Question: I have a question regarding Small Airway Disease
18 years ago I took the first of 7 PFT's, the last in 2016. All have been similar, basically normal but with fluctuations in PEF 25/75 and PEF 50. The albuterol part of the test raised the FEV1 by roughly 10% and the PEF 25/75 went up 37% and the PEF 50 went up 24%. This occurred when I had the broncho test given in tests 2 and 3 also I will give the last test numbers a bit later.
I have had chest xrays that show normal
I have had a CT last January that showed no Lung disease but it had the early stage of Lung Cancer showing. That was removed in a robotic method lobectomy. The Dr stated no signs of emphysemous changes
I had chemo and a new CT and still no signs of lung disease.
Because of my personal life, i have relocated and because of that I have seen several Pulmonologists. I have heard about very mild Copd, Bronchial Asthma, Asthmatic Bronchitis, and Asthma. In there, Exercise Enduced Asthma.
I also have Generalized Anxiety Disorder. One pulmonologist has made a distant connection of Anxiety to the inflammation of my small airways and has commented that if i let my persistant state of anxiety regarding my breathing difficulties relax, so will my breathing difficulties.
Now some of my life since I stopped smoking 18 years ago.
I used to ride a bike 75 miles a week until i took care of my mother as she died of copd.
I had lost 3 siblings raising my anxiety as I had to bury all.
I went through 2 divorces, found I had lung cancer. now its possible bone cancer.
I want no sympathy but I want to know if the Anxiety Mediators as one pulmonologist called them can actually act on the allready inflamed airways. I am a bit confused to inhalers also. I have been prescribed the albuterol rescue and a corticosteroid and had been given a Laba Advair. Nothing ever happens when I use them
Here is the last PFT, numbers are the % of predicted for my age
FVC 112%
FEV1 98%
FEV!/FVC 74%
25/75 62% 99% after test
50 70% 94% after test
TLC 117% Slightly high
RV 103% OK Range
DLCO 99%
RV/TLC 31%
DLCO/VA 107%
With this info, what thoughts do you have regarding my Lungs and Small AIrways. I forgot to include that in the past 3 years, i feel like I have a tighter chest and a upper lobe area reduction in inspiration but was told that the whole lung fills at the same time so not one portion fills first then stops because of an obstruction.

First I want to thank you for taking the extra time to read my tome or novel that I wrote, and to think it over carefully. That says alot.
Yes you are right, all agree it is small airways,

I now wish to openly say that I kept one thing back to see what your response would have in it. I apologize but I didn't want another physicians diagnosis to pollute your thoughts.

What I kept back was that the last 4 pulmonologists who know nothing of the others have said the same thing, NO COPD. Two of the four did say it would help my breathing if I exercised more like i used to because it would make more efficient use of oxygen, heart and lungs if I did exercise.

SO I wish to thank you for your help, I will move to the LABA, Is there any that are/contain small enough particles of medicine to fully reach the small airways or should I use the rescue inhaler each morning and let a few minutes pass to let airways relax to let advair get farther in?