COPD

[rt44]

i was wondering if you could help me out with the interpreting my test results

Age 63 - quit smoking 3-1/2 years ago - no meds

Pre Drug Post- drug
Sprirometry Actual Predicted %PRED Post %PRED %CHG
FVC L 2.47 2.88 86 2.27 79 -8
FEV1 L 1.62 2.09 77 1.46 70 -9
FEB1/FVC % 65 73 90 64 88 -1
FEF25-75% L/S .92 2.44 38 0.84 34 -8
FEFmax L/S 5.00 5.76 87 4.67 81 -6
FEF25% L/S 2.78 5.26 53 2.34 44 -16
"50% " .98 3.87 25 .92 24 -5
FEF 75 L/S .40 1.51 27 .35 23 -12
TET (SEC) 4.41 4.10 -7

I work out 3 - 4 times a week - sure there is shortness of breath but i can still talk - this test was performed May of last year.

I also have lung volumes and diffusion results

thank you

[Davy9]

These test look at volumes and flow rates. The volumes you exhaled were in the 70th to 90th percentiles. The peak flow which occurs as you first blow out is at 87% of predicted. Then the flow rates drop to 50% and below of predicted. The mid-maximal flow rates (25-75) were under 40% of predicted. (Predicted are the normal values for your age, gender, etc)

That suggests to me that you do experience airflow obstruction with forced exhalation but you can still move adequate volumes mostly on the initial thrust. It would be helpful to be able to see the actual flow/volume graphs.

You did not benefit from whatever medication they administered between the studies. In fact your volumes and flows all deteriorated on the post study.

Please do share the rest of your information (the volumes and the DLCO).

[rt44]

thank you...Pre-Drug* AVG

Lung Volumes actual predicted %pred
VC (l) 2.83 2.88 98
IC " 2.07 2.02 103
ERV .76 .87 87
FRC " 2.93 2.65 110
RV " 2.17 1.79 121
TLC " 5.00 4.67 107
RV/TLC % 43 38
He Equil. (Min) 4.25

Pre-Drug* Std
Diffusion actual predicted %Pred
DCO ml/min/mmHg 4.49 18.24 25
VA (rb) L 4.03 4.67 86
D/VA 1.11 3.90 29


Pulse Oximeter
93 - 71 BPM - 95% 70 BPM 96 67 BPM

[Davy9]

The volumes reflect a mild increase in total lung volume, that is also reflected in the reserve volume and functional residual capacity. The DLCO study looks like it may not have been done correctly or under some peculiar conditions.

All in all is shows a moderate degree of COPD. What did they tell you about the studies? Since this was done last May are you experiencing problems now that give you cause for concern? Do you plan to repeat the study soon?

[rt44]

no problems - i see a lot of improvement since first diagnosed - i was DX in hospital after having surgery for another condition - they said i had severe - they based this on oxi and ct scans - I saw a pulmonary upon release and had first tests in april 2006- i have embraced exercising - stairs can be a bit of a problem if i try racing up them....shortness of breath at times but overall not too shabby - i do intend to see the pulmonary doc again in May and retest. I do not intend to start inhalers etc. at this point

thank you.

[Davy9]

The interpretation of these does vary and what I had was quite limited. Yet the data did not appear that bad to me. Severe does not correlate with your level of activity either. They don't have you using oxygen do they?

[rt44]

no, i don't do any RX or oxygen - i am determined to keep it that way - 2006 was a year i would like to forget - they wanted me on oxy in 2006 - in fact in order to be released from hospital had to go home with it..never turned it on - got a doctor to write an RX to get rid of it. I have seen more harm done with RX - so - hopefully with proper diet, exercise, etc. i can keep pharma away from my door.

thanks for your continued interest

[Davy9]

Of course from where I sit there's a limited amount of information. Low oxygen levels can have some real consequences that are easily avoided by using supplemental oxygen. It would be smarter to use it and not need it than the other way around. Before you exclude it be certain it is not needed. Yes, you can be quite active and feel well and need additional O2. I understand your intentions, I just want you to be certain they are not haphazard. Think of oxygen more along the lines of a vitamin. You absolutely require enough of it when you need it. Too much is not good but not enough is also a serious problem. Do not discount its importance.

[rt44]

how would you ascertain oxy was needed?

[Davy9]

2 ways in particular. Assessing changes in oxygen saturation while exercising and during sleep. Those are the 2 things you do daily which can impact O2 levels.

Your DLCO values were way low. They were so low that I felt they did not jive with your other data. It is a test that is susceptible to problems and I presumed something was amiss. But, I have only what you share here and it is not for me to say what your status might be based on such limited info. A low DLCO suggests trouble oxygenating. I would rather you be certain about this.

Anyway, if you need oxygen you do yourself no favors by 'John Wayne-ing' without it. The body naturally works to compensate for low oxygen tensions in ways that you do not need and which can make your health worse.

You have done very well with your care. Incorporate what the doctors can provide you to assist and safely conduct that endeavor.