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Test Results
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Test Results

I've been having problems with breathing, choking & at times vomiting in my sleep.  I had a CT scan of my upper chest & dr. found a prominent thymus, tracheal diverticulm & left-sided heart enlargement.  I also have sleep apnea, constant chronic sinus problems & was told that I have allergies & CHF & possibly asthma.  So my doctor had me do Pulmonary Testing and here are the results:

                                                 PRE                  POST
TLC                                            84%                    
TGV                                           90
RV                                             44
VC                                           105
RV/TLC                                      51    


FVC                                         100%                   99%
FEV 1                                        91                      92
FEV 1/FVC                               102                    105
FEF 25-27                                  53                       61
PEF                                           87                       98
FEF 25                                      82                       94
FEF 50                                      51                       63
FEF 75                                      37                       49
PIF                                            71                       71

FEF50/FIF50                          56.60                    76.43

R 0.5 (raw)  (cmH2O*S/1        146%
sRaw 0.5  (cmH2O*s)             228%
eGaw 0.5                                44
DLCO SB                               98
DLCOc SB                             98
DLCO/VA                              172
DCLCOc/VA                          171

PI MAX           65.42
PE MAX         83.08

My father passed away almost two years ago from Amyloidosis & it scares me because with the many problems that I'm having, my father also had and my blood work mimicks his.
                
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242588_tn?1224275300
With the exception of an increase in the RV and RV/TLC ratio, your pulmonary functions are either normal or nearly so.  Your breathing problem does not reside in your lungs.  Your nighttime symptoms suggest that you are having serious gastroesophageal reflux disease (GERD), commonly called acid reflux, a condition in which stomach contents, including acid, reflux back up the esophagus possibly into one’s lungs.  Then again, if what you are having truly is vomiting with the characteristic retching, then you may have another stomach or esophageal problem and it could be amyloid.  Amyloid can involve the skin, GI tract, heart and kidneys among other organs.  You should consider consultation with a GI specialist, also known as a gastroenterologist, for evaluation of your stomach and esophagus.

Enlargement of the thymus gland is usually due to a thymoma, a tumor that is benign about 90% of the time and, not infrequently associated with a neuromuscular condition called myasthenia gravis.  This enlarged thymus warrants further investigation.

Good luck.
4 Comments
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Avatar_n_tn
I'm no MD, but did want to respond to your posts here.  I know you're concerned about your test results and having trouble getting your doctors to respond to you.  I share your frustration - in fact, I just posted my own concerns about 'demanding' a CT scan, but that's another story....

I wanted to reply to this post because I also used to wake up in the middle of the night, sometimes choking because I was unable to swallow, and sometimes choking because I had inhaled reflux.  Not sure the word "scary" does justice to how that feels.

At any rate, I finally had an upper GI done a few years ago, and it turns out I have GERD.  Mine is exacerbated by the fact that I smoke.  Once I started taking medication for the GERD, I started sleeping a lot better.  But here's where it gets interesting - GERD is often associated with asthma, and asthma is not infrequently associated with ventricular hypertrophy.  In fact, it became a deadly cause-and-effect for my brother, who died in his sleep at the age of 37 after a particularly brutal year of the kind of nights I just mentioned caused severe pneumonia.  No specific cause of death was found (although he was in the hospital at the time), but his autopsy report did show that he had ventricular hypertrophy, which might have led to a fatal arrythmia.  

I'm not trying to scare you, here - in fact, he was on a load of pain killers at the time that all agree was the most significant contributor to his respiratory failure; but I do hope this gives you some concrete beginning to a conversation I hope you take to a non-VA doctor as soon as you can.  Better to pay privately, out of pocket, if you have to than to spend years with the anxiety of knowing you aren't getting the answers you need.

I hope things look up for you soon, and my hat is off to you for serving our country for so long.
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608956_tn?1233803015
I'm taking medication for the GERD.  I take it 15 minutes before I eat.  I was just given the medication two days ago and yes it has helped a lot.  My VA doctor has referred me to a GI doctor and have me set up for genetic testing for Amyloidosis.  He said that he already checked me for sarcoidosis from the start, because my medical problems led towards that, but said the CT or ultrasounds did not show it and neither did my blood work.  He said he's staying focused on checking me with the Amyloidosis.

One of my brother's just had mitro valve replacement, he's had a bad heart ever since he was young.  My entire family would go up to the children's hospital & spend the weekend while doctors performed all types of test on him.  His valve finally gave in one year ago.  He's doing a lot better.  My doctor also told me that heart defects must run in my family because of what was found on my CT & ECHO of my heart.

The cardiologist said that I have Mild Concentric Left ventricular Hypertrophy, but he believes that's from not being able to get my hypertension under control for over 7 years.

I used to take Inderal when I was in the Navy, but my old VA doctor switched me to Atenolol and ever since the switch, my BP has been uncontrollable.  The VA doctor told me that Inderal was for older people and I should have never been on it, but the navy doctor told me when he first put me on it that he put me on that because my readings have been severly high and he wants to control it.

My VA doctor also told me that I my left lung is partially collasped and they don't know if that's due to the tracheal diverticulm that was seen on my CT.

Here's what part of one of my chest CT's read:  a small amount of residual soft tissue density is seen within the anterior mediastinum, representing thymus.  No filling defect to suggest pulmon. embolism, no hilar or mediastinal adenopathy is identified.  A few scattered nonpathologocially-enlarged mediastinal & hilar lymph nodes are noted.  The lung parenchyma demonstrates diffuse coarsening without focal consolidation, pleural effusion or pneumothorax.  Minimal peribronchial soft tissue density along the right mainstem bronchus is seen, which I believe is atelectatic change.  The osseous structures are grossly intact.
IMPRESSION:  PROMINENT THYMUS

HERE ARE TWO DIFFERENT MEAUREMENTS OF MY THYROID GLAND:

THIS WAS DONE IN 1999 DUE TO LOWER LEFT NECK SWELLING:  
RIGHT LOBE:  4.0 x 1.4 x 1.4 cm
LEFT LOBE:  3.8 x 1.6 x 1.4 cm

THIS WAS DONE IN 2008 FOR SAME REASON & BECAUSE OF THYMUS ENLARGEMENT:

RIGHT LOBE:  4.3 x 2.0 x 1.8 cm
LEFT LOBE:  4.0 x 2.0 x 1.5 cm

Any thoughts on any of this?  I thank you very much for all of your help!!!!
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608956_tn?1233803015
Thank you for the information.  I've read more upon the LVH.  My doctor said that it's in a mild form and he's going to do his best to control my HBP.

I don't take pain pills.  I have fibromyalgia, I injured my back while in the navy and was medically discharged and I also have monsterous daily migraine headaches and a pinched nerve.  But I refuse to accept any type of pain medications any of my doctors have tried to prescribe for me.  I have three children that I have to take care of and I love to keep or try to keep focused and have a straight mind, that's why I always refused medicine they prescribe.  
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