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History of smoking. Recurring chest infections, persistent cough. Normal chest x-ray. Should Spirometry be done?

I am 45. History of smoking , not heavy, but over a long period and not for last 2-3 years. Symptoms are recurring chest infections, non-productive, spasmodic, persistant cough . Greatly reduced activity levels due to breathing challenges. Chest x-rays clear, blood counts normal. Anti-biotics seem to have little effect clearing my symptoms when I have a chest infection. Steroids greatly improve but do not eliminate cough and breathing difficulty. I am mainly concerned because every time I catch a little cold it ends up going to my chest and I don t get better until I am prescribed prednisone tablets. Until the course of steroids I can barely get out of bed. I have been ill frequently over the last year to point that I have not scheduled a Spirometry test recommended by my GP. He said I need to be 100% before I take the test but I think perhaps I need to re-evaluate what I consider to be 100% as I am never there it seems. Although it would be great if you could say what I have and need to do, I am more looking for an opinion on what steps and tests I should expect from my GP. Certainly the Spirometry test seems like a good idea. Are there other tests that might be prudent for my situation though? A CT Scan , bronchoscopy , etc.? Thank you in advance
Asked On : Mon, 26 Nov 2012
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Pulmonologist 's  Response
HI rob

you symptoms seems to be of a disease called chronic obstructive pulmonary disease(COPD). three cardinal symptoms of this disease are: breathlessness which is persistent and progressive, cough which is intermittent and sputum production.

spirometry has to be done to diagnose the disease as per the new guidelines.

you need to be on inhaled bronchodilator and steroid combination alon with inhaled anticholinergic tiotropium.
apart from this you need annual influenza vaccination.

best wishes
Answered: Fri, 29 Mar 2013
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