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possible copd,-follow-up question for Dr. David T.
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possible copd,-follow-up question for Dr. David T.

Thank you for your thoughtful response. I agree with your response - very true!  I have not smoked at all since that day 3 weeks ago and will not smoke!!  The bronchial spasm sounds very possible based on my reaction. My SOB and other symptoms are getting a little better.   I have a sinus infection, second this year, got antibiotics today but I generally do not get many colds, etc., one in the last year.  


I had PFT today (spirometry).  I have the numbers but they have not been read yet.

Most of the spirometry results are good - I'd like to go over it and get your response. FEF75% and FIVC are scary.

My FVC pred is 3.03, best 2.74, % pred is 90 , FEV1 is 2.29 pred, 2.18 best, % pred is 95,
FEV1/FVC % pred is 75  and best % pred. is 80.  FEF25-75%pred is 2.71, best is 1.97, % pred is 73,
FEF25% is 4.40 (no predicted?), FEF50% is 3.35 pred, 3.64 best, % pred is 108;  
FEF75% is 1.23 pred., 0.55 best, % pred is 45 - ( this is a scary one); PEF 5.68 pred. 5.62 best % pred is 99; FET100% best is 8.58
FIVC pred is 3.3, 1.14 best, % pred is 38 (scary)
FEF/FIF50 is <1.00 pred, best is 1.58
Vol EXTRAP is 0.11
MVV pred is 98

These were al pre and post rx.  There were pretty good improvements every time after the inhaled rx, average for example, is FVC pre-rx is 2.74 best (90), post-rx i 2.81 best (93), although I don't think they were huge improvements.  Example : FEF75% pre-rx was % pred 45 - post-rx was % pred 56.

Hope all these numbers make sense in this format.  Basically the main numbers seem good, but the FEF75% and FIVC seem bad - small airway obstruction?  No diagnosis of COPD  (yet)??    If I never smoke again, will this reduce my chances of getting COPD?

This is scary stuff.  Thank you so much for your help!
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Your concern about the deviation, from “predicted normal values”, of two values FEF75% and FIVC is unwarranted.  The former because the FEF75% has never been validated as a measure or indicator of lung function impairment.  The FIVC of 1.14 (38%) is probably in error: for technical reasons (faulty Spirometry measurement), poor effort (by you) or failure by you to exhale completely (to residual volume) prior to the FIVC maneuver or your failure to inhale completely to total lung capacity, following a complete exhalation.

One caveat.  Persons with a condition called vocal cord dysfunction experience inappropriate closure of the vocal cords during inspiration.  This reduces inspiratory flow rate and results in a flattened inspiratory loop (see B below).  The FIVC is usually normal or nearly so but it is possible that, in the presence of inspiratory obstruction by the cords, an individual might not inspire optimally.

Ask your doctor to focus on your inspiratory flow-volume loop to see if there is any sign of VCD.  Barring this diagnosis, rest assured that your pulmonary function is fine and forget about the inconsequential values..

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