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Pulmonary test results - anyone knows how to read it ?

Discussion in 'Autonomic, Cardiovascular, and Respiratory' started by Dechi, Jan 16, 2018.

  1. Lipac

    Lipac Senior Member

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    @Dechi I used to order these and read them all the time. I liked exercise physiology, so it made sense to me.

    We did them mostly in office to assess asthmatics during a flare/bronchitis and after treatment of brochitis/ flu to see if continued therapy was needed.

    OR... To see if the asthma was improving with age ( childhood asthmas). Or getting worse with time though the patient didn't think it was. Or clearly related to a trigger ( during a cold only, after exercise only, etc)

    (I haven't don't them for 20 years.. just a disclaimer.)

    A lot of the interpretation of Pulmonary Function Tests depends on your age, size, conditioning and other factors ( known lung damage, history of Asthma, chest wall defects, smoking, etc).
    That usually gets programmed in beforehand.

    You probably know the main thing they're looking at in asthma is your FEV1. Below 75% generally means some active asthma.

    If testing to diagnose the possibility of Asthma, FEV1/FVC should be normal- that's how big a breath you can possibly take, compared to how much and how far you can blow it out.

    Yours is a little low- could be effort that day or a small amount of Asthma that lingers around that you aren't aware of.
    Best to ask the Dr who ordered it, since he knows why he had you do it- what he's looking for.

    Without meds or illness...?... I suppose they are looking for how well you are doing compared to a past test, or if you need meds changed or added ( why would they test you without meds anyway? It's generally done pre-inhaler then post-inhaler... See those pre and post columns?)

    Anyway, isolated restrictive disease is a different problem from asthma. It indicates some external compression or " restriction" of otherwise normal functioning lungs-the air gets in and out, just not the amount there should be for age, size, conditioning.
    It can be a chest deformity ( that's what mine shows) , scar tissue or inflammation around the outside of the lungs , a muscle problem like in ALS... Not a problem within the lungs themselves.
    In restrictive The FEV1 can be normal but the TLV or FVC is lower than expected .

    Obstructive is anything that makes forcing air out normally, reduced/difficult. It can be mucus plugs, asbestosis, the spasm of the small airways in asthma, or lung damage from many things.
    The Lung volume TLV can be normal ( typically in Asthma) but the ability to FORCE the majority of the air out in 1 second is reduced ( that's FEV1).

    COPD, lung surgery, miners lung, can be both obstructive and restrictive but that's another topic.

    You have excellent lung volume.
    Your ability to FORCE the air out is somewhat reduced, but without knowing what else was going on that day, it's hard to say if it is really good for you, average for you, etc.
    Were you recovering from a cough or cold? Did you come down with one the next day? Were you inhaling dust recently? Smoke?

    About the best from an isolated test with no other history is, you have normal lung capacity, and moving air is maybe hindered a bit by either effort, or a bit of Asthma.

    The flow rates have more to do with other complex states, like COPD, Asthma recovering from pneumonia or smoke inhalation, worsening of muscle diseases like ALS.
    They're scientific but don't have a lot of clinical significance in general in patients without complex lung conditions.

    I noticed there aren't any tests that measure expelled O2/CO2. Maybe those tests aren't included now.
    It was an indicator of how much oxygen you were absorbing from deep breaths, and how much carbon dioxide you were able to get rid of.
    That indicates scarring of the lungs or chronic mucus etc that plugs the alveoli and reduces actual lung function( the tiny air sacs where carbon dioxide and oxygen are exchanged between the blood and the airways).

    My dad's lungs worked great- he'd been a coach. He felt ok. But he'd been scarred by asbestos in the Navy. No one found it till his late 60s.
    He didn't exchange quite enough oxygen and carbon dioxide. It probably contributed to his non Alzheimer's dementia, and inhalers didn't help because it was permanent scarring. As he got older, his body and brain didn't get as much oxygen as it could have. Still, he lived to 95, so.... :)

    Sorry if this was confusing.
    Not knowing your age or medical history, I'd say the tests look pretty good.

    Btw, no one gets an FEV1 of 100%.
    Your lungs need to retain Residual Air, or we'd all pass out and die from holding our breath for one second!
     
    Last edited: Jan 18, 2018
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  2. Dechi

    Dechi Senior Member

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    @Lipac thank you very much ! I’m glad to know this isn’t bad at all. I think my doc was just trying to find traces of COPD, if any. I am almost half a century (lol) and have a history of asthma since my 20’s.

    This day was just a regular day for me. No asthma, no cold (haven’t got a cold since getting ME), no dust inhaling. That’s just how I am everyday when resting. With any effort, it gets a lot worse. I am frequently put of breath from just standing up, bending down, walking a few steps, ect.
     
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  3. Pen2

    Pen2 Support, Good Medicine.

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    @Dechi and @Gingergrrl, there are many different tests. The FVC is your forced vital capacity. How hard and fast you blow out all the
    air in your lungs. That's why they keep saying, blow blow blow blow.....:lol: To make sure you get all the air possible out.

    There's one called a peak flow that asthmatics do at home on a peak flow meter.
    This one you blow out as fast and hard as you can. They determine your best and mark the meter.

    Then each morning and evening you do it and if it drops lower than your mark than your asthma could or is acting up. You do a bronchodialator then wait a few minutes do your peak flow again to see how much it improves.

    If it doesn't improve, Then you try again 4-6 hrs later and watch it. If it doesn't get better time to call the doctor.

    Dechi, Do you use one? It's an important tool for asthmatics. I think you said your asthma has been fine.

    That's it for today, I'll explain a different one if you want tomorrow.

    I'm going to have to rack my brain to remember some of them there's so many. Interesting enough, the reason I had to stop working was because I couldn't think fast anymore. What was always second nature didn't come to me anymore.

    A Respiratory Therapist has to be a quick thinker since we're the airway, many times in emergencys.

    Talk to you soon, @Dechi let me know if there's anything else I can help you with.

    You too GG.
    Hugs,
    Pen2
     
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  4. Pen2

    Pen2 Support, Good Medicine.

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    I just noticed @Lipac gave you a really nice thorough explanation. :rolleyes::thumbsup:. I didn't see the full test results till just now.

    Not bad @Dechi :)
     
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  5. Dechi

    Dechi Senior Member

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    Yes, I must say I’ve been lucky having knowledgeable people like @Gingergrrl, you and @Lipac look at my results ! :)
     
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  6. Lipac

    Lipac Senior Member

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    I didn't exactly mean it wasn't bad at all...COPD can come crashing down without much warning except shortness of breath and cough. It's irreversible.

    Long history of Asthma is a risk factor for COPD.
    I'd say you have a good Dr. if he's following your asthma for progression to COPD.
    I'd see him regularly, and follow up every attack or infection.

    Asthma's no joke.

    I can't lift my arms or legs at times, or sit up. Climbing the stairs feels like I have heavy ankle weights on. I feel exhausted every morning.
    I'm 60.
    My lung capacity is smaller than normal and I don't work out.

    But I'm never short of breath.

    So...Please keep an eye on it.
    ( Preaching to asthmatics who waited too long to come in was my life... Sorry if I sound preachy).
     
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  7. Dechi

    Dechi Senior Member

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    @Lipac thank you for clarifying ! :)
     
  8. Gingergrrl

    Gingergrrl Senior Member

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    @Lipac In your experience, had you ever seen someone to have pulmonary restriction from muscle weakness of the diaphragm (or other breathing weakness) due to autoantibodies?

    The FVC score is what was always low for me and I was told I had a restrictive pattern on every single test (even though my most recent FVC was 84% vs. prior tests in the upper 60's to low 70's).

    Thanks @Dechi and I am not sure how much I really contributed but it is sweet of you to say!
     
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