PFT results

[jeric]

I have had dry cough for 10 weeks now along with shortness of breath. I used to go walking at the gym a couple times a week and am now unable to do so due to SOB. Even walking up the stairs leaves me breathless. It is harder for me to breathe in than it is to breathe out.

I'm 19 year old non-smoker (though both of my parents used to smoke). I weigh 183 (I don't keep too close an eye on my wieght but at least 10-15 pounds were gained since I have been so short of breath and coughing).

I have had two chest x-rays done, both were normal.
I had a spiral chest CT w/ contrast done and it was normal as well.
I have been treated with no results for Asthma, GERD and PND.
I had PFT done and after my doctor got these resluts she said she wanted me to see a pulmonologist. She never did explain the results to me. I was hoping you could help me with that.

Spirometry
                  PreMeas.   PostMeas.
FVC            132%      128%
FEV1          128%      125%
FEV3          132%      126%
FEV1/FEV%  87           88
FEF25-75% 119%       121%
PEF            116%        97%
FIVC            123%       115%

Plethysmography Lung Volumes
VC            132%
TLC           134%
RV            123%
RV/TLC%     19
FRC PL      120%

Plethysomography Airway Resistance
Raw     150%
Gaw     71%
sGaw    68%

I have tried searching so what these results mean and all that I was able to find was about the spirometry... which from what I found my spirometry results look real good. However I know TLC is total lung capacity, and that Raw and Gaw measure airway resistance and conductance.... however beyond that I don't know anything else.

Could you exlain my PFT results to me further and any ideas as to what is causing my problems??

Oh, I'm working on getting in to see a pulmonologist but it's hard because I live in the middle of no where.

Thanks

[National Jewish Health]

With the exception of increased airway resistance, your pulmonary function tests (PFTs) are within normal limits.  "Normal values" for PFTs fall along a bell-shaped curve, based on age, height, gender and race.  That means that the values of some individuals, in the general population, will fall below the "predicted normal" and some above; above the “predicted normal” is where you seem to be.  These results are normal, including the FEV1/FVC ratio even if the percent values given are percent of predicted.

You have been checked for asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis and clots to the lungs called pulmonary emboli.  The lack of improvement with the asthma medicines argues against the diagnosis but does not exclude the diagnosis of asthma.

Assuming that all the results cited are accurate, it is hard to attribute your shortness of breath to your lungs.  However, clear lungs by chest x-ray and CT scan with your history of it being harder for you to breathe in than to breathe out, suggests that the problem might reside in your voice box; specifically, with your vocal cords.  Against this is the fairly good inspiratory flow rates but it would be good for the pulmonologist to check the flow-volume loops of your PFTs and he/she may want to directly examine your vocal cords, before and after a methacholine challenge.