ongoing coughing // mucus in chest // asthma or not ???

[Michaelccc]

38 male. Pack a day smoker for 15 years. 5'6 160 pounds . 7 months ago cough that lasted 5 weeks
then 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 with pulmonologist said no its NOT chronic bronchitis it is just irritated airways.
1. so  is it chronic bronchitis like the ER doc said or NOT chronic bronchitis like pulmonologist says?
2. do i have reactive airway disease? whats the difference with that and asthma?
3. is 550 normal on peak flow meter
4. can this be COPD?
here are the results of my spirometry test. is it normal? borderline? bad?
          SPIROMETRY
                                pre             %pred         pred
FVC                         3.79            81              4.67
FEV 1                      3.24            84              3.88
FEV 3                      3.79            84              4.49
PEF                         8.66            101             8.55
FEF   25/75               3.85            93              4.13
FEF   25                   7.44             94              7.92
FEF   50                   4.61            100             4.62
FEF   75                  1.46            78               1.88
FEV   1 % FVC        85.67           104            82.76
FEF 50  % FIF50     101.39      
              BODY PLETHYSMOGRAPHY
IC                            2.76            
ERV                       1.03              74              1.39
RV                          2.25             141             1.60
TLC                        6.03              94               6.42
RV % TLC               37.24            144             25.80
ITGV                       3.27             108             3.02
SR EFF                 17.96             150              12.00
             DIFFUSION
DLCO SB               28.55             96               29.63
DLCO/VA               4.51             103               4.37

[David Tinkelman, M.D.]

Chronic bronchitis is sustained inflammation of the bronchi, a pathologic diagnosis, the most common cause of which, in the U.S., is cigarette smoking.  The American Thoracic Society definition of Chronic Bronchitis, defined in clinical terms, is: “the presence of chronic productive cough for at least 3 consecutive months in 2 consecutive years.  With strict adherence to this definition, the pulmonologist is right:  you do not have chronic bronchitis.  That is not the same as saying that you have no airway disease.  You do.

Two episodes of acute or sub-acute bronchitis in a period of 7 months, in a person who has smoked heavily for 15 years is almost certainly indicative of chronic airway damage, secondary to cigarette smoke and a sign of increased risk for the development of COPD.  You should heed this warning signal and engage in smoking cessation immediately.  Should you continue to smoke, it will be only a matter of time until you develop full-blown COPD, by both clinical and pathologic criteria.

Your pulmonary function test results fall within the range of predicted “normal function”, with one notable exception – the increase in Residual Volume, reflective of one of the early signs of COPD, air-trapping.  There is a wide range of normality in pulmonary function test results and your results are just about in the middle of that range.  Without previous testing for comparison, there is no way of knowing if your PFT results would have been even higher in the past.


Without post-bronchodilator pulmonary function testing, it is not possible to make a statement about whether you do or do not have reactive airways.  Even if you did, that would in no way alter my conclusions about chronic bronchitis.  Peak flows of 550 are deemed to be normal but are a very poor indicator of early COPD.

Can what you’ve experienced be an early sign of COPD.  Absolutely.

[Michaelccc]

how come a doctor has not answered this? i thought if i paid the $15 dollar fee here its answered. am i doing something wrong in the posting procedure? someone please help out . thank you