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spirometry results: asthma? copd? or reactive airway disease?
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spirometry results: asthma? copd? or reactive airway disease?

38 male. Pack a day smoker for 16 years. 5'6 160 pounds . my brother has asthma his whole life so i guess you can say  there is family history ?   7 months ago i developed a  cough that lasted 5 weeks then just a month ago got the same thing. cough. non productive or hardly productive any production was clear phleghm. took antibiotics. ER doc said it was possibly chronic bronchitis. follow up pulmonologist said its possibly "reactive airway disease" he also said i should NOT be taking medicine for it and does not feel like he should prescribe anything since its 'mild"
once a week once every other week i get a cough that feels like my breathing is slightly congested. i try to cough it out but nothing comes out. it usually happens when im stressed or having too much anxiety. also happens mostly at my girlfriends house. she has pet rodents there. can i be allergic ?

1. chronic bronchitis or reactive airway disease?
2. difference between reactive disease and  asthma?
3. 550 on peak flow meter normal?
4. do i have early copd?
5. what exactly copd ? is it not reversible? are asthma or reactive airway disease considered COPD ? or is COPD just emphysima and such ?
6. did i get asthma at 38 ?
7. can it be coming form my girlfriends pets? allergies?
8. is this going to get worse with age? will it go away if i stop smoking?
10. how do my spirometry results look to you ?
11. last question. on the second page of spirometry report. it says. "the diffusing capacity is normal. however the diffusing capacity was not corrected for the patients hemoglobin. --- ok my question. does this have to do with my blood circulation or heart or anything? does it indicate some sort of undiagnosed congestive heart disease?
      ok. attached are the results of my pre and post med spirometry results. click link to see the photo attachment of the spirometry
http://i115.photobucket.com/albums/n303/michaelccc/spirometrypage1.jpg
http://i115.photobucket.com/albums/n303/michaelccc/spirometry2.jpg
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242587_tn?1355427710
Your family history of asthma and 16 pack-day smoking history are consistent with chronic bronchitis and/or asthma, both conditions associated with inflammation of the airways, cough, increased mucous production and obstruction to air flow through your bronchial tubes.  Either condition, chronic bronchitis or asthma, will invariably be worsened by exposure to cigarette smoke and chronic bronchitis seldom occurs in the absence of exposure to any kind of smoke or industrial irritants.  The important thing, at this time, is not to place a label (diagnosis) on your condition but to understand that your lungs are sensitive (family history) to irritants and are being harmed by cigarette smoke.

The good news is that the obstruction to air flow is significantly reversible with the administration of a bronchodilator.  The post bronchodilator results are within normal limits, including the DLCO (diffusing capacity) and that means that you have not yet sustained a great deal of permanent lung damage.  But, with continued cigarette smoking, it will be only a matter of time, until permanent/irreversible damage to your lungs occurs.  In addition,  there is a fairly wide range of “normal values” for the diffusing capacity and, in the absence of prior testing, there is no way to know if the current diffusion capacity value is lower than it once was.  However, the value is usually on the high side of the normal value range, rather than the low side of normal, when asthma is the only diagnosis.

COPD refers to chronic bronchitis and/or emphysema, most often a combination of the two.  In the early stages of the disease, chronic bronchitis may be reversible; in the later stages, not so.  Emphysema is the destruction of lung tissue; it is not reversible.  Both diseases are almost always associated with sustained exposure to smoke. You probably do (microscopically) have early COPD.  Your peak flow is normal but that does not exclude the diagnosis of COPD; is not a good measure of it.

You may be allergic to animal dander at your girlfriend’s house and that could worsen bronchitis and/or asthma.

Your condition will almost certainly improve with smoking cessation and almost certainly worsen if you continue to smoke.  You are fortunate in that your PFT’s show that you still have good lung function, that can be preserved if you stop smoking and avoid chronic exposure to industrial lung irritants.

You didn’t just acquire lung disease at age 38.  It has been coming for a long time and has just now become severe enough to cause symptoms.

You can preserve your lung function for the rest of your life, but there is no time to waste.  Work with your doctor to do everything necessary to quit smoking, now!

Good luck
5 Comments
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213398_tn?1202674074
please copy and paste the bottom two links of my spirometry results into adress bar. they are not coming up as direct links unless copy and pasted. thank you in advance for your answers to my concerns
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213398_tn?1202674074
thank you for your quick response doctor. it is very much appreciated. just two more concerns/questions

1. when you mentioned that on a "microscopic" level i probably do have some early copd. what exactly does that mean? does it mean that i have the chronic bronchitis or early copd? or empyhisima part of copd? either case does that mean its gonna degenarate my lungs further and be irreversible? even if i quit smoking ?

2.on the second page of spirometry report. it says. "the diffusing capacity is normal. however the diffusing capacity was not corrected for the patients hemoglobin. --- ok my question. does this have to do with my blood circulation or heart or anything? does it indicate some sort of undiagnosed congestive heart disease?
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Avatar_n_tn
Hey I was wondering if you could enlighten me on the signs and symptoms of asthma and bronchitis together.  My boyfriend has this and he suffers alot with chest pains and soreness.  He says he is immune to inhalers.  I wish I knew more about his medical history though I have seen some of his doctors notes yes.  Like medical records.  I just wish I knew more about ways that I could try and help him its hard watching him and not being able to do anything about it.  I know this has nothing to do with the comments above but I didn't know how else to get a hold of anyone I just joined this site and don't know how to use it yet hehe
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213398_tn?1202674074
hey goodgirl. i don't think doctor tinkelman is going to come back to this page to answer the question. i asked him the question here in the "expert" or "doctor" forums. it cost me $20 to ask the queston. once they answer it once they hardly ever come back to answer again. you can either start a new question in the expert doctor forums and pay $20 or ask in the community forums to people who are going through similar ailments.
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