Brief Answer:
follow the advises.. maintain a healthy lifestyle..

Detailed Answer:
Hello XXXXX, welcome to HCM,

I've gone through your query and understand your concern,

First of all, please note that effect of chronic smoking (at least 20 yrs of exposure) causes such changes like emphysema (even in cases of mild, it takes years to develop)..and it takes several months (duration varies from individual to individual) for the body to change accordingly from it's adverse effects..

Yes, your right, mild emphysema can certainly be stopped after complete cessation of smoking as well as long term treatment management by the pulmonologist..

Good that your already on ventolin, please continue it, it'll provide you long term benefit..

The early morning breathlessness will take time to go (even another few months, it depends on your body's overall response to the current therapy, environmental pathogen level, overall allergic status and several other variable factors..)

Please discuss with your doctor regarding a comprehensive allergic panel testing for you, as it'll give a complete list of the objects to which your allergic primarily, thus will make the further management easier and more specific..

Try to install air purifier with humidity controller in your bed room, it's extremely helpful in reducing the number of pathogens and also controls the early morning humidity (it generally gets dried with a significant rise in the level of pollen and other allergens and pathogens in the air..)

For the time being start taking simple steam inhalation three to four times a day, mainly after getting up..before going to bed..

Alternatively saline nebulization can also be tried on routine daily basis..

If breathlessness is getting better this should be enough along with ventolin but if you notice it's not improving then there'll be a need to start low flow intermittent home Oxygen therapy(via nasal prongs)..this'll provide you a lot of relief from those intermittent breathless spells, please discuss them with your doctor..

Let me know if your having any further queries, I'll be glad to clarify..

Take Care
Kind Regards

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Brief Answer:
No need to discontinue it abruptly, as pain has to be controlled too..

Detailed Answer:
Hello XXXXXXX Welcome back,
Thanks for sharing the vital info,

Neuropathy is an extremely painful condition, thus it has to be kept under control too, I'd suggest reduction of the dosage to half the current dose and observe for next 48-72 hrs how you stay, if you observe significant improvement just because of this, then it's confirmatory of gabapentin induced, in that case alternative regimen/ dose modification can be planned accordingly..

However, I doubt this is the cause simply because the patho-physiology is different behind this, so I'd suggest you try the above mentioned approach and observe how you stay, meanwhile if you notice any further increase/worsening of the breathing- please don't hesitate to start implementing all of the previously mentioned(in the first reply) advises, it's for the long term benefits only..

Please also discuss the same with your doctor, he/she has to be kept informed as I don't have the privilege to examine you clinically..

Let me know how you stay in the due course..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

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