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Respiratory Disorders (Expert Forum)
Lung function test
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Lung function test
by mindyrk, May 28, 2004 12:00AM
Hello! Thank you so much for taking the time to answer my question. I am a 26 y/o female. I have had asthma for since I was a child, but it has never been bad enough for oral medications. I have always just used inhalers. I have had one time a few years ago when it got bad and I needed to add a steroid inhaler. Since that time I have not even used albuterol. My PCP refered me to an allergist because I have been having weezing, and anaphylaxis type reactions to something (not sure what it is yet). When this happens my asthma seems hit immediately with it. I have noticed over the last year that I get very SOB with exercise (even going up the stairs), and wake up almost nightly coughing, and having difficulty breathing. I very rarely (I did have a very bad attack on 5/25) feel any symptoms during the day. The allergist did a lung function test which said I was at about 57%. How bad is this? After the test it took about 10 min. to catch my breath. The dr. ordered: singulair 10mg qd, pulmicort 2puffs BID, clarinex 5mg qd, continue albuterol rescue inhaler, and a CXR. Does this sound appropriate for this test result? He said that I probably don't notice it is bad because it has been that way for a long time. Avoiding allergens is difficult because I am a hospice nurse so I work in peoples homes. Is there anything else I should be doing? Do you think all these meds are appropriate, or is it to much? Is this something that usually gets worse? How long do people usually take these meds? Any advice you can give would be appreciated! Thanks so much for your help!
Doctor's Answer
by National Jewish, Jun 08, 2004 12:00AM
, Jun 08, 2004 12:00AM
Asthma varies from person to person. The symptoms of asthma are chest tightness, coughing, shortness of breath, and wheezing. Wheezing is the most common symptom. However some people only cough. Waking up almost nightly coughing like you have described is not unusual. Each person with asthma could have only one of these symptoms or a combination of any of these symptoms, including all four of them.
Once you have asthma, you always have asthma. It is possible to go through a period of time without symptoms, but it is also possible that the symptoms may return at any point in time. Asthma is a variable disease. For some people the symptoms will come and go. For others the symptoms are constant. Asthma can change at any point in time without warning for the better or the worse. This change may be temporary or permanent. Generally the only way to know is with the passage of time. This change may be very gradual so you don’t realize how much worse your breathing has become. Without routine treatment your asthma may have changed from intermittent to constant. This can make you more susceptible to asthma triggers that can cause very bad attacks. Nighttime, exercise, and allergies are common triggers.
With asthma the basic problem is chronic inflammation along with tightness of the airways of the lungs. This inflammation increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people allergies cause more asthma symptoms, but for other people allergies do not cause asthma symptoms at all. Exercise is a common trigger. Also asthma tends to be worse during the night. Please read our What Makes Asthma Worse MedFact at http://www.nationaljewish.org/medfacts/worse.html for more detailed information identifying your triggers and minimizing your exposure to them.
Generally testing for asthma starts with a simple breathing test called spirometry. This test provides detailed information about how your lungs are working. It will show if there is obstruction in your airways. Usually 80% or higher is considered normal, so your result of 57% is rather low. To really test for asthma this test may be repeated after using a rescue inhaler, like the bronchodilator albuterol that you are using. This measures how much the bronchodilator helps your lungs by reversing the problem. When there is a 20% increase the test is positive for asthma. A chest x-ray is done to be sure that there isn’t any other problem that would need to be treated differently.
Generally asthma needs to be treated on a regular basis to keep the inflammation under control. Often the treatment is continued indefinitely because asthma is a chronic problem. There is no cure at this time, but it can be controlled with medicine. Albuterol works on the tightness, but does nothing for the inflammation. You may need an inhaled anti-inflammatory medicine, like the Pulmicort Turbuhaler® (budesonide inhalation powder) that your doctor has recommended. This will decrease the inflammation so your symptoms and spirometry will improve. The treatment that your doctor has recommended is very appropriate. This is by no means too much.
Once you have asthma, you always have asthma. It is possible to go through a period of time without symptoms, but it is also possible that the symptoms may return at any point in time. Asthma is a variable disease. For some people the symptoms will come and go. For others the symptoms are constant. Asthma can change at any point in time without warning for the better or the worse. This change may be temporary or permanent. Generally the only way to know is with the passage of time. This change may be very gradual so you don’t realize how much worse your breathing has become. Without routine treatment your asthma may have changed from intermittent to constant. This can make you more susceptible to asthma triggers that can cause very bad attacks. Nighttime, exercise, and allergies are common triggers.
With asthma the basic problem is chronic inflammation along with tightness of the airways of the lungs. This inflammation increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people allergies cause more asthma symptoms, but for other people allergies do not cause asthma symptoms at all. Exercise is a common trigger. Also asthma tends to be worse during the night. Please read our What Makes Asthma Worse MedFact at http://www.nationaljewish.org/medfacts/worse.html for more detailed information identifying your triggers and minimizing your exposure to them.
Generally testing for asthma starts with a simple breathing test called spirometry. This test provides detailed information about how your lungs are working. It will show if there is obstruction in your airways. Usually 80% or higher is considered normal, so your result of 57% is rather low. To really test for asthma this test may be repeated after using a rescue inhaler, like the bronchodilator albuterol that you are using. This measures how much the bronchodilator helps your lungs by reversing the problem. When there is a 20% increase the test is positive for asthma. A chest x-ray is done to be sure that there isn’t any other problem that would need to be treated differently.
Generally asthma needs to be treated on a regular basis to keep the inflammation under control. Often the treatment is continued indefinitely because asthma is a chronic problem. There is no cure at this time, but it can be controlled with medicine. Albuterol works on the tightness, but does nothing for the inflammation. You may need an inhaled anti-inflammatory medicine, like the Pulmicort Turbuhaler® (budesonide inhalation powder) that your doctor has recommended. This will decrease the inflammation so your symptoms and spirometry will improve. The treatment that your doctor has recommended is very appropriate. This is by no means too much.
