pft result ct result

[Dawn1214]

Hello,
46 yr F smoker 25 yr 1 pk a dy, tumor removed from spinal cord 4 mo ago. extreme pain upper back. sinus cong. productive cough, trouble getting deep breath at times.
Pft test results:
Spiomety                           Actual                      
FVC (L)                              2.91                                                  
FEV1                                 2.11                                                  
EV1/FEC%                        73                                                    
FE 25-75                           1.50                                                    
FEF                                   5.37                                                    
FEV6                                 2.90                                                    
FEV1/FEV6                         73                                                        
MVV                                  94                  
LUNG VOLUMES
SVC                                 2.92                
IC                                     2.06                
ERV                                 0.86                
TGV                                 2.49                
TLC                                  4.55                
RV/TLC                               36                    

AIRWAY REISTANCE
RAW                                1.64                                              
GAW                                 0.61                                              
SRAW                               5.20                                            
SGAW                              0.19                                                

Neck ct results: Pleural parenchymal type scarring assoc w/ lung apices w/ findings of emphysematous type change w/ small blebs
Chest x ray normal
Can you tell me what these results mean and if the pain in my back could cause trouble getting a deep breath.

Thanks Dawn

[National Jewish Health]

I am so sorry that you have been left with “extreme pain upper back”, following removal of a spinal cord tumor.  Such pain, in addition to significantly affecting one’s quality of life, can indeed hinder respiration and, specifically, impair your ability to take a deep breath, or feel short of breath.  That findings suggestive of emphysema with apical scarring would be observed on a CT Scan is not surprising, given your smoking history, and not necessarily indicative of clinically significant COPD/emphysema. Apical scarring is a common finding, even in individuals without a smoking history. In fact, an FEV1 of 2.11 L., an FEV1/FVC ratio of 73% and an RV/TLC ratio of 36%, along with a normal chest X-ray is not consistent with severe or even moderately severe COPD (regardless of the predicted values).  It is not possible to be any more specific than this, without having the Predicted Values for the PFT’s.

I believe that your main goal should be pain relief.  I assume that your surgery was performed by a neurosurgeon.  You should contact that doctor to try to determine the most likely cause of your pain and possible remedies for it, that might include nerve blocking procedures or even nerve resection if the nerves involved are not also serving vital functions.  You might also want to seek the opinion of an Anesthesiologist/Pain Specialist; such specialists are often the persons, most qualified to relieve such pain in a variety of ways.

Good luck

[Dawn1214]

I forgot to tell you that I am 4' 11" and weigh about 105. Also the ct scan was done of my neck and radiologist noted this finding on what he could see.

I am not sure how to read the pft test so I am hoping that i gave you enough information off it as I was limited to my space allowed. If you need more information please let me know.

Thank you so much

[Dawn1214]

Thank you so much for your response.
I tried to put down all the values but did not have enough room.
The predicted values are:
FVC            3.08
FEV1           2.48
FEV/FVC         81
FEF25-75      2..66
FEF               6.19
FEV6             3.01
FEV/FEV6        83
MVV                90
SVC              2.92
IC                 1.98
ERV             1.10
TGV             2.40
RV               1.48
TLC              4.38
RV/TLC           33
RAW            1.86
GAW            1.03
SRAW           4.76
AGAW           0.20

I truly appreciate your suggestions for pain management.I just started taking amitriptyline for pain. I am at a very small dose as I am sensitive to meds. Do you have another suggestion for a med that would help with nerve and muscle pain?

I would love to be able to manage the pain. I am not complaining about the surgery I endured as I am able to walk and have just very slight problems with bowel and bladder. I was definitly lucky in that aspect. The tightness in my upper back and neck just wears me down. I have been so concerned about my breathing issues and am trying desperatly to stop this smoking habit. Any suggestions on that would be appreciated as well.

In you opinion should I be on any type of meds for my lungs? I am also struggling terribly right now with sinus congestion, and coughing up thick phlegm. Possibly allergy related. The coughing increases the pain in my upper back.

Anyway there are my predicted values so any other information you can provide would be highly appreciated. Thank you so very much.. Dawn