Very long first post. Sorry. I’m struggling and need to offload everything because I don’t understand how I ended up like this. Skip to the Symptoms section if you don’t want to read my backstory. I know no one here can diagnose me. But maybe someone can relate to my experience. I’ll try to attach the different spirometry results. No one’s really explained the readings to me. Even when my pulmonologist went over things, she just said, yeah it’s obviously COPD because of the FEV1 value.
Backstory
I’m a 29 yo male and have a long medical history. I was born premature and had Bronchopulmonary Dysplasia (BPD). As a result, all my life exercise had to be limited due to dyspnea and it was known that my lungs were impaired. This in turn adopted me to be more sedentary than I should be, including my job which is in the computer science field. My lungs did improve during my childhood but then appeared to drop to an FEV1 of 55 liters during my early teens without explanation. However, results showed a bronchodilator response and I was diagnosed with asthma. A few years ago, I had flown back to Florida to help my ailing mother with her Lupus. After I came back, I developed a slight cough but didn’t think much of it at the time. I had been away longer than I intended (a full year) and my carpeted studio was filthy. There had also been a fruit fly infestation while I was away that my apartment building took care of for me. I cleaned as best I could and the cough seemed to clear up. If it came back I’d just clean or assume it was the seasons here in the Northeast. It wasn’t really a hacking cough, more of a throat clearing one.
In late October of 2024, I had a massive panic attack while I was trying to sleep. I had somehow convinced myself that I had blood clots because I had aches in both my legs near my calves. The panic subsided and everything seemed to be back to normal. Then two weeks later, I had two syncope episodes at work and was rushed to the ER. They checked my heart and everything came back okay, minus idiopathic tachycardia. I was discharged in a couple days. The next months were rough: multiple episodes of tachycardia seemingly at random and occasional chest pains + tightness either near the sternum or on the left side. Cardiology said I was fine after multiple EKGs and stress test. They told me it was likely anxiety. Also, in mid November, I had some kind of illness. Mild fever and cough, but recovered in a few days. No clue what it was. But I think after that is when I started experiencing more chest discomfort. It’s hard to tell because so much happened in close proximity.
In February, I finally got in with a pulmonologist, since I wanted to rule out my lungs. A chest x-ray at the ER and a walk in clinic in November came back clean. Turns out (at least according to the numbers), I have borderline severe COPD. My pulmonologist put me on 200mcg Trelegy and never formerly discussed the results with me until this Monday (almost 6 months later) other than telling me I had a severe obstruction. Back in May, I told her I thought I was getting worse and she told me to keep taking the Trelegy and that she didn’t hear anything wrong with my lungs when I scheduled an early followup with her. A chest CT also came back clean.
Also, I’ve tried to be cautious my whole life avoiding secondhand smoke and never smoking. Unfortunately, my job required me to relocate to an urban city in early 2020. Thankfully, it’s a commuter city so the air quality is usually acceptable with a few bad days here and there. I try to stay in those days, but prior to February, I hadn’t really been checking air quality. Also worth mentioning, to my knowledge, I’ve never had COVID-19.
Symptoms
I’m not really coughing or wheezing. But I wheeze through my nose constantly and have been for several months. I only wheeze consistently when mouth breathing if I forcefully exhale. But I have chest tightness, sometimes near the heart (sternum area) and other times along the left breast or ribs. It used to come and go. For example, in January and February, it had subsided completely. Panic attacks seem to exacerbate the condition. In early August, I suffered multiple panic attacks at my work’s office, which led me to become more secluded. I don’t think I’ve left my apartment in a few weeks aside from going downstairs to get mail. I’m afraid something will happen to me. The chest tightness sometimes gets worse with exercise, especially since my call with the pulmonologist this week. I’ve been burping nonstop since November last year. I’m taking omeprazole now and the degree it helps varies day to day. It’s hard to tell if the Trelegy is helping since I felt fine breathing-wise before I was told something with my lungs. These past couple nights have been scary. I’ve woken up in the middle of the night with my chest feeling really tight. Idk if I’m imagining it, but it feels like my left side of my chest is pushed out more than the right and as though my ribs aren’t symmetrical in position. Within a couple breaths it returns to normal though.
I brought up emphysema to my pulmonologist and she said she didn’t think so. It feels like I’m being told I have a severe illness but the particulars aren’t explainable. It’s making me afraid and depressed. If it is COPD, I’m at a loss for how I developed it. Unless I was so high risk that just being in a city and dealing with allergies caused it.
