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Sandy9s
Senior Member

USA
629 Posts

Posted - Oct 08 2012 :  10:01:23 AM  Show Profile  Reply with Quote
When I was doing Pulmonary Rehab, the one "trainer/technician" did my breathing test both before I started the program and after I completed the program. I took the before and after tests to my Pulmonologist at my next appointment, he looked at the papers and said that they must be wrong because with these numbers, I'd be dead. And I was (and am) very much alive. How often are these tests performed inaccurately? This particular guy never did do a "good" test on me during my 3 different years of Pulmonary Rehab. Obviously, he didn't know how. I'm now doing Silver Sneakers 2 times a week.
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PennyPA
Contributing Member

USA
5932 Posts

Posted - Oct 08 2012 :  1:02:53 PM  Show Profile  Reply with Quote
Actually, it's up to you to make the test good or bad. Granted, a technician can encourage you when you blow, blow, blow but if you don't put forth your best effort, even the best technician won't help.

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You can’t change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: You’re still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Jturbo
Rookie

2 Posts

Posted - Nov 14 2012 :  3:32:34 PM  Show Profile  Reply with Quote
Hi All,

A little background on me. I am a 28 year old male, parents smoked in out house up until I was around 12. Then I picked up the habit at 15 (stupid I know). I was an everyday smoker for about 10 years then just socially. I did not smoke more than around 10 a day unless it was the weekend and I was out. I was diagnosed with Asthma around age 8. Within the last month my breathing has gotten terrible. I have always coughed up mucus but this is different. I am constantly short of breath even sitting and upon any exertion I get winded very quickly. My heart rate is over 100 resting and sky rockets to 140 with just walking. I seemed to fit all of the COPD symptoms so I started researching. I had a PFT done and below are the results.

Pre Bronch – Post Bronch -
FVC(L) Actual – 5.78 Pred. – 5.10 % 113 FVC – 5.84 %114

FEV1(L) Actual – 4.03 Pred. – 4.26 % 94 FEV1 – 4.88 %114

FEV1/FVC Actual – 70 Pred. – 84 % 82 FEV1/FVC – 84 % 21

DLCO Actual – 44.91 Pred. 32.52 %138

I realize that my results point strongly toward asthma, but I have been on four rounds of antibiotics and nothing is clearing this up. My pulmonologist basically said there is nothing other than Asthma going on but I explained that I have had asthma all my life and I have never felt like this. I feel like there is a weight on my chest 24/7 and I can’t get a good breath. I have chest and upper back pain all of the time. I feel like when I use inhalers or a nebulizer it helps for a bit and then I am right back to fighting for air.

I was wheezing very heavily during the pre bronch test so that is why there was such a change between the pre and post. If it had been done when not wheezing I am sure there would not have been such a difference.

So group, what do you say? Should I accept the just asthma DX or look further into COPD?
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GaGirl
Senior Member

605 Posts

Posted - Nov 14 2012 :  4:40:06 PM  Show Profile  Reply with Quote
I can only tell you that with your excellent FEV1 you surely don't have emphysema.

Did he give you a treatment course to try and get the asthma under control? (I don't know anything about asthma but there'll be people here who do.)
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Jturbo
Rookie

2 Posts

Posted - Nov 14 2012 :  5:02:03 PM  Show Profile  Reply with Quote
I have been on Singular, Ventolin, Dulara and now Prednisone. For the possible infection I was on two rounds of Zithromax and now 3 weeks of Augmentin. Nothing seems to be helping and I am constantly SOB sitting or moving.

I did have a CT scan which was clear and my peak flow is between 650-790 depending with an FEV1 of 3.9-4.9.

I have an O2 meter which is always at 98-99% even with the SOB. My heart rate on the other hand will go from zero to one hundred with the slightest movement, ie. rolling over in bed etc.

Edited by - Jturbo on Nov 14 2012 5:37:20 PM
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Dave-OH
Administrator

USA
4372 Posts

Posted - Mar 22 2014 :  9:17:50 PM  Show Profile  Reply with Quote
They seemed to have changed the standard.

In GOLD COPD, classifications are then used to describe the severity of the obstruction or airflow limitation. The worse a person's airflow limitation is, the lower their FEV1. As COPD progresses, FEV1 tends to decline. GOLD COPD staging uses four categories of severity for COPD, based on the value of FEV1:

Stage I ----- Mild COPD ------------- FEV1/FVC<0.70 or FEV1 > 80% predicted
Stage II ----- Moderate COPD --------- FEV1/FVC<0.70 or FEV1 50-79% predicted
Stage III ----- Severe COPD ----------- FEV1/FVC<0.70 or FEV1 30-49% predicted
Stage IV ----- Very Severe COPD ------ FEV1/FVC<0.70 or FEV1 <30% predicted, or <50% normal with chronic respiratory failure present*

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
Your source for peer support and COPD Info


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Juli
Rookie

USA
15 Posts

Posted - Sep 16 2014 :  12:51:06 PM  Show Profile  Reply with Quote
Is a spirometry basically the same thing as a Pulmonary Function Test?
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PennyPA
Contributing Member

USA
5932 Posts

Posted - Sep 16 2014 :  2:24:48 PM  Show Profile  Reply with Quote
Spirometry is a "quickie" test, usually given in a doctor's office. It (spirometry) is also part of a pulmonary function test (PFT). If you have a choice, go for the PFT. Much more information for you and the doc.

****************************************************************
Do Not Regret Growing Older. It is a Privilege Denied to Many

You can’t change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: You’re still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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baber34
Rookie

USA
1 Posts

Posted - May 31 2015 :  02:02:03 AM  Show Profile  Reply with Quote
Hi All,

I have been suffering from pulmonary ailment for almost 5 years now.I have been smoking since the age of 14 and now i am 34 years old. I have been a heavy smoker most of my life and have smoked between 1.5 to 2 packs a day .

I have suffered from " gerd" since i was only about 18 years old.I found it very difficult to follow the strict precautions advised by doctors since i was too young and carefree at that time.I had a bout of pnemonia or bronchitis 5 years ago when i was coughing sputum everywhere but was unwilling to go to a doctor , thinking that it must have had something to do with " gerd" . I had a good reason to believe this because i had been to the " er" recently due to palpitations, chest pain and also pain on the left hand side.The doctors at " er" judging by my symptoms were very convinced that i had a " heart" issue but later discovered after complete testing that it was " gerd".

I was having sputum almost everyday at that time followed by severe fatigue but i ignored it thinking that it must be " gerd". I went for a routine check up to my gp who discovered wheezing and gave me symbicort 80/4.5 and ventolin along with a referral to a specialist.When i visited the specialist, I had my 1st " pft" and i was around 29 years old . It was wierd that after i had the " pft" the specialist was very nervous when i visited him. According the pft i did not have a obstructive defect but a mild restrictive defect.He kept on staring at me which made me more nervous because prior to that i dint have any " lung" ailments and was not aware of anything at all.He was unable to make a firm diagnosis which got me even more worried.

I changed my pulmonologist and visited another one and he did the pft again 2 weeks after the first one . According to this doctor i had mild copd (emphysema). He gave me symbicort 160/4.5 and ventolin. I was even more confused as one doctor had told me that i had a mild restrictive defect based on spirometery and only 2 weeks after that a new specialist told me that i had copd.

Bottom line i gave up smoking but did not use any medications prescribed. almost 6 months after quitting smoking , My father who was going home had a severe heart attack on the aeroplane. We were informed a day later and my younger brother along with my rushed to qatar where luckily he was resusicated and luckliy survived.

During that period i was alone with my middle brother who was recently diagnosed with a bipolar disorder.He was pursuing his masters degree at columbia university but had to discontinue his education because of his newly diagnosed ailment.Due to the stress brought about by my fathers severe heart attack and with added stress of dealing with my brother who had recently been diagnosed with bipolar i restarted smoking.Even at that time i was having shortness of breath and sometimes even talking was difficult.

I visited my gp who gave me prednisone for 3 days and then scheduled me for another spirometery exam 2 weeks apart.The prednisone really helped me a lot and i got much better in 2 weeks.When i had the third spirometery surprisingly my fev1 was 87% and fvc was around 82% , My pulmo told me that i dint have an obstructive disorder but a mild restrictive disorder i.e scarring due to smoking.

I had started smoking again but now had new symptoms aside from shortnes of breath which got worst after eating or lying down especially when i had bloating or reflux symptoms. I also had severe muscle fatigue, insomnia and felt like i had absolutely no energy in my body whatsoever .I visited a new doctor who did a spirometery 2 years ago and my fvc was 80% while fev1 was 87% , I told him that i had chronic productive cough, In his opinion i had chronic bronchitis which had not developed into clinically recongnizable copd . I was also scheduled for sleep tests .I had 2 sleep study tests and one of them showed severe apnea while other was almost normal.I was given a cpap but i couldnt use it because of my nasal allergies , It was a full face mask and i tried severeal days but couldnt even sleep for one hour with the mask so i decided not to use it.

I have been very sick for almost a year , I am having severe muscle fatigue,dyspnea, i am tired all the time, i seem to have no energy in my body whatsoever. lot of sputum all the time even while talking on the phone and the voice is rarely not hoarse.

I recently had another spirometery done almost 4 weeks ago, Please kindly see the results below :-
ref pre % ref post %ref %chng
fvc 5.27 3.98 75 4.15 79 4
fev1 4.09 2.81 69 2.65 65 -6
fev1/fvc 77 71 64
fef 25-75% l sec 4.27 2.54 60 2.45 57 -4
isofef25-75% 4.27 2.54 60 2.59 2
pef 9.53 3.29 35 31
fet100% 2.95 2.51
fif 50% 2.57


lung volumes
TLC 7.05 5.17 73
VC 5.27 3.98 75
FRC N2 3.27 2.56 78
ERV 1.75 .24 14
RV 1.93 1.19 62
RV/TLC 28 23

Diffusing Capacity
DLCO 33.7 36.2 107
DL ADJ 33.7 36.2 107
DLCO/VA 4.46 6.25 140
VA 7.14 5.79 81
IVC 3.67

latest diagnosis from doctor copd ( asthmatic bronchitis). I asked the doctor if it could be emphysema as well but he thought it was unlikely because according to him diffusing capacity was normal.

But the fvc and tlc is also reduced and he doesnt have a convincing answer for that . I repeatedly asked him as to why i had so much muscle fatigue and no energy at all his answer was simple sleep apnea . I am exteremely confused and find it hard to believe that it could be only due to sleep apnea . My hands even start shivering now . I have come to the point that sometimes my neck muscles dont have enough energy to hold the neck and it falls down unless i put effort and their is pain even in my jaw muscles.
i feel as if i might have some kind of auto immune disorder as well but the dr doesnt seem to believe it .

I have a very bold decision to make , Either be confined in a 2 bedroom apartment with a brother who has bipolar and smokes all the time with little help from any one or go back to my country. I would like to choose the latter as i have a house in my county , there is plenty of space and even a few servants , my quality of life would be much better there as my father has a good business over there . I have the potential to make much more money over there as compared to here but my primary concern is how productive i will be there in my current state. I mean i cant be huffing and puffing and throwing sputum in a corporate environment. I am really double minded dont know what to expect from future.

I asked my doctor as to how my fev1 got down from 87% to 69% in 2 years and if it continued at this rate i would be done and dusted in 6-7 years , He told me that it was due to exacerbation. I requested him to give me a quick dose of prednisone but to no avail. For now he gave me symbicort 160/4.5 which hasnt helped a lot.Infact i feel that normal steam is more effective than symbicort.

Please kindly advise me for which act of kindness i shall be indebted to you . Please suggest me as to what i should do ? are all these symptoms normal according to my spirometery results ? could i be suffering from an auto immune disorder ? is there anything that i can do to reduce the sputum production ? i know i am asking a lot of questions . I would be very grateful to you for your help



baber
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palmsFL
Rookie

USA
23 Posts

Posted - Mar 17 2016 :  09:06:12 AM  Show Profile  Reply with Quote
I just got my PFT results and there are no numbers so I am confused. Mine says:
1. The flow volume loop has an obstructive contour.
2. The diffusion capacity is reduced.
3. The lung volumes show minimal increase in the RV and FRC.
4. Spirometry shows reduction in the forced vital capacity and the FEV1 and the FEV 1% with a significant bronchodilator response of 16% in the FEV1, from 1.68 L to 1.94 L.

Impression: Pulmonary function testing consistent with moderate obstructive airways disease suggestive of emphysema with minimal air trapping and a significant bronchodilator response.

Can anyone explain? Saw my internist who offered two inhalers to do daily but I asked about side effects (I am so very sensitive to all medications) and he said if I am ok with it we could wait and he gave me a rescue inhaler. Should I have started the other inhalers?
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Dave-OH
Administrator

USA
4372 Posts

Posted - Mar 17 2016 :  12:13:39 PM  Show Profile  Reply with Quote
So you have some asthma components (number 4) and moderate COPD. Probably in the range of FEV1 of 70 to 90%.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
Your source for peer support and COPD Info


My Site: http://lungresources.com
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palmsFL
Rookie

USA
23 Posts

Posted - Mar 17 2016 :  12:30:46 PM  Show Profile  Reply with Quote
Does that make it worse the asthma component? I know the PFT tech said I had a score of 78 which meant she had to give me the med because it had to be above 80 and then it improved.
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jmrommes
Contributing Member

2159 Posts

Posted - Mar 17 2016 :  8:18:11 PM  Show Profile  Reply with Quote
No, actually, that's better because you show a positive response to the med, which means that your breathing improves after you take the inhaler or breathing treatment. As for other meds, I agree with Penny. Take them and don't worry about the side effects unless you actually have one. Most people don't, so don't borrow trouble, and I suggest you don't even look at them until something seems off, because often if you know what they are, you can convince yourself that you have every one you read about and some you didn't! Taking all meds is a trade-off: you trade the positive effects of the med for the potential side effects because the positive effects outweigh the potential negatives.

Exercise not only lets me live, it enables me to have a life.
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palmsFL
Rookie

USA
23 Posts

Posted - Mar 17 2016 :  8:50:16 PM  Show Profile  Reply with Quote
jmrommes I am super sensitive to all meds so that is why I try normally to avoid as much as possible. I still don't understand why I should take inhalers if I am not having trouble breathing at this point? Maybe I am dense and not getting it but I don't understand.
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