I don't know what form I'd copd I have.

Thank you for the information 😊

That's usually only if copd is severe Vee.  If it is mild and even moderate it is very common to be just diagnosed via spirometry.  Sometimes a chest x-ray is given (I had to fight for one).  

A CT scan is not routinely done in the milder cases (unless the findings are not completely consistent with copd),  nor is a referral to a consultant.   I have never had the latter and am high moderate.  I have asked but always been refused with 'it's not necessary'.  x

Hi Hypercat!!!  I live in Lakewood, Colorado, USA.  I really think that perhaps some physicians either don't want to become too involved with people with COPD OR they are not well-educated about it.  I am just shocked that a doctor would not have a patient go for a CT scan.  I told my CURRENT doctor, when my oxy level dipped below 80 that many years ago, at age 69, I was told I had asthma.  He had spent 12 years at Jewish National Hospital which is a TOP respiratory hospital in the USA.  This doctor told me "I find it hard to believe that suddenly at age 69 you developed asthma (I was 71 at the time).  He immediately sent me for a CT scan and had me WAIT at the office until the radiologist called him with a diagnosis.  My treatments were started THAT day for emphysema.  I am SO grateful that I finally have a conciencious doctor and pulmonary specialist!  

True, it could be due to being, highly moderate, in other words, maybe too soon to have one. I didn't have my first cat scan until I was classified as serious, and have 20% lung capacity. 

Forgot to add....I am in the USA, and have Obamacare's private insurance, which is law abiding. 

Trouble ie... it is necessary to us. It's about the person. Wellbeing begins in the mind.

Not in my case hypercat, but my circumstances may well have been very different to your own, especially if you were diagnosed in the mild stage and not showing many symptoms.

I was ill for over 10 months, after 10 months of testing and various scans, it was the CT scan which resulted in my diagnosis of emphysema.  I was not breathing properly, too tired all the time, could not talk for very long or walk even a very short distance without tiring to the point of exhaustion, lung infection not responding to treatment resulted in thorough tests to find the cause.

My obstruction then was minimal  now its moderate after 12 years. My problem was and is gas exchange (not a retainer though).   However the CT scan showed only 50% lung functioning. A spirometry test alone was inadequate in my case.  

After diagnosis eventually I was prescribed the medicine that helped breathe easier and allowed me to become more affective to the point I could achieve attending PR,  so in my own experience I am glad eventually I got my diagnosis through the CT scan and not spirometry.

So you see the procedure is in accordance with the patients symptoms and if a patient is not responding to treatment, one inhaler only prescribed (ventolin) until I got a diagnosis which did nothing to help me.  After diagnosis more suitable inhalers were prescribed.

I had a chest xray every 2-3 months which showed a shadow on the lung and chest infection which is what lead to my being referred to a respiratory consultant.

My GP had no option but to send me for xray because I was not responding to ABs prior to diagnosis.  

Mild cases without symptoms perhaps the spiro is adequate to indicate a breathing obstruction.  You cannot diagnose the actual lung damage with a spirometry test nor which lung illness the patient is experiencing, the spirometry test is inadequate in this respect.

Bronchietasis, chronic bronchitis,  emphysema, idiopathic pulmonary fibrosis, the CT scan can identify which lung disease a person has.  

If you were mild obstruction when diagnosed with very few symptoms where perhaps asthma was already present and controlled, it would be unlikely a patient in these circumstances to be referred to a consultant or sent for a CT scan, it cost too much money.  These things happen only when the patient is in real difficult and investigations need to be made to clarify what the problem is so that the correct procedure in treatment can be achieved.

Of course if symptoms excessively deteriorate and things become more difficult and if not responding to current medication, not responding to treatment for lung infection etc, further investigation is required, and in these cirumstances it is the doctors duty to refer the patient.

In addition you may want to familiarize yourself of the difference between obstructive and restrictive lung disease.  Web MD have a page on this.

Hi Vee I was always told different - that the test for copd is a spirometry and that this picks it up.   The normal procedure if you are having problems,  as far as I'm aware,  is to visit the doctor.  They then either do the spirometry themselves,  or book an appointment with a respiratory nurse. 

You then go through the list of symptoms you have (in my case breathing problems and wheezing) and if they match up to copd then that's what you are diagnosed with.  I was told that if your symptoms don't match or they become worse then at CT scan might be done. 

It is not uncommon I have heard for people to be diagnosed with copd (especially if they are smokers or former smokers,  in accordance with thr NICE guidelines)  and years down the line they get lots of infections which don't clear up.  Then they are given a CT scan to see if it's something else instead ie bronchieactasis.   A CT scan isn't routinely used where I live.   My GP's are fund holding and have said it is expensive to do one without a very good reason.  x

 

Oh and the NICE guidelines recommend everyone should be given a chest x-ray on diagnosis of copd.   I was refused this with 'It's not necessary as we know the damage'  by my doctor.  She got angry when I kept asking.

After a few years I saw a different doctor and asked her and she agreed.  It showed copd and 'long lungs'  which is common I understand.  x

My chest xrays were before any diagnosis, as I mentioned above.

Just as well you changed docs

That is your experience and that of some others, but not all others and not one size fits all because its just doesn't happen the same way for everyone.

I know people who have never seen a consultant and do not know their actual lung damage or diagnosis other than COPD. 

I also know many who are referred to a consultant, *its mainly those patients who are not responding to treatment are experience great difficulty, or if there is uncertainty of the cause of the shortness of breathe, shadow on the lungs, unresponsible to treatment for lung infection etc.  as in my case, or those who persistently have lung infection and previously unidentified lung issues..*   Often thorough tests are carried out in these more serious symptomtic patients, cardiac, cancer, lung damage.  Its far more tramatic than just having a spirometry test.

A spirometry test will only measure your ability to exhale.

Quite right it is very expensive to do a CT scan without a very good reason, the above mentioned *.....* are some of the very good reasons.

When someone is very ill, referral to a specialist is required.

As I've said already, if their symptoms are mild of course they will not be referred to a consultant or sent for a CT scan.

I think I am just repeating what I have already said.

Oh! I will. Thank you

If any of you are still here. Update...... I saw a specialist and they believe I have been misdiagnosed for 3 years. I may have asthma. You have no idea how angry/relieved I am. Have they actually put me through this for nothing? I have to be retested now. If the diagnosis is copd then I will have been punished. 😕