Can we talk about Chronic Bronchitis and COPD?

[fourcatmom]

I am really frustrated after seeing my Pulmonary doctor today and wanted to see if anyone here could shed some light on either Chronic Bronchitis or COPD. 

 

What are your main symptoms?

 

How old were you when diagnosed? Or general age

 

 

Was there a final test that made the diagnoses possible? 

 

My doctor told me today that my symptoms act like Chronic Bronchitis and if I were older he would diagnose me with COPDr? Without going into all the details, this just doesn't make sense to me. He wants me to be tested for Acid Reflux which I feel isn't even a problem and I think it's a waste of time. 

 

I have always felt that this is what I had. Also, there was doctor who reviewed my notes over the summer and noted, "Obstructive Chronic Bronchitis with Acute Exacerbation's'this comment was then "hidden" on my account for some reason and I didn't even know it was there until recently. 

 

Any information you can share with me would be great. Thanks! 

[Jean in Newcastle]

Acid Reflux can be "silent" and not have noticeable heartburn.  It can come with constant cough and irritation.  I've just had a full work-up for it (which came out negative).  

 

In my case I think I do have a chronic reactive airway disease that causes me to cough to the point where I"m almost vomiting at times.  I use my rescue inhaler then and it helps.  

[gardenmom5]

my mother had them.  she was older when she was diagnosed - and the comment was her lungs were badly scarred - even though she had never smoked.  she was exposed to chemical fumes in a job.  she also was diagnosed asthmatic, but it was later when another dr said it was CB.

 

acid reflux can cause chronic coughing - and people don't even realize they have it as the cause because the amount of acid is so small. go ahead and be tested - it's a lot easier to treat than chronic bronchitis and copd.   it can also cause a lot of damage to the esophagus if it is left untreated.

[fourcatmom]

I guess my main issue with the reflux is that most of my coughing happens when I get a flare up and it's usually when I am out of the house. The weather, chemicals, smells, triggers like that as well as activity can make me cough and produce large amounts of mucus. I can stay in the house for days and control the environment and have no episodes. If it were reflux, you think I would have the same symptoms inside. The flare up's come from triggers that I mainly experience out of the house unless I am sick. I also run frequent temps which doesn't come from reflux. When I had the bronchoscopy they said my lungs were inflamed and I had a lot of mucus.

 

I feel like I almost have to do the Bravo test to prove that I don't have it and I really don't want to.

[fourcatmom]

Acid Reflux can be "silent" and not have noticeable heartburn.  It can come with constant cough and irritation.  I've just had a full work-up for it (which came out negative).  

 

In my case I think I do have a chronic reactive airway disease that causes me to cough to the point where I"m almost vomiting at times.  I use my rescue inhaler then and it helps.  

 

Sorry if this is TMI!

 

My flare-ups can come within minutes of being exposed to a trigger, like being out in the wind seems to be a big one for me. I have had days where I am been fine inside, went out to take my dd to soccer and simply walked out on the field with her. Within minutes I am coughing and the coughing escalates quickly in severity. I can feel the mucus increasing in my throat, so much that I feel like I am choking on it. I have to get myself out of the environment as quickly as I can. In this case I barely made it to the car. My eyes start to water uncontrollably and I can't breath. It usually ends in vomiting and having to have a treatment with the nebulizer. That was why the portable one was so important.

 

Is this really what relflux looks like? My dd had ulcers and GERD at a young age and I remember her coughing after eating and when sleeping to the point of vomiting but it was not environmentally triggered, it was food related and in her case it was obvious food was a trigger we just didn't know why until they discovered the ulcers and diagnosed her with GERD.

[Jean in Newcastle]

Sorry if this is TMI!

 

My flare-ups can come within minutes of being exposed to a trigger, like being out in the wind seems to be a big one for me. I have had days where I am been fine inside, went out to take my dd to soccer and simply walked out on the field with her. Within minutes I am coughing and the coughing escalates quickly in severity. I can feel the mucus increasing in my throat, so much that I feel like I am choking on it. I have to get myself out of the environment as quickly as I can. In this case I barely made it to the car. My eyes start to water uncontrollably and I can't breath. It usually ends in vomiting.

Have you gone to an allergist?  

[fourcatmom]

I see an immunologist since my levels were low and he is also an allergist. He thinks my issues are mainly pulmonary and half the time my lung tests shows signs of asthma and half the time they don't. My lowest LFT was about 59% and most recently I couldn't even complete the test. He hasn't done as specific allergy testing. It seems more often in the winter when I am sick that they show signs of asthma on the test.

[Jean in Newcastle]

I see an immunologist since my levels were low and he is also an allergist. He thinks my issues are mainly pulmonary and half the time my lung tests shows signs of asthma and half the time they don't. My lowest LFT was about 59% and most recently I couldn't even complete the test. He hasn't done as specific allergy testing. It seems more often in the winter when I am sick that they show signs of asthma on the test.

I would ask for specific allergy testing for environment allergens.  

[fourcatmom]

So I guess my question is for those of you who have COPD, what does a flare up look like?

[Robin M]

Sorry if this is TMI!

 

My flare-ups can come within minutes of being exposed to a trigger, like being out in the wind seems to be a big one for me. I have had days where I am been fine inside, went out to take my dd to soccer and simply walked out on the field with her. Within minutes I am coughing and the coughing escalates quickly in severity. I can feel the mucus increasing in my throat, so much that I feel like I am choking on it. I have to get myself out of the environment as quickly as I can. In this case I barely made it to the car. My eyes start to water uncontrollably and I can't breath. It usually ends in vomiting and having to have a treatment with the nebulizer. That was why the portable one was so important.

 

Is this really what relflux looks like? My dd had ulcers and GERD at a young age and I remember her coughing after eating and when sleeping to the point of vomiting but it was not environmentally triggered, it was food related and in her case it was obvious food was a trigger we just didn't know why until they discovered the ulcers and diagnosed her with GERD.

My mom had severe bronchitis many times over the years and then got a fungus in her lungs. She is exactly the same way and she had no allergies whatsoever. Lungs get scarred and weakened, really sensitive to wind, smoke, heavy perfume. She has copd now, among other issues.

 

There are different stages to copd. They did lots of X-rays and other tests which will show whether have spots, holes, scarring on lungs. Her main symptoms were similar to asthma and she's had a mucusy cough for years. She was diagnosed 15 years or more ago. Then they tried to attribute to. MAI which is related to aids type lung infections but without the actual disease. Docs know more now and there are lots of inhalers therapies that work such as spivira, etc.

 

Lots of information online now. Hopefully some of this helps.

[fourcatmom]

My mom had severe bronchitis many times over the years and then got a fungus in her lungs. She is exactly the same way and she had no allergies whatsoever. Lungs get scarred and weakened, really sensitive to wind, smoke, heavy perfume. She has copd now, among other issues.

 

There are different stages to copd. They did lots of X-rays and other tests which will show whether have spots, holes, scarring on lungs. Her main symptoms were similar to asthma and she's had a mucusy cough for years. She was diagnosed 15 years or more ago. Then they tried to attribute to. MAI which is related to aids type lung infections but without the actual disease. Docs know more now and there are lots of inhalers therapies that work such as spivira, etc.

 

Lots of information online now. Hopefully some of this helps.

 

Yes, it does. Thanks. There are signs of scaring on my lungs from CT scans. The other reason why it seems pointless to go off on another tangent. I had whopping cough in 2010 and again in 2011 and I have never been the same. I guess it's just a matter of time if it COPD. Thanks for the info. I also had bronchitis I don't know how many times in my 20's and I am always sick. Kids get a little cold, I get a fever and cough and it takes me down for days.

 

Smoke is the worst. I was driving on the freeway one day with my kids and traffic was stopped due a car fire. I could not breath, could not control anything and could not get out. It was very scary to be in control of a vehicle, even in pretty much stopped traffic and have such an intense reaction - with kids in the car. I literally drove coughing, throwing up into a bag trying to get myself out of the area. Pulling over in this case wouldn't have helped since the smoke was the trigger. I am at a point where I wont drive unless I am in my neighborhood. Even shopping with a cart full of groceries and someone comes down with heavy perfume. I have had to walk out and leave my cart. I can't tell you how many time I have left a full cart at the store because I couldn't finish. That's why I go multiple times a week for small shopping trips. It has changed my life in every way.

[Mrs Mungo]

I think you will find this journey to be longer than you probably imagine. COPD isn't usually an end diagnosis for someone young, who doesn't smoke, etc. Unless you show signs of emphesyma in addition to the scarring, then it won't be diagnosed as COPD. Any pulmonologist would test you for reflux. It is one of the first things they eliminate.

 

Have they given you a sweat test?

[Mrs Mungo]

Blood tests, especially for your IgE levels, along with the CT scans and broncoscopy should be suffient for diagnosis.

 

It really depends upon the final diagnosis. It took 9 years for my son to have a diagnosis, and he was seen at one of the top pulmonology hospitals in the world.

[Pawz4me]

My mother and FIL both had COPD.  Their main symptom by far was shortness of breath.  Neither could walk more than a few steps w/o having very noticeable difficulty breathing.  Also, even when resting and not exerting themselves they stayed much more tired than other people of the same age (due to not getting sufficient oxygen).  Typically they'd do some normal small chore around the house that took just 10 minutes or so and then they'd have to sit down and rest.  Both of them were former smokers and had minor smokers' coughs, but the coughing was far from being a main symptom.

 

Other than your lung function test, I echo what others have said about acid reflux.  I have a horrible cough with mucus production when mine is flaring.  Now occasionally I have that same cough/mucus production when it's not flaring, and I do believe allergies play a role.  But it's *much* worse when my acid reflux is acting up.  Acid reflux can cause many atypical symptoms, and respiratory issues are among them.

 

What about asthma?  Has that been ruled out?

[NoPlaceLikeHome]

Why a test for reflux and why not just try a medication like omeprazole which can be had over the counter? My doctor prescribed for me when I was getting a lot of shortness of breath with my asthma and COPD. The omeprazole improved my breathing greatly. Apparently, you get reflux which irritates your lungs and not even know about it. I would also get a sleep study test to check for sleep apnea since CPAP machines have been shown to improve symptoms of COPD and asthma. In fact, they are recruiting for a study to see if CPAP without sleep apnea improves asthma. All I know is that my breathing has been much better since CPAP and I have managed to avoid prednisone for colds all but one time since starting CPAP over 2 years ago. Whereas, prior to CPAP I ended up on Prednisone 2 to 3 times a year with every cold for 4 years prior.

 

Also, has he prescribed anything like a steroid inhaler and other meds? Have you had any tests for asthma or allergies?

[NoPlaceLikeHome]

Also have you been tested for alpha anti-trypsin deficiency? I also recommend if you can to go to major medical center renowned for your condition and lung conditions for a second opinion. US News and World Report can help you find a doctor and hospital that specializes in lung disease.

[NoPlaceLikeHome]

Since you respond to many environmental triggers, it could not hurt to carry respirator masks with you to protect your lungs when there is a triggering situation.

 

Also, at any sign of a cold I would seek medical treatment and ask about nebulizers prophylactically. Do you have a nebulizer machine at home? I would want one. Exercise also helps. There is pulmonary rehab which can help with exercise.

[LMA]

The diagnosis of COPD tends to be given to the Medicare crowd. It may have something to do with having Medicare pay. My father in law was asthmatic until he went on Medicare. My mother just had allergies and chronic bronchitis until she went on Medicare.  She went on oxygen when she went on Medicare, also.

 

People with a COPD diagnosis are usually given a maintenance inhaler with some form of albuterol. It is not for emergency situations. You need the other type of inhaler or nebulizer for wheezing. Exercise such as just walking helps but ask before you start any exercise. Weight loss helped my mother. She got off the oxygen and she only got pneumonia once a year instead of 5 times a year. The pulmonologist said the weight loss was very significant to her health of her lungs and heart. 

[fourcatmom]

Thank you everyone for the responses. I have been diagnosed with severe sleep apnea but the CPAP made it me sick. Bloated and sick to my stomach. They finally took it back because it just wasn't working. I have a dental piece that I am trying to get used to but I don't sleep well with it and it gives me a headache. I am so very tired, napping most days. I do feel short of breath even with daily living tasks, like taking a shower. I have to spread out what  I do (cleaning, dishes, cooking, showering, laundry, groceries) I can't do too many things in one day. Most of the day I just sit and help the girls and then nap. We try to go out several times a week but I usually end up not feeling well and then I am just exhausted.

 

I have a nebulizer at home which I use, it does help. They ordered a portable one but it was not covered. I have rescue inhalers but they don't help much. Stopping the activity, resting and getting out of what ever is bothering me helps in combination with a treatment and usually throwing up helps to since it relieves some of the mucus. I know my oxygen is low at night (from the sleep study test) but I don't know about during the day. When I am sitting in the office, it's normal. I am curious as to if it drops during at attack or when I am having a hard time breathing. My regular doctor said to come in and he would put a machine on me and have me go walk around the office and see if it changes. This doctor yesterday walked out of the room during at attack and said I could buy one.

 

The thing about the flare ups is that two years ago when i went off of work they weren't this bad, they are getting worse and more frequent. My symptoms have progressively changed which to me is more consistent with a lung problem then a reflux problem. I could be wrong. Also, remember it started after my second episode of whopping cough. I think that is a key.

 

Thank you for all the advice. I know some of the info I put out there was very personal and TMI but I really need to figure this out. I just want a plan of action and the right treatment for what i have. I would love to see a respiratory therapist?

[Jean in Newcastle]

If the CPAP made you sick then you did not have the right mask.  If you were feeling bloated then I'm pretty sure that means that you were swallowing air, which means that you need a mask that also covers your mouth or you need a strap that keeps your mouth closed.  Severe sleep apnea is a very dangerous thing.  I would go back to an actual sleep specialist and I would work with them to find something that works for you.  I would want to know if the apnea is due to a structural problem (the airway collapsing) or a brain problem (the brain not telling you to breathe at times).  The treatments for each of these is different (even if they do share the use of a CPAP machine).  

[fourcatmom]

I tried both kinds of masks, each one had the same result. I was swallowing huge amounts of air. The button of my pants was at my sides - not in front where it should be, that's how bloated I was.  Even at the sleep study, they sent me home due to being sick to my stomach and couldn't even finish the sleep study. I guess that's part of my frustration, the Pulmy I saw yesterday is suppose to be a sleep specialist as well and I told him again that the other dr. took my CPAP away and it was going untreated. I asked about having oxygen at night. He said he couldn't find my sleep study in the computer to show that my oxygen level dropped. He said if I wasn't using CPAP then oxygen at night would make the apnea worse. My sleep apnea was about 14 episodes per hour lasting up to 50 seconds long each time. Yet, he didn't address it at all. I am crying, telling him I am tired, exhausted, frustrated, vomiting and short of breath and he wants me to pursue reflux. It just doesn't completely make sense to me. 

[fourcatmom]

http://sleepdisorders.about.com/od/sleepdisorderstreatment/a/Oxygen-Therapy-In-Sleep-Apnea.htm

 

Well, I found this: 

 

The Danger of Oxygen Use with Sleep Apnea and COPD

There are situations where the use of oxygen to treat sleep apnea may actually be dangerous. When chronic obstructive pulmonary disease (COPD), such as emphysema, occurs alone, oxygen has been shown to be beneficial. However, when it occurs with obstructive sleep apnea, a different picture emerges.

In this so-called "overlap syndrome," the use of nocturnal oxygen without relief of the airway obstruction can cause worsened breathing overnight. This may result in complaints such asmorning headache or confusion. Therefore, it is important that continuous positive airway pressure (CPAP) be used to treat the obstruction, with supplemental oxygen infused into the system as needed to confer the other benefits.

Therefore, it is important that individuals with COPD undergo a sleep study if there is suspicion of sleep apnea contributing to their complaints. And clearly, oxygen alone is not an adequate treatment for those suspected of having sleep apnea.

Sources: