I quit smoking and have questions

[pepperbelly]

What do I need to do to check for COPD?
I work fairly hard outdoors but not as much now that I am a supervisor.
My daughter has asthma and her pulmonologist gave her some plastic things to check her breathing. So far on both the inhale and exhale tests I am good.

 

[fmerkel]

The plastic 'blow' thing is called a peak flowmeter. Your number is a function of age+gender+size. There should have been a chart with it if you still have that. It's a fairly gross test of bronchospasm (larger airways) and is better at showing asthma exacerbation than COPD which tend to affect smaller airways.

If there is an 'inhale' thing that is sort of an exerciser called an incentive spirometer, that's primarily for post surgical issues to not get pneumonia. That really won't do you much good. Plain old exercise is more worthwhile.
If there is a plastic tube that is used with f one of the inhalers, that's called a spacer or more accurately a valved holding chamber. They facilitate taking inhalers better and should be used. They are NOT a gimmick.

The test you are after is called spirometry. A primary care physician may have a suitable device, a pulmonologist certainly would and would be a better place to go if you really want to follow up on that as proper interpretation of the results are important.

Currently smoking cessation is the best thing you could have done. After that some gradual improvement in your cardiovascular fitness is the most worthwhile investment. If you have issues in getting in better shape that seem to be more than your age or conditioning would lead you to think, especially if there are breathing issues, then I'd see that pulmonologist.

You WILL have improvements in lung function, most of it fairly soon but will continue for months. Improvement in health primarily related to heart disease and lowered probability of cancer and other nasty things smoking does will go on for a long time. Exercise will likely improve your BP. If you get off that patch sometime that should also help as nicotine causes vasoconstriction.

There are some medications similar to what your daughter uses to support COPD. It does not fix it, or cure it, simply supports it if you are having symptoms consistent with difficulty breathing related to COPD. That path definitely has you interacting with a pulmonologist to start.

 

[chillyinCanada]

I love that you've quit smoking! So happy for you! You will feel so free. Now you're your own person again instead of being at the beck and call of the white stick.

Isn't it amazing that we'll let a little white tube of tobacco control us, as we would never allow another person to do!

 

[emoreira]

I consider this is a good starting point :
WRSTC Medical Guidelines

 

[pepperbelly]

I am having zero issues breathing- not out of breath, no wheezing, etc. for the first time in a long time I can take a deep full breath and blow it out forcefully without wheezing or coughing.
The inhale thing has a ball that has to be kept in a specific range while a pointer shows how long the inhale is.

I will check with my primary dr.
My pulse O2 is 99% and my resting pulse is between 65-70 bpm.

I will be getting off the patch. It’s just a temporary crutch while I solve the mental habit. I won’t be using it longer than absolutely necessary.
I have also avoided substituting another habit for smoking. No hard candy etc.

I am also hopefull that quitting might help cure the dry mouth I tend to get while diving.

 

[fmerkel]

That's the incentive spirometer. No harm in it, but it won't do you much good. If you can do a strong and large inhalation you don't need it. Most problems with COPD are NOT inhalation, the problem is with exhalation. The person feels like they can't get enough air, but in physiological fact they can't get the 'bad air/carbon dioxide' OUT due to air trapping.

Pulse Ox is of little value unless the Saturation=SaO2 value actually drops significantly (below 88%). At that point you KNOW you are hurting anyway. FWIW all it measures is "color red", VERY VERY accurately. It does not measure your O2 level. It interprets the 'redness' into SaO2 values.

Carbon Monoxide makes blood cells (hemoglobin) VERY red. People that smoke have a higher than normal carbon monoxide level (inhaling smoke, eh) so their numbers are generally fine if somewhat erroneous....until they have really bad COPD. By then there is very little that can be done except symptom support (O2 and medications).
People dying of CO poisoning will show fine SaO2 on pulse ox.

I'm a Respiratory Therapist and the smokers always wanted to have their SaO2 measured. They were always relieved if it came out OK and of course wanted to interpret that as a clean bill of health. It simply is not. The spirometery is the test you want for that.

Dry mouth is a function of breathing cold dry scuba air. You may get a bit of benefit from cessation, but I wouldn't count on it. A decent all metal 2nd stage would be more helpful. I use an old SP M109. Some old Aqualungs work fine also.

IMO, pulse ox is an overused and poorly understood tool. It's a great tool, but it gets slapped on perfectly normal, healthy people when they go to the Dr. For that use it's about as revealing as taking your temperature when you aren't sick. You will always get an acceptable #, unless you have really cold hands. Poor circulation can screw up the results.

I've made it a game of asking the nurse/MA, even primary care physician, what pulse ox ACTUALLY measures. I tell them it's a trick question. In several decades of asking that only a few medical people have gotten it right.

 

[pepperbelly]

I can do a large strong inhalation and exhalation.
One of the meters my daughter has measures exhalations. I blow through it as hard and fast as I can and a pointer shows a number. My wife and daughter blow around 350-400. I blew around 525 a couple of weeks ago.
My breathing keeps getting better and I will check in a werk or so after I finish with the cold I picked up. Everyone here seems to have caught it. My sinuses are finally clearing.

I will be able to tell more when I can get out and walk or get on the treadmill. I am curious how I feel breathing hard during exercise.

I am still mad at myself for ever starting smoking. I was an athlete and I know what I could have been capable of.

 

[dmaziuk]

I need to lose some weight too but that is coming.

You do know most people gain weight after quitting, right? -- Not throw a wrench in the works, rather, you'll have to work twice as hard on that now.

With breathing I would wait a couple of months at least: it took mine 2-3 months, and that was at 40-somehitng, not 60. If you can get to a pool, take up swimming: it's great for cardio, great for the back, and easy on the joints.

 

[fmerkel]

Put [Peak Flow Calculator] into Google, fill in the blanks and you can get an estimate of what your PF should be. This is based on statistical norms so being a little over or under your estimate is not cause for much concern. Being way under the mark is a problem. The tool is far more useful for asthmatic and checking to see if the are having an attack/deterioration, how bad it may be, and if they respond to their medication.

PF tests LARGE/UPPER airways. COPD affects smaller/more distal airways down to the alveolar level. As stated previously, you really need a full spirometry to get that info.

Pretty much everyone is mad at themselves for ever starting smoking. If you are under 20 and smoke, you think you are cool. Over 20 and they know they are addicted even though they seldom admit it. Most people start smoking in their early teens when they have absolutely no concept of being older....ever. By they time they get a clue it's too late.

Interesting anecdote - I worked for a homecare company for about 12 years. Their main product was O2 delivery, and the vast majority of that went to (almost always) ex-smokers that had really bad COPD. I saw a lot of these people. Only ONE guy freely admitted, "I did it to myself, it's my own damn fault". Most hid behind some excuse like "my Dr. never told me to quit", or "no one ever told me they were a health hazard", both of which are usually complete BS.
Warning labels came out in 1966, and they were commonly referred to as cancer sticks long before that. The entire industry is full of deceptive, amoral misanthropes. Smoking as a costly health problem far exceeds the costs of ALL other drug related problems combined, legal or illegal. That is completely ignoring the social and personal costs.

 

[pepperbelly]

Using that estimation I should be around 532 l/min. I checked on the peak flow meter and I blew 550.