Expert: Kevin Smith - 8/21/2009

Question
QUESTION: I am 33 years old and have been having a lot of chest infections lately, three courses of anti-biotics that still didnt clear it up. My doctor sent me for a chest xray that showed up bronchitis. He put me on a Symbicort inhaler but he changed it to a flixotide evohaler after Symbicort caused a lot of headaches. Is it possible to become asthmatic at my age or it is the start of copd? (Yes, I do smoke and have done for the past 20 years).

ANSWER: Hi Siobhan,

Yes, it's very possible to become asthmatic at your age. The prevalence of asthma across all age groups has climbed in recent years, but the ratio of late-onset asthma has been one of the fastest-growing areas.

Did your doctor do breathing tests with you ( a spirometry test )? Were you, in addition to your Symbicort and later, Flixotide, put on a 'rescue' inhaler such as albuterol or salbutamol ( commonly called Ventolin ), and, if so, does it help to that inhaler much when you're feeling an attack?

Diagnosing between COPD and asthma can be a bit tricky at times - from what you've said so far, it could still be both, but irregardless, and as I'm sure you've heard before, decreasing, or ideally stopping, smoking would be a huge benefit.

Take care!



---------- FOLLOW-UP ----------

QUESTION: He did a breathing test, but he never mentioned the name of it. I had to breathe hard into a tube. The Flixotide does help more than the Symbicort, but not really when I do get breathless. My son is on a ventolin inhaler and I have been so tempted to use it when I do get breathless but I am afraid to. I did get a scare when I first started with the breathing difficulties and I have cut down to a milder cigarette and only smoking half the ammount that I used to. I do hope to give them up altogether in the very near future.  

Answer
I would be tempted next time you're at the dr. to ask about having a rescue inhaler on-hand for when you feel breathless. It may be very helpful, or only mildly depending on what is really going on in your chest, but if your dr. is willing to prescribe it, it would be worth a shot.

Congratulations on the smoking decrease! You're taking a great step in the right direction for whatever breathing issues you're having - asthma or not.

I have several friends with asthma who smoked who are now trying the 'electronic' cigarettes too - perhaps they could prove to be a useful smoking-cession aid.