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kolbe
Rookie
USA
3 Posts |
 Posted - Jul 22 2010 : 6:35:59 PM
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Hi all - a little background on me. I'm a 45 year old male who smoked socially during college...over 20 years ago. I may have smoked 1 pack a week for about three years. Is that enough to cause COPD? I was just diagnosed yesterday and I'm a little freaked out about this. I have six children ranging in age from two to 13, and as a parent many of you know how I feel.
I'm fairly healthy, although about 30 lbs. too heavy. I've been running for about 30 years now, off and on and have completed numerous 10k's, two half-marathons (one as recently as last December) and a full marathon. So, I'm not a couch potato, but I have been for the last couple of months due to how I've been feeling lately. I had what appeared to be a cold over the winter that would just not go away, and a mucus producing cough that seemed to last for a couple of months. By the time lawn-mowing season came around I would start mowing and have to quit every five minutes or so because I was so worn out. It started taking nearly twice as long to mow. Anyway, I chalked it up to allergies because they can wipe me out in the spring and early summer. After awhile I started getting very tired all the time, the cough disappeared and I went to the doctor after having a couple of scary wheezing, shortness of breath episodes which again I attributed to allergies.
My family doctor scheduled me to have a PFT done. I had my PFT a couple of days ago and had a couple of questions. My FEV1/FVC% is 69, which puts me at stage 1 for COPD. I am wondering if there is an asthma component to this - the reason I'm asking is that the woman who performed the test didn't do a post-bronch test. From what I've been able to gather so far from my limited research if a bronchodilator is used and there is no change in the numbers, that would indicate COPD, right? Had there been a change of 15% or more in the FEV1 or FVC, or the FEF 25-75 increases by > 30% that would indicate asthma, correct?
In addition I'm showing an obstruction with hyperinflation with a normal (actually increased) DLCO which from what I've read shows asthma. My diffusion capacity percentages are all over 100%.
I'm also showing what appears to me to be conflicting diagnoses. One doctor wrote,
"The FEV1/FVC ratio is reduced and there is curvature to the flow volume loop. The MVV is with normal limits. The normal airway resistance and decreased specific conductance indicate a peripheral or small airway disease. The TLC, RV, FRC and RV/TLC ratio are all increased indicating overinflation and air trapping. The diffusing capacity is nomral. However, the diffusing capacity was not corrected for the patient's hemoglobin."
"Conclusions: Minimal airway obstruction and overinflation are present. Although bronchodilators were not tested, a clinical trial my be helpful to assess the presence of a reversible component."
"Pulmonary Function Diagnosis: Minimal Obstructive Airways Disease"
That was one interpretation from the doctor at the place where I had the test done. The one who made the final determination (at a different doctor's office) wrote: "Findings: Spirometry demonstrated mild airflow obstruction based on a depressed FEB-1/forced vital capacity ratio. He has small airway dysfunction also noted. He has a normal MVV. He had normal lung volumes. He has a normal diffusion capacity. He had a normal airway resistance. Assessment: THIS PATIENT'S PFT DEMONSTRATES MILD AIRFLOW OBSTRUCTION. Clinical correlation is required.
Are these two assessments/diagnoses the same thing and are they denoting COPD? I apologize for this being so "windy" (ha ha) but I can't seem to get a good answer from anybody. My PCP said it was COPD, but the lung doctor receptionist said that they couldn't tell me what it was, and that I should call my PCP, even though I read the same assessment to her from her office as listed above! It's all very frustrating and I've only just been "diagnosed". |
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PennyPA
Contributing Member
USA
1564 Posts |
Posted - Jul 22 2010 : 9:57:23 PM
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Call your pulmo doctor and ask him just what it is you have. Since you are so young, also ask him to take blood for an alpha one test which will indicate if you have the inherited form of copd. Be firm about this since there is a different treatment program for that.
I am not good at reading or interpreting PFT's unless they show a decreased FEV1 which usually indicates copd. According to the interpretations by the various doctors, you have mild airflow obstruction but at that stage, you shouldn't be having such noticable symptoms.
And, if your doc says you have copd, ask him what "brand" of it....emphysema, chronic bronchitis or what? And don't get too uptight about it yet. I was diagnosed when I was 43 and I'm still around at 68...traveling around the country in our RV.
There is nothing (yet!) to "cure" copd; the meds we take are to alleviate and control the symptoms (coughing, tightness in the chest, shortness of breath). So hang in there...find out just what the pulmo doc says you have (it's not up to the PC to tell you) and treat any symptoms you might have. You'll live to see your youngest graduate from college and start his/her own family. |
Penny's LVRS Blog
And Our Travel Blog After LVRS
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Dave-OH
Administrator
USA
1226 Posts |
Posted - Jul 22 2010 : 11:45:00 PM
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| You have a mild obstructive lung disease, and it could be asthma. The two highlighted items are consistent. I make this statement based on what is in your post. |
Dave, Forum Administrator
COPD Support, Inc.
http://www.copd-support.com/
Your source for peer support and COPD Info |
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majseventh
Senior Member
USA
414 Posts |
Posted - Jul 23 2010 : 02:16:34 AM
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"From what I've been able to gather so far from my limited research if a bronchodilator is used and there is no change in the numbers, that would indicate COPD, right?"
No, that would indicate that there isn't asthma on top of the COPD.
" Had there been a change of 15% or more in the FEV1 or FVC, or the FEF 25-75 increases by > 30% that would indicate asthma, correct?"
Yes to the increase in the percentage of FEV1, that would indicate asthma, but they didn't test you for that.
Ask your doctor to schedule the test for the "Conclusions: Minimal airway obstruction and overinflation are present. Although bronchodilators were not tested, a clinical trial my be helpful to assess the presence of a reversible component."
The reversible component is asthma.
If you have had allergies and the wheezing you could very well have asthma in addition to the COPD (Chronic Obstructive Pulmonary Disease) or the mild obstructive lung disease.
69% is not too bad and you have caught it very early.
That is good.
I also have asthma with emphysema (COPD)
I am at 46% and you are a long way to that.
So, relax and learn all you can.
Get your flu shots and pneumonia shots.
Welcome to the group.
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CaseyCA |
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kolbe
Rookie
USA
3 Posts |
Posted - Jul 23 2010 : 09:40:26 AM
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Thanks for the very informative responses. I spoke to the young lady who did the test to ask her why they didn't do a post-bronch test. She said it was because my FEV1/FVC number needed to be below 80 or 81, it was at 87 (whatever the number is in the far right column; I don't have my test in front of me).
I've already contacted a hospital that tests for the alpha one antitrypsin deficiency. They are offering the test for free and are sending me a test kit. Not too keen on being on some super secret list with my DNA under supposed lock and key.
I've also scheduled an appointment to sit down with the family doctor to discuss the test results. Majseventh, my interest is peaked by the statement "reversible component".
Finally, I don't feel too bad during the days here lately. I cough a few times a day, it's usually unproductive and I feel the occasional shortness of breath. Nothing too bad. I wonder if I'll be able to run again. That would be something that I would definitely miss. |
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PennyPA
Contributing Member
USA
1564 Posts |
Posted - Jul 23 2010 : 10:22:18 AM
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Just for the heck of it, Kolbe, if you have the insurance that will cover it, why not ask for a ctscan? Tell your doc you want one for a "start" place. There are other diseases that can cause sob and a cough (including the asthma Casey was talking about) and you might want to rule them out.
And when you were doing your running, were you also doing weights (well, not at the same time, of course....:-)? Weights, especially upper body weights, will help strengthen our chest muscles and other breathing muscles. Running is good for legs and aerobic but I don't know what it does for upper body. Uh, losing those 30 pounds might make a world of difference, too <hint><hint> :-) |
Penny's LVRS Blog
And Our Travel Blog After LVRS
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tsainta
Member
41 Posts |
Posted - Jul 24 2010 : 12:11:29 AM
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| Two cents worth: if you really want a credible evaluation, ask for a referral to a pulmonologist if one is reasonably available to you. |
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kolbe
Rookie
USA
3 Posts |
Posted - Jul 24 2010 : 10:49:53 AM
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quote:
Originally posted by tsainta
Two cents worth: if you really want a credible evaluation, ask for a referral to a pulmonologist if one is reasonably available to you.
Thanks. I will definitely look into that. |
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PFT questions
