My Spirometry Results Range From Very Bad to Normal!

[jonkob]

I was a smoker of 1 pack a day for 15 years. I am 44, 50 pounds overweight and in bad shape. I have always been in bad shape since im a couch potato.
I had a spirometry test done about a year ago at the doctors office. First reading of set of 3 the printout read "severe pulmonary obstruction" I say no way, this cant be right, I beg to try again. so on the second round I got one that said "moderate obstruction" and another that said "mild obstruction"
Doctor said to stop smoking and come back in a month.
I did that, and I made sure I had an empty stomach when I went back.
I blow 3 times. first one said "mild obstruction, second one said "mild RESTRICTION"
Now Im really determined and the last blow read "NORMAL SPIROMETRY"
Mind you, I had to blow every single of drop oof air out of my lungs to get to the normal, I think I was even spitting. I thought I was going to pass out or collapse a lung doing this final blow.
By the way I used an inhaler on all days and there was no difference with the inhaler.
Doctor wasnt too concerned. I was very nervous about the poor results and asked him how could I have a severe obstruction. He said that if I indeed had a severe obstruction I wouldnt be able to walk across the room with being winded.
My question to you here is, how could so many tests result in so many different readings from severe to normal, and what exactly is my diagnosos?
Do I have COPD?

[Lisa5165]

I am 49 and diagnosed with emphysema. I work out daily, run the treadmill and walk a few times a day briskly, life weights, etc.  I quit smoking about 4 years ago. I am scared to death. I wonder if I will soon be unable to breathe and I am making myself sick with worry. Any advice is appreciated. Thanks

[little_weed]

I am quite shocked at what you say about the cost of the inhalers over there!
It never occurred to me that you have to pay for them! I always thought it was included in the insurance that you pay for health care.

We pay for prescriptions in the England at £7.20 per item, or you can get a cheaper package deal over three or 12 months. It is nothing compared to what you are paying!

I'm quite lucky in that I do not pay for prescriptions due to another condition I have, which makes me exempt from prescription charges.

Wales, and I think Scotland, have free prescriptions.

I think it's bad enough trying to come to terms with the diagnosis; giving up smoking; the whole life change thing, plus the possibility of having to give up work etc etc. and how to cope financially.
Paying for the medication is like rubbing salt in the wound!

Blimey, does it get any worse . . .

[teko]

Thanks for sharing! lol  I like sending the elephant back to the circus!

I am on advair, well supposed to be, as well as an emergency inhaler, but have not been able to afford them. 200.00 a month at Walmart and Im not working steady right now, so if it keeps up, maybe doc can give me something cheaper, I hope!

[little_weed]

hi again teko,
I just saw your post and wanted to share my experience of that "heaviness" in the chest. When I went to see the doctor two or three months ago, I had the same thing first thing in the morning.
I could only describe it as an "elephant sitting on my chest".

The doctor told me that it was "hyperinflation" and put me on an ihhaler, "Seretide" to be used first thing in the morning as a "preventer". I was also given another inhaler "Salamol" to be used "as and when" as a "reliever".

This treatment worked, and the elephant went back to the circus! However, I had the most dreadful nausea instead!

When I was referred to the specialist at the hospital, she took me off the Seretide - apparently nausea is a rare side effect. I was then given Spiriva, which so far has not given me any side effects.

Hope the info helps.

I will also mention that a CT scan, at least over here, is  usually used to confirm a diagnosis of emphysema.

[teko]

There is a reason it is called the silent killer. By the time we begin to exhibit symptoms, we are in mod to severe stages. Spirometry is based on how much air you blow and then how long you keep blowing. For instance, I keep blowing out alot longer than it takes me to blow in. CT is used to pick it up in the lungs before you start having symptoms and combined with x ray and spirometry a diagnosis is made. If it is restrictive, I believe it points to asthma and can be reversed. Emphysema is obstructive, and hyperinflation of the lungs may or may not show up depending on damage sustained. Smoking is the only thing that affects the progression or lack of.  If you quit, progression slows down, if not, it accelerates.  I am moderate and have just recently began to be short of breath, no cough, upon waking feel heaviness in my chest.  I have not quit smoking, and am in the process of addressing this as we speak.

[little_weed]

Hi jonkob,

Just in case you are still watching this - got my letter today and it stated I had "significant" damage, secondary to cigarette smoking, and have requested a CT scan to assess the lungs further.

Starting to get more than a little concerned . . .

I don't understand why it should, or could be, secondary to cigarette smoking . . .

Anyway, hope it still goes well for you, and you've started shedding those few pounds!

Take care x

[jonkob]

No CT Scan. I asked the pulmonologist about it at NYU Medical Center, and he said that with a normal spirometry and normal chest X rays there is no need for a CT Scan and it goes against medical protocol. I said to him "well it couldnt hurt so why not try"?  But he made a very interesting point. He told me that if they gave CT Scans to everyone as just a regular part of the medical exam it would cause way too many un-necessary procedures, operations, further testing and anxiety.
I do believe this. CT scans would show a spot on a kidney, spot on the liver, spec in the lung etc etc etc. Its just endless.
Like my grandmother used to tell me, "if you keep running to doctors looking for trouble, you will find it "

[JerseyGirl0111]

welll jonkob I am glad you have good news!  I have no real symptoms either - that doesn't mean my lungs are ok - I work full time - unless I go up steep hills or steps I am perfectly normal - my spirometry was normal.

Did you have a CT Scan done?  My chest x-ray was also normal.  My CT Scan showed the emphysema.  Don't let our guard down - do quit smoking -

Have a great weekend. Julie

[JerseyGirl0111]

Yes I got a printed copy of my spirometry test....did worse when they gave me a breathing treatment - but both test were within normal limts.  But - I still have emphysema - per my CT Scan. and I have ground glass opactices.

It has almost been 3 months since I quit smoking and to be honest I can breath better now.  

[little_weed]

Now then, dismayed, it's your turn!

Get to the specialist and get ALL tests done again, especially the full funtion tests. Get the specialists opinion!

The equipment in docs offices can be unreliable, especially if someone has not been specifically trained to use and interpret the readings.

You and I may not be as lucky as jonkob, but that's no reason to not get properly assessed!

Get going and good luck!

[dismayed707]

Congratulations jonkob ... you are safe now  if you dont smoke ... you can go out and live your life and never look back.
Its nice to read some good news.

[little_weed]

I am so oo pleased for you, jonkob! You must be so relieved!

Lose those few pounds and you will be the fittest man on the planet! You can always chuck a few in my direction!

I've been chewing my nails waiting to hear how you got on!

I feel almost as if it might be a good omen for me too . . .

Good Luck JK, and keep up with the giving up smoking. (then tell me how you cracked that one!)

[jonkob]

PS-when I asked why I get out of breath going up stairs doc said to loose 40 pounds :)

[jonkob]

Well I went to a specialist (pulmonary) as promised, and I am glad I did!

As I explained earlier, about 3 years ago in my family doctors office my spirometry results stated "severe pulmonary obstruction" with very low fev1 numbers. I was sure I had COPD. I since quit smoking for about 2 years and last year resumed smoking but only about 4 cigs a day.

So yesterday this doctor (whos office is in NYU Medical Center) in NYC performs a complete PFT with EKG, Spirometry, and chest x-rays.
My spirometry was normal, I was shocked. When I questioned him about my fev1 he said I was at 98% :)
My chest X-rays were also normal as well as EKG.
Doc said I most certainly do not have COPD.
SoI am very happy, and my only conclusion about the results from 3 years ago are that the family doc had faulty equipment.
But I still plan to quit smoking.
Good luck to all of you

[little_weed]

I am so glad you are seeing (have seen?) the specialist. He should answer all your questions, but should also do the full range of other lung function tests, to determine exactly what your problem is.
Fingers crossed for you.

You may turn out to have asthma, which would be common enough with your wieght issue, and there is some reversibilty with that.

I'm still waiting to get my appointment through. The system in the UK is much slower than yours. If I'm lucky, I'll get the letter this week, but god knows when the appointment will be - in 2 weeks or maybe three.

Boy, will my anxiety levels go through te roof! I'll have to start biting my nails, instead of reaching for a cigarette!

Let me know when you have got some news. I'm going to be nervous for you! (You seem to have got your head round all this a bit better now)

Good Luck!

[jonkob]

By the way, I have an appointment with a Pulmonary specialist tomorrow morning. I would like to repeat the Spirometry in a specialists office and get a better understanding of whats really going on, if anything. I want to ask him how I can blow six different times and get six way different readings from normal to severe. I will report back tomorrow evening.

Little weed did you get your results?

[little_weed]

Hi dismayed,
Listen to jonkob he is so right. He is becoming very wise and objective on all of this. But don't beat yourself up about being pessimistic either - it's an easy trap to fall into. I know, believe me.

What you have to remember as well is that COPD is an umbrella term for chronic lung conditions, be it emphesema, asthma, or chronic bronchitis.

You need to see a lung specialist to determine exactly what your particular problem is. This can only be done by re-doing your spirometry with more sophisticated equipment, and a full range of lung function tests, known as PFT's, or LFT's, including diffusion tests to determine the volume capacity.

My GP, like yours, does not want to call COPD emphesema, even though that is in fact what I have been diagnosed with, much to the surprise of the hospital to which I was referred.
Why, I do not know. But for whatever reason, you need to ask to be referred to a specialist who will determine exactly what you do have and treat you accordingly.

The treatment is important, whichever your particular problem turns out to be. (asthma for example, will be treated differently to emphesema etc etc)

Well done for stopping smoking!

Good Luck!

[dismayed707]

I read my previous post again and apologise for being so pessimistic ... I tend to panic. You are correct in what you say jonkob ... thanks for the wise words.

[jonkob]

Just because one test said 55% and the one a couple years earlier said 61 doesnt mean anything, in my opinion. Remember that test is not like an Xray, blood test, or CT scan, its dependent upon your EFFORT.
Maybe you were tired that day, maybe you didnt blow as hard, too many variables to just assume you will be loosing 6% of lung capacity every 2 years

[dismayed707]

Hi ... I am 53 and diagnosed with COPD about two years ago with FEV1 of 58% ... then about a year later another spirometry said 61% and I was pleased with that ... and recently one year on from that my last spirometry said 55%. So I have dropped 6% in just one year and I dont smoke. At that rate I wont survive long. I was hoping that it would slow down since I stopped smoking 2 years ago.
When I was diagnosed I asked my doctor if copd was emphysema and he said no its copd .... I now know he was lying. He said that if I stopped smoking I would lose lung function at a normal rate and showed me a chart .... again he was lying or just plain wrong. I know there is nothing that can be done and I know that I have only myself to blame but I just want to know the truth so I can make plans for whatever future I have left and make arrangements.

[little_weed]

Hi Jonkob,
Morning from the south coast in the UK, well, it's lunch time!

I totally understand where you are coming from! That's how I feel! But believe me, when I was first told by my own doctor that I had COPD, I didn't know whether to take it as a death sentence (my grandfather had emphesema) or be relieved that I didn't have lung cancer!
Is the glass half empty or half full????

I am just 54, (acting like a thirty year old) with a partner of 44, who is devoted to me, and is distraught at all this. While he is supportive, he can't handle the bad stuff, so who do you talk to? That's why I came on here.

My partner and I have had a **** 5 years, travelling up and down the UK to be with my parents, who had, and have, cancer. My mum and dad were divorced 30 years, mum remarried, and so now we also have step-father to keep an eye on. As I mentioned, we lost mum last year, dad was classed as terminal four years ago, but is still hanging on.

My partner and I were hoping to get our lives back on track this year, and now this. It is almost like we are doomed not to be together!

You and I have some similarities. I don't get winded walking either, so I disagree with your doc on that one. There is a scale, I forget the name of it just now, but you and I fall into the catagory of  "breathless on exertion"  - you with the stairs, me with hills etc. (I live in a bungalow, so don't know about the stairs)

My weight is an issue, too, but in the opposite direction. I am very underweight, and this creates difficulties for the lungs and heart, I believe. Also the prognosis is poorer for underweight people with COPD, so I have been desperately trying to gain weight.

I don't want to think that I have this either, After the initial shock, I have been burying my head in the sand a bit, hoping it will go away. I feel too young. There's a lot I want to achieve.

I will get to hear whether it is mild, moderate or severe when I get called back to the hospital when the pulmonary consultant gets the results of these last tests I had done on Friday. Apparently, she will look then at all the test results and will evaluate it from that.
A bit worrying, as I didn't feel these last ones I did too well.

After all the complex tests I have had done at the hospital, compared to the basic one spirometry at the GP's (the hospital spirometry was more more sophisticated and actually easier to blow into) I really think you HAVE TO see a lung specialist doctor, or whatever you call them over there, and be tested properly. To put your mind at rest one way or the other, if nothing else.

Your GP sounds a bit complacent to me. Surely if there was the slightest hint that you have COPD, be it emphesema, asthma, or severe bronchitis, you need to see a specialist to find out exactly which so you can get the treatment.

Yes, you feel a prat with an inhaler to begin with, crippled almost as well, but after a few times, you don't even think about it. And there's so many kids now with asthma that people don't take any notice if they were to see you, which they won't.

You will need to have the inhalers, JK, the main thing that I can gather, is to ease things now, avoid all irritants, and infections, to SLOW the progression of the disease. If you sit on your butt and do nothing, it will progress QUICKER! Which do you want???

You've done the hard bit - you've stopped smoking! I haven't cracked that one yet!!!!

We can get each other through this.

[jonkob]

Little Weed may I ask your age?
Wow your story sounds very scary. Noof course I realize that going up a flight od stairs is not supposed to make you winded, but I have always been winding going up the stairs at the subway for as long as I can ever remember. I mean, even before I was ever a smoker!
To put it plain and simple, im fat. Im 5' 11" and weigh 245 pounds. So I guessmy ideal weight is 180 so im 65 pounds overweight. I live in NYC and I do alot of walking and I'm fine, I donly get winded with flights of stairs, like the subway etc. But as I said, thats nothing new. I couldnt run 1 block with out passing out, but even 20 years ago I couldnt run one block.
You still smoke? I quit for 5 years, then last year while having a few drinks I made the mistake of having one cigarette and then I was right back to a pack a day, for about a year, I quit again about 3 weeks ago.
My GP doctor who did the spirometry said dont worry about it, you dont need an inhaler based on these tests, and if you had severe COPD you would be out of breath walking across the room. When I asked him in a panicky tone "do I have COPD" ? he no. But then when I looked at the chart I see he did write it in the findings.
Maybe I dont want to face the possibility of having this, or maybe I dont want to go to a pulmonary doctor and hear bad news?
Maybe its my hope that if I do have COPD it will be dormant and not require any medical do intervention (medication, inhalers etc) until Im in my 60s.
This is supposed to be a slow disease.
Do you know if yours is severe , mild, or moderate?

[little_weed]

Blimey, you did 3 posts while I did the 1 !!!
Sorry, I only use three fingers.

I think I have answered them all in my one.

I will say that I had a chest xray 12 months ago that was normal, so in only one year the xray has gone from normal, to showing evidence of COPD.

I don't often cough, and don't have much in the way of plegm or mucus, only if I have picked up a cold or am feeling a bit "chesty".

The docs also gave me what they call a "red envelope" which is an emergency supply of steroids and anti-biotics, to be taken at the first sign of a chest infection. To be renewed after use, so they are always available.

[little_weed]

Forgive me Jonkob, but do you not think that getting out of breath going up the stairs is a breathing issue?

I work outdoors in a very physical job. Problem is I work at the bottom of a hill, and rest breaks and tools, exit etc are all up the hill. I become out of breath about half way up and have to stop.
That's when I went to see the doc. initially.
Then in the mornings, I began to get a crushing feeling in the middle of my chest, like an elephant was sitting on my chest. This, I was then told by the nurse, was "hyperinflation" and was given two inhalers, Seretide to take daily in the morning, and Salamol (a reliever) to use as and when required. They worked a treat. The elephant went back to the circus, lol.
I did notice a difference. The only problem I had was the Seretide gave me terrible nausea in the mornings, which is a rare side effect according to the hospital consultant, who took me off it, and gave me Spiriva, which I've had no probs with.

You should really go by their advice. I think you would benefit from inhalers.

I am sorry about your dad. I lost my mum last year to  colon cancer, which she had been told had been successfully treated 5 years ago. Then out of the blue, last Feb she was told it had come back, and gone to the lung and brain. She was given three months, but died after two.

I get a hint from you that you do want this sorted, because you are asking the
questions. but like me, perhaps after seeing your dad die, you think what the hell - cancer will get me or something else. Done it, worn the Tshirt.
Then I looked at my partner, knowing how much he is devoted to me, and think how can I not try to go on as long as possible. Do I want to destroy him too??

All I want is to know the facts in black and white so I can make informed decisions. For example, I don't know how long I can work for. Do I want to wait until I'm carting around an oxygen cylinder before packing in my job? I want some quality time left with my partner, not save it for working my butt off for peanuts.