Is it COPD or Another Lung Condition? How Can You Tell?

Health Professional

In Part I we talked about how your doctor figures out if you have COPD or if it is asthma or pneumonia instead. Here in Part II we will discuss Pulmonary Fibrosis, Lung Cancer, Black Lung Disease, and also find out what was wrong with Jane's eye and how they figured it out.

COPD vs. IPF (Idiopathic Pulmonary Fibrosis)
Idiopathic Pulmonary Fibrosis is not an Obstructive Lung Disease like COPD (trouble getting the air out). It is a Restrictive Lung Disease (trouble getting the air in) involving stiffening and scarring of the lungs that leads to problems with oxygen getting into your bloodstream and around to the rest of your body. In IPF, a cough is often hacky, uncontrollable and dry, whereas COPD tends to produce mucous. "Idiopathic" means that there is no known cause. With most COPD, the cause is known. Because IPF is not a disease of the bronchial airways, inhaled medicines are usually ineffective.

Methods and Tests for Diagnosis
Health history, listening to lung sounds, Complete Pulmonary Function test, X-ray, Chest CT scan, Bronchoscopy (scope with tiny camera to look into the lungs), biopsy.

COPD vs. Lung Cancer
We all know that both COPD and Lung cancer can be caused by smoking, but the development of cancer is a totally different process than developing COPD. In cancer there is commonly a tumor that starts in one area and has the potential to grow and spread (slowly or very rapidly). COPD is caused by lung tissue becoming damaged or destroyed. It is found throughout the lungs and slow in its progression.

Methods and Tests for Diagnosis
Health history, listening to lung sounds, X-ray, biopsy, blood and/or sputum tests to check for cancer cells, Chest CT scan.

COPD vs. Black Lung Disease
Black Lung Disease (Coal worker's pneumoconiosis-CWP) is possibly the world's oldest known occupational disease. Whereas COPD can have a variety of causes,   Black Lung is brought on by something more specific - the accumulation of coal dust in the lungs, and the lung tissue's reaction to it. Depending on the type of dust and particles that have been inhaled, CWP can progress slowly or very quickly. Inhalation of silica and quartz dust are common causes of pneumoconiosis and can lead to severe scarring of the lungs.

Methods and Tests for Diagnosis
Health history, listening to lung sounds, High resolution Chest CT scan read by a person trained in recognizing Black Lung Disease, pulse oximetry, ABG (arterial blood gas).

You've probably noticed throughout these two shareposts on COPD vs. other lung conditions that Health History plays an important part in diagnosis. A record of your health history is taken when you answer questions about your health and tell as accurately - and briefly - as you can; about your environment, substances you've come in contact with, and what your symptoms are. Let's look at the end of my story and see how Health History solved the mystery.

At the beginning of Part I of this series, you came with me to see the eye doctor, the opthomologist. Some time after he left me with three possible causes of my blown pupil (when the black part of the eye becomes extremely large) - which were 1.Medication (pharmacological), 2.Adie Syndrome, or 3.Brain aneurysm - he and the nurse returned.

"Well, we think we know what it is." Smiling and giving the nurse a nod, he said, "She figured it out."

"Okay"" I said slowly.

"When you were on the cruise, did you wear a patch for motion sickness?"

"Yeah. And it worked great"

"Did you wash your hands when you put it on and took it off?"

"Well, I did when I put it on, and I did when I switched it to a fresh one after 3 days."

I paused. "Then, I wore the second one for 4 days. We were packing up to come home, I was in a hurry, and figured that after 4 days, it didn't have much medicine left on it. Uh oh"maybe I didn't wash them."

"Okay," he said, "That's probably it. The pharmacological cause - caused by a medicine. The motion sickness medicine can cause your pupil to dilate - even if only a tiny amount touches your eye."

I felt relieved, but foolish.

He went on. "I really think that's it. These things happen. Okay? It should resolve in a few days. Call me if it doesn't, or if you get a headache or see any other change."

Medical diagnosis involves a lot of science, yes, but it's sometimes also good old-fashioned detective work. Pay attention to your symptoms, be honest with your doctor and give a complete and accurate health history. And yes, follow the instructions on your medication package (Duh!). If you do, you and your doctor - your partner in health - will have a good chance of getting it right.

Jane M. Martin is a licensed respiratory therapist, teacher and the founder and director of http://www.Breathingbetterlivingwell.comand the author of Live Your Life With COPD: 52 Weeks of Health, Happiness and Hope and Breathe Better, Live in Wellness: Winning Your Battle Over Shortness of Breath.