There are two widely accepted "staging" tools used for COPD.
One is by the Global Obstructive Lung Disease (GOLD)
and information can be found here: https://goldcopd.org/wp-content/uploads/2018/11...

The other is the COPD Foundation's COPD Pocket Guide that can be found at www.copdfoundation.org. Just put Pocket Guide in the search tool and you'll get there. Both staging tools have been around since about 2005 or so.

Initially, the "staging" was designed to help docs who aren't pulmonologists, but primary care docs, know what the best alternatives for meds are for their patients who also have COPD and may not have access to pulmonologists. They weren't designed for patient at all, but over the years, the Foundation has understood that patients are interested and often know more than their docs about new meds, O2 delivery systems and a variety of other things and are very interested in what "stage" they're at. Staging usually depends on FEV1 values and exacerbations per year.

In reality, and any of the docs associated either with GOLD or the Foundation will readily agree, the staging is just a guide and may lead to good choices for meds, but the important thing is what the person with COPD can do and how they feel. Staging shouldn't define the patient. Technically, I'm a stage 3 or a C, depending on which tool you use: my FEV1 is in the mid-30s and I usually have two mild exacerbations a year. In reality, I feel good most of the time and even when I do have a bug, it doesn't usually impede my activity level. I use O2 for most activities. However, I fly somewhere around 30 times a year, work part-time, and do a lot of COPD advocacy work, including attending major conferences, speaking, working with various groups and spreading awareness.

How people respond to COPD is very individual, both medically and personally. Some of us can figure out how to continue what we've always done and do it. Others find that more difficult because of their response to the chronic condition. People in the very early stages of COPD sometimes can't do what people at stage 4 can do. Staging is helpful in that it increases knowledge; but it can also be limiting if you make the assumption that, "Oh, I'm stage 2, so I should be able to do this, but not this." So treat it as another tool in your toolbox, but not the defining one.

1 2 3 4 or a b c d stages are same one on alphabetic other on n.basis

You do have a bunch of things going on, and it's not going to be easy to sort it all out. First, many adults who experience asthma as adults find that their asthma does lead to COPD and we are learning that there are many people who have experienced this. Part of the "newness" of this is that with better meds, people with asthma are living longer; most didn't survive to be 60-70 30 years ago. That's one of your issues. There are studies being conducted by the COPD Foundation and other research entities regarding the COPD/Asthma connection so it's to be hoped that we'll know more in the future.

The other issue you've brought up is the connection between the cardio and pulmonary systems. There's a reason it's called cardio-pulmonary; they're so closely connected that it really is hard to sort out just what's causing what. Your pulmonologist is saying you may have Secondary Pulmonary Hypertension the problem with the right side of your heart) ; the cardio doesn't know this.

One thing you might want to try is to find a doc who is experience with the total system, not someone who specializes in both. The other thing is to try to get your pulmo and cardio people to talk with each other and with you to try to sort it all out. At the least, you need to be sure that both of them get everything the other does: test results, procedures, notes, everything. If they're in two different health systems, you'll need to be sure to stay on top of this. Even if you give them permission to share, they won't always remember to do it unless you tell them every time.

It is possible to sort this all out, but you're going to have to manage the process. I wouldn't worry about being a pain in their asses......if they really object, find someone who will help you get to the bottom of it.

@A MyCOPDTeam Member
What you are saying totally applies to my issues , lucky for me my wife was able to convince National Jewish to accept me as a patient ,because their M,.O. is exactly as you describe my cardiologist and pulmonologist have been totally inter-active since day one Usually I can schedule most of my appointments and tests to happen in one day by scheduling 2 months in advance , it makes for a busy day but it means I am only facing the public 1 time every 3 months.

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A MyCOPDT...

@A MyCOPDTeam Member I appreciate your response. My search for information is leading me in so many different directions. About 11 years ago, a pulmonologist told me that I have Asthma, now the talk is only about COPD. I also feel that I am running into the age old practice of the cardiologist is saying most of my shortness of breath is a lung problem, and the pulmonologist is saying I have something going on with the right side of my heart. All I am wanting is some straight answers, what my problems are, what is the severity, what must I do to keep things from progressing faster than normal, my whole life I have met things head on, I want to continue to do this, but if I am not getting all the information, there is no way I can meet this head on. I do not mean to be a pain in the backside to my doctors, but I probably want more detailed information than most people, and I also realize that even some doctors have trouble talking about major problems with their patients.

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A MyCOPDT...