Hi,
I am trying to figure out if I have COPD and what, if anything, I can do about my situation.
I am 53 now and am under medication for hypertension. I was a heavy smoker (20 a day) from 1990-2004. I stopped completely after that (I might have smoked cigar with friends 3-4 times). I had an afib ablation done in Dec 2023. I started feeling a bit breathless. I am not sure if I felt it before the ablation. But, I definitely did after the ablation. I mentioned it to my PCP and they had an "ECG Stress VO2" done. There, they noticed some wheezing and sent me for Spirometry. The FEV1/FVC came at 62 (%Predicted at 77). FVC 3.55(%Predicted 83). FEV1 2.19 (%Predicted 64). So, they had a CT scan done. The CT scan came up with the following.
1. Vasculature: Limited evaluation without IV contrast. The main pulmonary artery is mildly enlarged, measuring 3.3 cm. The thoracic aorta appears unremarkable.
2. Lung parenchyma and airways: Minimal centrilobular emphysematous changes at the lung apices. Scattered groundglass and more solid appearing micronodules measuring up to 3 mm. Mild bronchial wall thickening. Mild right basilar atelectasis.
Turns out I had another CT before my ablation (for calcium score) and they compared this CT with that one. At that time, nothing was noted.
I have the following questions:
1. Can emphysema develop in 3 years (from 2023-2026) after so many years of non-smoking?
2. Can "minimal emphysema" cause dyspnea? Or, could it be because of "mild" right basilar atelectasis? If it is indeed the later, would it be reversible? If so, what do I need to do for it?
I understand that there is no harm in living healthy (COPD or not). But, I would like to indulge in a beer or two (with some wings :-) ) once in a while with friends. Just trying to find out if I should deny myself that too, to live a little longer to take care of the responsibilities.
A more generic question. I get that COPD is "progressive" in smokers as there will be "more" damage done due to continued smoking. But, why would it be "progressive" if one stops smoking? Does the "damage" grow (like cancer) OR is it that the damage remains the same, but as lung capacity reduces (with aging), we just feel the effects more (as in 50% of large lung capacity is good enough for you to not feeling anything, but the same 50% of reduced lung capacity will make you feel out of breath)