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Old 09-24-2003, 09:58 AM   #1
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Smile Spirometry test

Hi, this is my first time on the boards. I have a lot to ask, but first has anybody ever had a misread spirometry test?My allergy clinic performed two on me and my numbers were low. I had a third one done at the hospital and it was normal. This was confusing to me especially since the hospital test was done a little different than the one my allergy doctor did. The hospital clamped my nose so no air would escape that way and it was more thorough. Which one should I go with? Thanks

 
Old 09-24-2003, 07:13 PM   #2
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Hi! I used to live in Edmond.

What numbers are low? Do you have a copy of the report? What is the fev1 on each report?

You have to remember that a spirometry is very "effort dependent." If you give a half-hearted blow, the numbers won't be real good. If you get a good respiratory therapist who eggs you on like a cheerleader (go, go, go) you can give a better effort and have better numbers.

What were you having the test done for?

Did you ask the people at the hospital why you would have such a discrepancy? I don't think your numbers were "misread" as the computer is the one who puts the numbers. It might just be that you tried a lot harder during the hospital test.

I'm also thinking about the numbers on a peak flow meter. You know the little plastic thing that asthmatics blow into to see if their lungs are constricted. If your normal amount is 400, and you feel short of breath and blow into it and the number is 200, then you know your lungs are constricted and you might have an asthma attack coming on. Well, I would think the same person would have different spirometry readings at the time his peak flow was 400 as compared to when it was 200. If your lungs are constricted, I would think your spirometry readings would be lower. But then, I'm not a respiratory therapist, and don't know for sure.

 
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Old 09-25-2003, 07:57 AM   #3
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Thanks for replying PLM. This is my story and is kind of long. I have had sinus and PND all my life. But when I was in my 30's (I'm 46 now) I had a bout with bronchitis that lasted about 2 months. It seemed after that I got it about twice a year. I never had a spirometry test done because my doctor never heard wheezing and my xrays were always clear. I have never head pneumonia. I finally went to the asmtha/allergy clinic and they did a PFT and my numbers were a little low. I'm sorry I don't have the report and I can't remember which numbers, but she said it was in my small airways. They put me on Advair and I went back in 4 weeks and my numbers had not changed. He put me on a stronger dose of Advair and told me to come back in another 4 weeks. By the way during all this time I had been on allergy shots and the bronchitis had stopped. Well, the Advair made me feel bad and by this time I had worked myself up into such a worry, I did seem short of breath. I called my GP and went in for a second opinion. He told me to go off the Advair, wait 6 weeks and he schedule a PFT at the hospital. That test came back normal without meds. That was a year and a half ago. Occasionally, I seem short of breath and a little tight, but nothing that reall limits me or I feel the need for meds. I just seem to worry about it. My peak flow is a steady 450 with occasional 500 (after I have just exercised) and I am 5'2". What do you think. By the way, I got off the allergy shots. I was so put out with that doctor for the wrong PFT results. I am trying to go natural. Cutting out sugar, wheat, milk and eating lots of fruits of vegggies and taking vitamins. I go to a chiropractor also which seems to help my senstion of breathing. What do you think? Thanks a lot



 
Old 09-25-2003, 05:45 PM   #4
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Howitt, We are close in age... I'm 49. If they said your small airways were constricted, you probably had low numbers in your fef25-75. That is exactly what I have. I have normal other numbers, just low in this area. That indicates constriction or restriction in the smallest airways. I have read information about the fef25-75, and it seems a lot of doctors don't pay much attention to these numbers. They are more concerned about fev1. That is the number that shows how much you breathe out in the first second. If that number is good, they are happy.

I was on a combination of Pulmicort (inhaled steroid) and Foradil (bronchodilator) for 3 months, and there was no change. (My only symptom is that I feel slightly short of breath ALL the time.) So the doctor switched me to Advair, which is a combination of an inhaled steroid and bronchodilator all in one disc. It's much easier to take. I've been on that one month and don't see a difference. But I'm sticking it out. I have a 3 month supply, and I'm going to finish it. I do find that it has affected my voice. I sound raspy.

You mentioned allergy shots, and I am on those also. I'm doing everything I can. I had allergy tests and was allergic to quite a few things. So even though I don't have runny nose, itchy eyes, etc. like most people with allergies, the doctor still felt the shots might help my lungs. So we'll see.

Don't be mad at your allergy doctor for "wrong pft" results. He was just reading the computer print-out. It's there in black and white. Obviously you had a problem during that test. But I hope he gave you allergy tests, didn't just put you on Advair because of a spirometry reading.

You said you occasionally feel out of breath and a little tight. that might be asthma. Asthma does not behave the same in everyone. I have never had an "asthma attack" but I know I have asthmatic lungs because I had a methacholine challenge test. It is the "gold standard" for diagnosing asthma.

I would suggest you go to a pulmonary doctor and get a methacholine challenge test. You might have a very mild case of asthma. Peak flow readings don't necessarily change even if you are asthmatic. Mine are always between 410 and 470 which is normal for me. I've talked with other people whose peak flow readings don't change unless they are having a really bad attack (or getting ready to have the attack). So for me, peak flow numbers are meaningless.

Doctors have changed their thinking on treating asthma. They used to just treat the "attacks". Now they feel it is important to have you on meds so you never get bad enough to have an attack. That's why many people are on Advair ALL the time. Or Singulair, or another med. It is to help protect your lungs and to prevent you from turning into a severe asthmatic.

Lungs are pretty important. It's easy to take them for granted until you feel short of breath. Then you realize how precious they are.


 
Old 10-03-2003, 09:19 AM   #5
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Ya know I never realized just how true your statement about taking your lungs for granted really was, until June of this year, moreso august of this year(2003).
On June 11 th I woke up, in pain, but not extreme, so I went to work as normal. Through out the night at work, in a paint booth, I began to feel more and more like I was having what I thought to be a heart attack. However being the macho idiot that I was, I continued to work on through the night saying very little to anyone. I still went out and smoked on my breaks like a normal night, even though each hit off the ciggarette about brought me to my knees in a raging coughing fit. Closer to morning, I called my wife, who worked in the same plant I did, only on a different shift, and I asked her to stay home because we were probably going to the hospital when I got home. I went home, sat on the couch, even laid down, trying to find some relief. Nothing would work, so I went on to the Emergency Room. Turns out what I thought was me having a heart attack, was my left lung being collapsed 60%. After about 45 minutes of talking to doctors and such, X-Rays etc. they placed the chest tube, and sent me to the critical care unit for a few days with the pleuravac sucking the air from the space between the lung and chest cavity lining. Many shots of pain killer and anti-biotics later, I was released, after going through what was the worst pain I had ever experienced in my life(the Pulling out of the Chest tube). This experience was enough to scare me, into quiting smoking for about two weeks, and it did force me out of painting. I went back to smoking, however considerably less than before. I now made one pack of smokes last me a week instead of 3/4 of a day. I thought I had really done something great, considering how much I smoked prior to this.
On August 12, I was sitting at home working on the computer, having since been laid off from my job, indefinately, when I felt this funny twist in my chest, and then the pain started all over again. I had made some plans to go work on a computer for someone within the coming hour, so I held through those plans, and then I went out smoked a cigarette with the gentleman, handed him the pack that I had and told him I was most certainly done, and proceeded to explain to him exactly why. Turns out I was right, I went to the E.R. again and sure enough the lung was down, 60% again. This time I was less fortunate, during the placement of the chest tube. I had a doctor that had never done one before, and he used a little benzocaine for the surface, and that was it, I felt every little bit of his placing the tube. Incentive right!!! After a couple days in the hospital, the thoracic surgeon came in to talk to me and tell me the results of the x-rays from throughout my stay. However he ordered one more set just prior to coming in. Which I am glad that he did. Turns out that My lung had collapsed down to 40%, over the chest tube, blocking off the pleuravac this time. This meant a new, different type of surgical procedure for me. So they drugged me up and shipped me by ambulance to Grand Rapids, the Closest Large town with major medical facilitys. I went down, went through the scope process where they rub the lining and the lung surface and by scaring the two surfaces are bonded together. I thought this could be a bonus, since the surgeon stated that he had also stapled the existing blebs on that lung, which were the cause for the collapse in the first place. Great I would not have to worry about it anymore. The only place that they could not rub and bond was the area close to the heart, for fear of doing damage, or causing inflamation there. So after a few days, I am once again put to the tolerance test, this time not one tube, but three. I have now 9 beautiful little reminders of what smoking and painting do for ya. but that is just the tip of it all. While I was there I contracted the lovely MRSA Staph Infection, which the surgeon passed of as normal when I questioned him about the infection I was purging daily from the wounds. keep in mind this is almost three weeks later.
I went and saw a doctor, who cultured the infection, ordered more x-rays, and gave me more pain killers for the continued extreme pain that exists within my chest cavity. The Doc. called my wife at work and told her to stop by on her way home and pick up a new script for me, because the one that they had given me previously would not begin to work on this infection. So we take that, then within the coming week, I return for my follow up appointment with the physician, at which time he tells me that there are additional blebs on my left lung, which was quite a devastating blow, since I was still recovering from what was supposed to have been a procedure to remove them all. But in addition, there were considerably more blebs on my right lung, which to date has not troubled me. The Doctor and I discussed the onset of depression that I was experiencing, and the possible effects, and causes for this, and I did reassure him that I had not smoked since I was admitted the last time. He ordered a CT Scan to further conclude his initial findings, in concurrance with the radiologist. ANd Sure enough, the CT Scan said the same thing. So I requested to see a Pulmonary Specialist. I am still in massive amounts of pain, constant burning within the chest, always feeling like there is something stabbing through my chest at any given time, without warning. This is a toss up of wheather I go to the emergency Room or not, each time. The Numbness and burning in the left arm, still has not left from the surgical procedure. However I did take my P.F.T(Pulmonary Function Test) to prepare for seeing the specialist on the 23 of this month. I feel as if I am sitting on a time bomb just waiting for someone to trigger the detonator. This is how much and how easy it is to take your lungs for granted. I painted cares, wrecklessly for 15 + years, along with many other careless occupations, I smoked for 18 years give or take a couple. Now I see that what I am experiencing is the wreckage fo my careless path. Please Please, if you are concerned about something in dealing with your respiratory system, take care of it, and be sure to get all the medical advice that you can before making any decision. 2 and three opinions are not a bad idea either. I did not, I allowed the bonding procedure to be done on my left lung and now if anything happens to it, they have to break my ribs open and go in through the center. Hearing that there are more blebs on the left lung especially this soon after the process was done, does not leave much room for encouragement. Right now I am at the point that I just want them to open me up, go in and pop all of them so that I can resume a somewhat normal life. Right now I cannot even get a job because of this. I have to tell any perspective employer this condition exists, and that instantly makes me a liability to them, because though it is pre-existing, the laws here state that if a pre-existing condition is irritated of further damage is done as a result of that employment, the company IS liable for it. That is not fair to the company, nor is it fair to me. I have to fight to get disability, I can not draw unemployment because I am technically unable to work. Therefore I strongly encourage you to seek out the professional advice in atleast scores of two if not three or four before you make any final decisions. I wish I would have, however at the time, I did not really have the time, and I was under the assumption that this would resolve the issue. WRONG ANSWER... Do not take for granted the things that you live with, for when they begin to leave you, you really notice it.


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Live each day to the fullest and make sure you do it in a way that you will be proud to be remembered for tomorrow is nothing more than a fantasy, tomorrow never comes.
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Live each day to the fullest and make sure you do it in a way that you will be proud to be remembered for tomorrow is nothing more than a fantasy, tomorrow never comes.

 
Old 10-03-2003, 10:01 PM   #6
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"Do not take for granted the things that you live with, for when they begin to leave you, you really notice it."

Wow. I had to read that line 3 or 4 times before it really sank into my head what you were saying. That pretty much covers all areas of our lives...health, relationships, etc. You really never know just how fortunate you are to have something - until you don't have it any more. It sounds like you've been to hell and back, more than once. I feel so bad for you, and you are right, we take our lungs and our capacity to breathe for granted. I see people every day doing things that I'm certain is causing damage, my 'favorites' being the construction guys, which here in Michigan we have just about everywhere you look. I see these guys standing in the middle of dust clouds, or jackhammering the cement and breathing in all those particles, and I just shake my head. These guys have nothing over their faces to filter what they're breathing, and then they'll pull out a cigarette and light up. I almost start gasping for air just watching them. And ya know, I feel so badly for them because like you, they have no idea what they're doing to themselves or the damage they're causing. I just know that one day those guys are going to have a problem, and they're going to wish with every breath they take that they could go back and undo what they've done.

I do hope you are feeling better soon, and please know that we are thinking of you.

 
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