatment, don't hesitate to look to other doctors for help.

I couldn't help but notice that your moniker is girlwithnolife.  I hope that is not the case and, if it feels that way, that you can muster the energy to see a behavioral health professional about it.  You are still a young woman and, trust me, you don't want to go through life as one "with no life."  Life is too good to waste.  You can do better.

Good luck

[ill13632]

I was recently diagnosed with asthma in the last 2 years and have had bad wheezing lately for 12 weeks.
the FEV1/FVC ratio may be a good marker of airway remodeling and the path to fixed obstruction