Is it asthma or COPD or both?

[Coraline]

1,58m - 47 - caucasian and african - 258 lbs

I have had chronic asthma since my childhood.

I would like to know what my PFT mean :

SPIROMETRY
                   PRE         POST
VC max -     66%          72%
FEV1          34.4%        44.9%
FVC            51.4%        55.7%
FEV1/FVC   57.18%      68.95%
PEF            47.1%        48.3%

SB
TLCO SB     58.7%
TLCO/VA     91.1%
VA               66.6%

LUNG VOLUMES
FRC-He        88.7%
RV-he          141.2%
VC max        79%
TLC-he          97.8%
RV/TLC-he     97.8%
FRC% TLC-he  96.2 %

During my test, a way of breathing had to be changed cause I could not do the test quickly enough to get a reading. I was actually tired and the fast exhale and inhale was just not working. Would this affect the data of my PFT; and if so,how?

Thank you.
  

[National Jewish Health]

Given that you were tired and had difficulty performing the test, the results are unreliable and should not be interpreted.  If you remain concerned, the test should be repeated and the results expressed in absolute values, rather than in percentages.  Your height and weight combine for a body mass index (BMI) of 47.  Whatever your true pulmonary function is, it would be improved by some weight loss.

[Coraline]

Follow up on this message:

Reversible, severe airflow obstruction on spirometry but not on PEF. Some reduction in transfer factor with some evidence of air trapping. Reduced FVC suggest restriction.

Could anyone tell me what does all this mean please?

[Grailhunter]

I will try as far as what I sort of know.  Don't try to cash this at the bank though.  Just a little something tell the Med Help Doctor answers you.  As far as being tired, if you were seriously feeling fatigued I would say yes it would change the results some for the worse of course.  Your assessory breathing muscles in your upper torso could have been tired from being worked preaty hard before you took this test.  The assessory breathing muscles kick in on your fast, hard, deep breathing, so I would think significant fatigue would be a factor.  It wouldn't effect lung volumne as much, but might mess up the reading for usable lung volumne and certainly sustainable hard breathing on how fast you can move the total lung capacity in and out.  Those numbers don't look quite right to me, but I am not a Doctor or technician that has seen allot of PFT's and it takes allot of knowledge to read them right unless you have the graphed image.  If it was me I would want to do a retest and make sure your rested, but its still going to show obstruction and restriction, but maybe not as bad.  Part of that looks like either severe fatigue or deconditioning or probably both.

[Grailhunter]

That is close to a 30 percent increase on FEV1 between pre and post, but it barely effected your PEF.  Has your asthma since childhood and especialy late adulthood seriously restricted your ability to get in excercise and work your deep breathing muscles?  Those upper numbers there, relative to the lung volumes are indicating to me that a lack of physical conditioning from your asthma could be a major factor in this picture and asking your Doctor about where you could start out on a exercise program reflecting your current physical condition, might seriously improve your breathing.  You have a very high level of reversibility and I would guess you also have a substantial level of reversibility on your conditioning if your overall health permits.  

[Grailhunter]

I forgot to add that where it says Reduced FVC suggest restriction.  That I believe is your Forced Vital Capacity.  The ratios on your Forced Vital Capacity and the FEV part there is what gives you the FEV1 which is the percentage they use for how bad the COPD is.  They are saying the reduced FVC is suggesting restriction.  That is actualy a good thing since restriction is better then chronic obstruction.  More narrow bronchials whether it be from Asthma or just small airways is restriction.  The mucous and stuff building up in your lungs would be obstruction.  That is worse then restriction because it can build up clog your bronchials to the point the inhalers won't help.

Also, the restriction its suggesting maynot even be happening in your airways beyond what is being reversed.  You can get that same, can't get allot of air in fast thing for other reasons.  You noted you were tired for instance.  A weak, unconditioned diaphram from breathing to much with your chest muscles and not breathing correctly off the diaphram for a long time, could produce that also, and it would showup on the test as indicating restriction.

Anyhow, the point I am trying to make is that I am sure MedHelp can interpret those numbers, but its still between you and your Doctor on how much has to do with Asthma and how much is something else, conditioning of your breathing muscles and proper breathing possibly being one of the issues.  But it looks like they are saying Asthma and some other cause of restriction coming into it then they are saying serious obstruction or lung damage.  Just my poor opinions though, and I could be totaly wrong.

[Coraline]

Thank you for your answer. My asthma has always prevented me to exercise the way I would have liked too and of course the weight that has piled up has not helped. I am followed for my weight now.

When I said I was tired, it was not when I actually before I took the test but after a while during the test when I had to breathe and out, putting a lot of strain on my lungs. I was even feeling very dizzy so we had to wait a while before I went on the test.

When I do the peak flow meter, I never go over 200; and I do 200 on good days.

How do you call what I have? Is it copd? and if it is, what stage would that be? What can I do to help myself, apart from the obvious weight loss?

Can we have restriction and obstruction at the same time?

I am on a cpap machine at night for sleep apnea and I am suffocating like I cannot exhale the air and I am having a hard time with that. But during the day, I am short of breath once I start moving too.

Am I a total disaster or is there any hope for me ... ?