Diagnosis: COPD

Something isn’t right. You find you run out of breath so easy. You’re so tired and rundown. You keep coughing. Thankfully you quit smoking a while ago, so it shouldn’t be a smoker’s cough. You decide that it’s time to call your doctor.

The Appointment

Finally, the day has come for your appointment with your family doctor. You have your medication list ready, even if the doctor knows what you take, you want to be sure that they do have all recorded. You wrote down “can’t breathe” and “tired, so tired”.

Your doctor listened to your heart and lungs with his stethoscope. He asked about your smoking history, then, he looked at your eyes and ears. He asked that you tell him about your shortness of breath (sob). You tell him you quit smoking about 6 months ago. No, you don’t use drugs. He can hear some wheezing. You say that you know you’re a bit overweight. He asks about your family history. You had one relative who had a heart attack, otherwise everyone has been healthy.

Your doctor then had you blow into a peak flow meter. He said that you didn’t blow as high as you should have. Then you went for a chest x-ray. Your x-ray didn’t quite look right. It doesn’t look like pneumonia. With your symptoms, he’s concerned that you might have asthma. He also wrote a prescription for a Pro-Air rescue inhaler. They scheduled you for an appointment with a pulmonologist, a lung doctor.

The Pulmonologist

A month later, you have your pulmonology appointment. They had mailed you a list of questions, you did bring that with you. It is a list of your medications, allergies, surgeries, family history, and comments. You gave the x-rays from your personal doctor. They did your height and weight, blood pressure and oxygen reading. You try to read the doctor’s mind. He isn’t saying much as he looks over all your records. He says that he is wanting to do a CT scan, which is a computed tomography (CT or CAT) scan that allows doctors to see inside your body. It uses a combination of X-rays and a computer to create pictures of your organs, bones, and other tissues. It shows more detail than a regular X-ray. You can get a CT scan on any part of your body. Then it’s back to the pulmonologist's office to wait.

The pulmonologist said that he has reviewed the CT scan and looked over the x-ray again. It looks like you have COPD, which is chronic obstructive pulmonary disease. You are stunned, you know very little about it, but it’s shocking. He sits down and talks to you about COPD and medications. He writes you a prescription for Advair and is going to schedule you for more pulmonary tests. In the meantime, someone from respiratory comes in. She shows you how to use Advair and shows you some coughing methods, also how to keep track of your own levels with your peak flow meter. She also tells you what to expect when you take your other pulmonary testing.

Pulmonary Testing

The big day is here. The technician has you come in and asks you a few questions. She notices you looking at the big, clear telephone booth. She asks if I’m claustrophobic, you say say no, then go in and sit in the chair. Each of these exercises require you to blow into a machine at certain times. Thankfully she walks you through it before testing and explains what to do during the exercise. Thankfully she encourages with her aggressive comments of “blow, blow, blow, etc.” Towards the end of the testing, they do a methacholine challenge. This methacholine challenge test is done to show how responsive and reactive that your lungs are in the environment. This also helps to diagnose whether you have COPD or asthma. Then they do a test where you are given albuterol. This lets them know whether the albuterol works for you and helps in the diagnosis. A final test is the six-minute walk. With mine, there were cones set up at each end of the hallway. The tech checks blood pressure, as well as my oxygen level. She said to take six-minutes to walk to the other end of the hallway around a cone there and back and around the cone on this site. This is to be done at my pace, if I need to stop for short breaks I could do that; if I would need to stop all together, I could do that. Off I go. At the end, she did another blood pressure and oxygen reading. Since I am on night oxygen, I was to take a pulse oximeter (pulse ox) meant for over nights. This will let them know what my oxygen levels are when I am sleeping.

I also have a small pulse ox for my home, then when I’m feeling short of breath I can check it to see what my O2 reading is, even heart rate. I do know though, I need to focus on how I feel, not on the numbers on the pulse ox.

With all of this information, the pulmonologist has you come in to review all of the testing. He has all of the information needed to properly treat you. You and your friends might have similar diagnosis, with different treatment. Or you may still be waiting for the additional testing. Maybe you don’t have a pulmonologist nearby. You then have a choice to go to your gp (general practitioner/family doctor) or you can travel to get to your pulmonologist. Maybe you can set it up to see your pulmonologist every 6 months or so and to see your gp as needed. Do find a support system, either face to face, a social media site, or a community such as you find here at COPD.net.