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 DLCO Testing
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Joe - Tx
Rookie

21 Posts

Posted - Oct 29 2006 :  8:32:37 PM  Show Profile  Reply with Quote
What is the importance of DLCO testing?
Since my fev1 dropped to 20 % and I went on O2 3 years ago none of my medical support team - Hospital & ER, 2 Pulmos. Cardo and PCP have recommended having it. Obviously it is important. Perhaps mine is such a obvious case of typical COPD that they do not feel it is necessary. Any opinions?

Joe - Tx

Dave-OH
Administrator

USA
3421 Posts

Posted - Oct 29 2006 :  9:00:35 PM  Show Profile  Reply with Quote
Joe DLCO measures the exchange of O2. They use CO (carbon monoxide) to test the ability to defuse gas between the lung and blood. Since you are on O2, your DLCO is compromised to the point that you require a higher degree of O2 than in air.

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PennyPA
Contributing Member

USA
4731 Posts

Posted - Oct 29 2006 :  10:34:57 PM  Show Profile  Reply with Quote
Joe, the DLCO is part of a full PFT testing. There's not much one can do about a low DLCO, I don't think. If your sats are good yet you're still sob, oftentimes, but not always, you'll find a low DLCO for the reason Dave mentioned above. Mine is lousy.

****************************************************************

You canít 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: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS





Edited by - PennyPA on Nov 07 2006 9:06:09 PM
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Z-IN
Moderator

USA
22 Posts

Posted - Oct 30 2006 :  11:37:42 AM  Show Profile  Reply with Quote
Your DLCO numbers are also taken in account when applying for SSD. My last full PFT was done a few years ago and only spirometries have been taken since. At the last full PFT my numbers were in the high 40's which is really low. DO NOT quote me on this but I believe I was told a few years ago the DLCO numbers help distinguish between restrictive and obstructive pulmonary problems. I have an appointment coming up on the 8th and will ask.

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lenal
Rookie

19 Posts

Posted - Oct 30 2006 :  1:48:50 PM  Show Profile  Reply with Quote
Here's a portion of an article on the DLCO question, you can read all at the link if interested further:


http://www.findarticles.com/p/articles/mi_m0984/is_2_125/ai_113852541
snip

Measurement of the diffusing capacity of the lung for carbon monoxide (DLCO) provides information regarding pulmonary gas transfer, and is an important and widely used pulmonary function test (PFT). A reduced DLCO often signifies a pulmonary parenchymal or vascular disorder, and the clinical implications of a low DLCO are well-recognized. (1) Polycythemias as well as some physiologic variations like the Muller maneuver and exercise are known to increase the DLCO. During the routine measurement of DLCO, an adjustment for hemoglobin levels is applied and other physiologic variations are usually avoided. (1-3) A high DLCO has been described in some clinical conditions such as asthma, obesity, and left-to-right intracardiac shunt. However, some studies (4-9) have shown conflicting results, and no large study has defined the relative frequency of these various conditions as a cause for a high DLCO. The use of DLCO for the diagnosis of pulmonary hemorrhage in Goodpasture syndrome has been described, (10) however, in clinical practice not many patients with pulmonary hemorrhage may undergo pulmonary function testing at the time of bleeding. A low DLCO on a PFT sets forth the search for a cause. Should the same be true with a high DLCO? The present study was designed to define the relative frequency of the clinical diagnoses associated with high single-breath DLCO values.


end snip


lenal
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berwyn
Rookie

6 Posts

Posted - Oct 30 2006 :  7:33:03 PM  Show Profile  Reply with Quote
quote:
Originally posted by PennyPA

Joe, the DLCO is part of a full PFT testing. There's not much one can do about a low DLCO, I don't think. If your sats are good yet you're still sob, oftentime, but not always, you'll find a low DLCO for the reason Dave mentioned above. Mine is lousy.



Penny- I thought that air trapping was the cause of SOB when the sats are in the 90s.

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PennyPA
Contributing Member

USA
4731 Posts

Posted - Oct 30 2006 :  8:01:39 PM  Show Profile  Reply with Quote
Yes, it can be. The air is trapped in the alveoli...and the alveoli isn't able to do the proper exchange...so it's a double-edged sword, sort of.

I just finished only 10 minutes on the TM with a sat of 94 and HR of 118...both within my "working range"...but I am so out of breath, I just had to quit. One problem is because by the evening, I just can't breathe well, period. That's why I usually do my TM in the a.m. I don't know why I do so poorly in the p.m. Tired lungs, I guess. Heck, tired body by the time I get home from work, LOL.

****************************************************************

You canít 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: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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MarthaK
Member

USA
35 Posts

Posted - Oct 30 2006 :  8:40:14 PM  Show Profile  Reply with Quote
Penny, I may be preaching to the choir here, but do you use your albuterol 15 minutes before you start your treadmill? That will help. Another thing I think you should try is to hang in there just a little bit longer. I have found that once I get warmed up and have walked about 15 minutes, it begins to be a lot easier. I think that is due to breathing more deeply and increased circulation. MaryKY just recently discovered this, too.
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PennyPA
Contributing Member

USA
4731 Posts

Posted - Oct 30 2006 :  10:26:23 PM  Show Profile  Reply with Quote
Thanks for the suggestions, Martha. I usually do the TM in the a.m. before work and am 1.5 mph for 30 minutes. Usually no problem in the a.m. (except boredom...and the occasional interruption to visit the bathroom!) but in the p.m., even after a shot of albuterol, I just can't do diddly.

What happened tonight was that I was on for about 10 minutes, had to go downstairs to the bathroom, then back upstairs to the TM. My numbers were 92/108 when I got back on the TM but it was the sob that was getting me. So, after another 10 minutes, I was so badly sob (to the point of needing to bend over to breathe) I decided to quit for the night. I will do my regular routine tomorrow a.m.

I need to invest in one of those wrist BP cuffs because I do have to keep track of that, too. Oh, I wish I could retire and go to REAL rehab and let someone else worry about the numbers, LOL!

****************************************************************

You canít 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: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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MarthaK
Member

USA
35 Posts

Posted - Oct 30 2006 :  11:01:11 PM  Show Profile  Reply with Quote
Good grief, I would have quit too! After the stairs I would have been done.

Having someone else watching the numbers in rehab was great. When I finished rehab and was on my own, I felt like I had lost my security blanket.
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Carolyn-Mi
Administrator

604 Posts

Posted - Oct 30 2006 :  11:36:38 PM  Show Profile  Reply with Quote
Penny,
If you get one make sure it has the electronic pump. I have one that if very accurate but I have to pump it up myself and it takes forever. But then again that is good arm exercise I suppose.

COPD Support
http://www.copd-support.com
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starion
Member

USA
51 Posts

Posted - Oct 31 2006 :  02:11:37 AM  Show Profile  Reply with Quote
Actually, you can have SOB/breathlessness for varying reasons with a saturation rate >90, including asthma, allergies, being deconditioned, heart issues, and others. For me, it's generally NOT a saturation or heart issue.

By the way, Costco & many other stores have some very reasonably priced blood pressure machines that are battery operated--some of them record all your readings for quite a while (I think 30-90 of your most recent tests or something).
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SandyIn
Rookie

7 Posts

Posted - Nov 05 2006 :  1:49:56 PM  Show Profile  Reply with Quote
PennyPa....A little slow on responding to this but it is taking me a little while to navigate through all the topics. I have a small BP machine (Reli-On). Not very expensive. It is a two piece, small recording box with a arm cuff that plugs into it. On my treadmill I have a decent size display panel. I put Velcro strips on the bottom of the BP box and mated that to the strips I put on the TM. BP box stays in place while I walk, cuff is on the arm so all I have to do is push button to get reading. You just need to try and not have your arm juggling around too much. I also attach my cell phone and remote control to TM.
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PennyPA
Contributing Member

USA
4731 Posts

Posted - Nov 05 2006 :  4:02:36 PM  Show Profile  Reply with Quote
Colleen-PA lent me one she had bought at CVS. I'm just going to use it for a week or two to see just what my BP does as I'm exercising. For the few days I've used it, my BP stays pretty good...ranging from a 133/75 yesterday, after the steps and really sob down to a more normal 96/55.

****************************************************************

You canít 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: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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