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suffering and no answers
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suffering and no answers

Hi, I am 46 years old -quit smoking 7 years ago after smoking 20  years.  My mother and grandmother died in their 40s from copd..  Mother had severe asthma her entire life.
I have not had asthma and untll now had been relatively free of any respirtatory ailments.  6 months ago, I got a cold, with cough, runny nose, etc., no fever.  These colds have always resolved in the past with no medical intervention.  This one got worse and worse leading me to a dr who diagnosed URI and gave me a zpak,  and cough suppressant.  Cough went away but came back a few days later like the early stages of a cold again.  Again it worsened and this time the dr gave me more antibiotics and more cough medicine plus prednisone.  Went away, came back.  Back to a dr who gave me Levaquin plus high dose of prednisone plus advair plus albuterol for nebulizer. chest x ray was normal. Went away and came back.  Finally, I went to an internist who suggested that due to my family history and possible alpha 1 deficiency that I had COPD.  I was referred to a pulmonologist who said I have asthma caused by allergic rhinutus and prescribed 2 nasal sprays plus prednisone (until the nasal sprays begin to work.   My spirometry the first visit was 78% and on the last vist was in the 40s.
That was 3 weeks ago.  My cough has gotten worse.  I have terrible wheezing, crackling  bubbling sounds in my lungs audible enough for my coworkers to hear.  I have to wear diapers due to stress incontinence and barely leave the house anymore.  PFT is scheduled for this week but I cant imagine taking it due to the current state of my lungs  Do I have to be sick like this forever?  Is there any end in sight besides death?
242587_tn?1355427710
Let me speak to the most important question first.  “Do I have to be sick like this forever?  Is there any end in sight besides death?”   My answer is that you do not have to be sick like this forever and death is not inevitable at this time in your life at age 46.
I agree with the internist that your family history is highly suggestive of an inherited predisposition to COPD, with or without alpha 1 antitrypsin deficiency.  Your description of symptoms and the course of your illness is more suggestive of COPD than of Asthma.  The recent worsening would fit into the category of what is called an Exacerbation of COPD.  You do, in all likelihood have COPD but most everything you mention suggests that you might also have an acute lung disease superimposed on the chronic lung condition, for example acute bronchitis or pneumonia.  Also, it is not uncommon for a person to have both COPD and Asthma (or at least symptoms consistent with asthma.).

The bottom line is that you have a worsening acute illness that must be diagnosed and treated.  I suggest that you contact your primary care physician immediately, describe the progressive worsening of your condition and request that he give further consideration to what is happening now and/or refer you to another Pulmonary specialist for a second opinion.  Yours is a treatable condition, the pulmonary function test result of 78% is very encouraging and, once again, COPD is a treatable disease and your decision to stop smoking seven years ago was one of the best decisions you have ever made and one highly likely to save your life.   But, you must seek help now, with no further delay.  Do not take NO for an answer from any of your doctors.

Good luck
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