Asthma, COPD or what...?

[Nickolas]

I am a 38 year old male ex-smoker (10 yrs totaluntil since Nov 05), just under 6ft tall and fairly slim. I was diagnosed with mild asthma when I was about 8. It got better in my teens & twenties. Now not breathing well. I first felt a strange almost indescribable feeling in my chest about 3 years ago. It is a tightness and has increased. I no longer have asthmatic wheezing but a slightly laboured breathing. Have been taking ventolin 3 times a day in last week as breathing gets worse (but not in the same sort of wheezy attacks I had before or early smoking). Strangely it feels slightly better when I walk. Started to take Beclo-wottsit recently 3 times a day. I feel like i want to clear my chest of mucus but can't cough or cough anything up. The feeling is also, without a doubt, a feeling of anxiety and as it has been there 3 years plus I would like to get rid of it. When I wake up it is strange as it is not breathing but as I wake i can feel a tightness spread & this real heaviness arise around the heart area and sort of stays all day. My Doc has said depression & anxiety (and yes i feel a little anxiety but of the breathing and not surely for 3 or 4 years!). A friend's dad gave me pulmonary test in late 2003 and it read FEV1 3.75, FVC 4.41. Also PFR was 420. I think the latter is low (even though doc said it was fine) and indeed my present Doc gave me a peak flow test last week and it was 470 odd. Another blow & it was 5oosomething. Are the spirometry measurments indicative of anything?  Have i got COPD? Uncontrolled asthma? Just anxiety? Will new meds work? Ta!

[National Jewish]

You’ve asked lots of good questions.  It is possible that this is asthma, but also possible that it is not.  The best way to find out if this is asthma is to have spirometry done again when you are not feeling well.  Then repeat the spirometry after using an inhaled bronchodilator, like the Ventolin® (albuterol sulfate).  This will determine whether or not your symptoms are related to your airways.  Peak flow is not a good measurement to determine if someone has asthma.  It is a good measurement to follow someone with asthma.

It is doubtful that you’ve got COPD, but possible.  Having pulmonary function tests (PFTs) will answer this question.

It is possible that this is just anxiety.  However, I would not make this assessment until you have completely ruled out the possibility that these symptoms are due to a problem in your lungs.

I would work with your physician or see a pulmonologist to get these tests done.