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micah35
Member

38 Posts

Posted - Jan 12 2017 :  12:39:21 PM  Show Profile  Reply with Quote
Hi all. I am hoping to get some information and opinions regarding the benefits of using medication for COPD prior to the onset of serious symptoms. I was diagnosed with mild emphysema (by ct scan) in March of 2014, and finally quit smoking in February of 2015. The first tests I had were spirometry only (in primary docs office with somewhat iffy test equipment) which showed all numbers in the normal range, with mid 90s for FEV1. (Note: I had spirometry tests done approx. 5 and 7 yrs earlier which showed FEV1 of 88-89). My first full PFT was in 10/15 and showed in part: FEV1 pre-93/post-109; RV 82%; DLCO 77/adjusted-67. My last PFT in 10/16 showed FEV1 pre-89/post-97;RV 99; DLCO 75/ adjusted-69. I still had some congestion left over from a recent very bad cold, and was told that the FEV1 reading may be somewhat lower because of that and had not necessarily gone down significantly. So all of the numbers seem to be decent except the DLCO, which is at least holding steady so far. The only medication I have is a rescue inhaler which I rarely use, both because I rarely feel the need for it and because it doesn't seem to make much if any difference when I do. I have some fatigue and some SOB at times, but that is possibly at least partly due to being somewhat out of shape (per previous pulmo), and has not changed noticeably over the last year. I'm hoping for input regarding whether it would be beneficial to take any additional medications to possibly help slow down any progression? Previous pulmonologist who I saw only once (and is now retired)had said that there is some research suggesting that Spiriva (or similar) possibly helps slow the progression, but did not seem to feel strongly about it one way or another. Since that time, I have only seen a pulmonary assistant once for the PFT, and she did not recommend any additional meds.

Sorry for the long post and thanks much for any input!

Bo H
Contributing Member

USA
1128 Posts

Posted - Jan 12 2017 :  2:35:38 PM  Show Profile  Reply with Quote
If I were you And you smoke I would quit before I got COPD. I think using any medication at this time would be a waste of money because you have nothing to help.

Bo in Al
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micah35
Member

38 Posts

Posted - Jan 12 2017 :  2:48:03 PM  Show Profile  Reply with Quote
Hi Bo, and thank you very much for responding. I quit smoking almost 2 years ago, and already had COPD/emphysema at that time. My question regarding medication is whether it would possibly help to slow any progression even though I may not need it for symptom relief yet.

Edited by - micah35 on Jan 12 2017 2:49:20 PM
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PennyPA
Contributing Member

USA
5826 Posts

Posted - Jan 12 2017 :  7:23:43 PM  Show Profile  Reply with Quote
The inhalers we take are to treat the symptoms so if you really have no symptoms, there really is no need to start them... yet. There may come a time in the future when they'll help but it doesn't sound like you need them now. I do recommend you get in a good exercise program though. Ask for reference to pulmonary rehab.

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jmrommes
Contributing Member

1730 Posts

Posted - Jan 12 2017 :  9:36:14 PM  Show Profile  Reply with Quote
I certainly agree with the previous posters that meds at this point aren't appropriate if you have no symptoms. What will help, and it sounds like you really need, is a good exercise program. That will probably do more to keep the disease from progressing and it will get you into better shape, so you probably won't even have that odd moment where you're SOB. Talk with your doc to be sure there's nothing you need to be careful about in setting up a good program, join a gym and get started. You need to be exercising at least 30 minutes every day.

Exercise not only lets me live, it enables me to have a life.
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micah35
Member

38 Posts

Posted - Jan 13 2017 :  09:52:42 AM  Show Profile  Reply with Quote
Thanks for all the responses. I have been exercising at least 30 minutes a day (fast walking) since the referenced conversation with the pulmonologist over a year ago, and haven't noticed much difference in my symptoms. I am not overweight and am fairly active in addition to the scheduled exercise time. I was interested in feedback regarding any possible benefits of starting some kind of maintenance inhaler at this point, partly because the prior pulmonologist brought it up as something to consider (although she said I would not feel any improvement from it), and because from reading various posts it sounded as if the rate of progression slowed down for some people after starting medications. From the responses it sounds as if that was likely more a function of exercise than medication, other than symptom control. Thank you very much for your input as I am just trying to make sure that I am doing all I can to slow the progression. While the FEV1 is still in the normal range, my DLCO is already in the mild to moderate COPD range --which is why I am very concerned with trying to avoid further decline as much as possible. Also curious if a low DLCO would explain the mild SOB and feelings of pressure I do have, which do not otherwise seem to match the spirometry results.
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PennyPA
Contributing Member

USA
5826 Posts

Posted - Jan 13 2017 :  6:43:23 PM  Show Profile  Reply with Quote
The DLCO is an indication of how well your lungs transfer O2 into the blood stream. I would imagine that number would normally decline as we age along with many of the other numbers. If the doc said she doubted you'd see any improvement, I really don't see any reason to start something before it's necessary.

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Do Not Regret Growing Older. It is a Privilege Denied to Many

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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joeabby
Member

USA
40 Posts

Posted - Feb 18 2017 :  2:20:09 PM  Show Profile  Reply with Quote
I feel I must throw out a big WARNING at this point about taking care of yourself: undiagnosed sleep apnea. If you snore, you may also stop breathing while you sleep. Untreated, this can take 10-20 yrs off your life. Your heart can't take it. Heart disease is a killer! You never hear that people die from having untreated sleep apnea. Only 5% of us who have it are diagnosed. One big symptom is being tired & sleepy during the day. My wife told me I quit breathing then gasp for air. A sleep test found that I quit breathing 7-8 times/minute.
I sleep very comfortably with my CPAP & I think it helps my lungs as well. Don't think I'd be here today without that diagnosis.

Gettin old ain't for wussies!
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micah35
Member

38 Posts

Posted - Feb 18 2017 :  7:25:26 PM  Show Profile  Reply with Quote
I appreciate the warning, joe, but I recently did an overnight sleep study which showed no sleep apnea and good/normal oxygen levels throughout, so at least for now that is not an issue.
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tsainta
Contributing Member

USA
1703 Posts

Posted - Feb 18 2017 :  8:07:20 PM  Show Profile  Reply with Quote
micah, the consistent exercise program is the key to staving off symptoms at this point. Over the years I have tried every class of inhaled COPD med there is. I am skeptical of any actually slowing the progression, but when you become symptomatic they will treat the symptoms and may seem to be slowing the progression. I don't believe there is any conclusive evidence they do. On the other hand, even if they only treat the symptoms they help you to maintain a more active quality of life for a longer time. A good deal anyway.

Tony-CA

50% of dealing with COPD is common sense.
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PennyPA
Contributing Member

USA
5826 Posts

Posted - Feb 19 2017 :  11:27:23 AM  Show Profile  Reply with Quote
Micah, I seriously doubt there is any benefit to taking more meds (other than your rescue) if you don't need to. As the doc said, all it will do at this stage of the game is flatten your wallet.

****************************************************************
Do Not Regret Growing Older. It is a Privilege Denied to Many

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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micah35
Member

38 Posts

Posted - Feb 19 2017 :  2:27:50 PM  Show Profile  Reply with Quote
Actually, I wasn't told that all it would do would flatten my wallet. The(only) pulmonologist I have consulted said that although she didn't think it would make any difference with my symptoms at this point, there is some research which suggests that Spiriva might help slow down progression; and she told me to think about taking it for that reason and let her know if I wanted a prescription -- this was the reason I posted this question. From the responses, it seems that no one seems to think it would likely be beneficial for slowing progression, and the last thing I want to do is take a medication that could easily do more harm than good, so I am no longer considering it for now. Per your suggestions, I will also double my exercise efforts as that seems to be the best known defense. My very sincere thanks to you all for taking the time to respond. Time to lift some weights now.

Edited by - micah35 on Feb 19 2017 2:31:11 PM
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PennyPA
Contributing Member

USA
5826 Posts

Posted - Feb 19 2017 :  4:09:52 PM  Show Profile  Reply with Quote
Taking spiriva would not do more harm than good at this point; it's just doubtful it would do any good. If you're wondering, ask you doc to prescribe it, take it for a month and see if you notice any difference.

****************************************************************
Do Not Regret Growing Older. It is a Privilege Denied to Many

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Bo H
Contributing Member

USA
1128 Posts

Posted - Feb 20 2017 :  2:58:23 PM  Show Profile  Reply with Quote
Micah35, For what its worth, I was on a clinical trial for Spiriva and they indicated that it could possibly stop the progression of COPD. I know I read a write up about it several years ago and it made the same claim.

Bo in Al
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micah35
Member

38 Posts

Posted - Feb 21 2017 :  10:26:34 AM  Show Profile  Reply with Quote
Thank you, Bo. That is likely one of the studies she was referencing. I guess it would be difficult for any individual to determine whether taking a particular drug had slowed down the progression at all since no one would know how things would have progressed without it, but I had been interested in knowing if anyone had noticed a leveling off of FEV1 decline (or other numbers) after starting Spiriva or similar medications. It doesn't sound as if that has been the case for anyone who has responded.
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SteveinMechanicsburg
Member

68 Posts

Posted - Feb 21 2017 :  11:36:40 AM  Show Profile  Reply with Quote
I think the "slowing of progression" comments we hear are kind of like what the real estate agent told me many years ago about the power lines and power pole outside our house before we bought it: "I think heard that the power company might be burying them."

I mean, it is a great tease and, in the end, nobody can hold you to it. (Power lines still there.)
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PennyPA
Contributing Member

USA
5826 Posts

Posted - Feb 21 2017 :  4:23:55 PM  Show Profile  Reply with Quote
I don't know, Micah, I was at 20/21% FEV1 for over 10 years. Is that because I was on spiriva or is it because I was still working and active? It could be that people exercise more if they aren't breathless and the spiriva (and other meds) help alleviate that breathless feeling.

****************************************************************
Do Not Regret Growing Older. It is a Privilege Denied to Many

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




Go to Top of Page

micah35
Member

38 Posts

Posted - Feb 21 2017 :  9:10:52 PM  Show Profile  Reply with Quote
Thanks Penny, great point.
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