emphysema versus asthma

[withie]

If I  were to send you a copy of my spirometry results would you be able to decipher them for me. I have asked my hospital if I can see them as I haven't really been told much about them by my doctor. I have been for that and a vq scan re a pe. which thankfully it wasn't but was told that I had emphysema the thing is my own doctor doesnt seem to think it is this and that I have asthma as I feel so much better with my inhalers. I never have had bronchitis or mucus or a cough but became unable to finish sentences without taking a breath when I was going through an upsetting period at home and was sent for these tests. I have stopped smoking although I never did have many. What do you think? p.s. the spirometry I had done at my docs (which was normal) previous to being admitted to hosp did not include the bit with the gas exchange box part do you think this is where they picked up on my "emphysema"

I was so pleased to have found this site as really there is no one else for me to ask

Thankyou very much Withie

[National Jewish Health]

Yes, do post your spirometry results.  And, yes, one can see V/Q scan abnormalities, areas of decreased ventilation or wasted ventilation and shunt effects, but this is not the way to make the diagnosis of emphysema.  Good pulmonary function tests (PFTs) and, if for any reason a CT scan has been done, CT scanning can give a semi-quantitative measure of emphysema.  I assume that by "gas exchange" you are referring to the carbon monoxide diffusion study.  Worth noting is that, with asthma, the diffusing capacity is almost always high normal or higher, whereas with emphysema the diffusing capacity is almost always low normal or lower.  However if your spirometry values are truly normal, the likelihood of clinically significant emphysema is slight at most.  And there are a number of clinical criteria used to distinguish between the two and your doctor would be familiar with the criteria.

The exaggerated response to your inhalers would favor, but not definitely indicate, the diagnosis of asthma.  Of course, smokers frequently have combined asthma/chronic obstructive pulmonary disease (COPD) disease.

Whatever the answer and whatever you do, you should give up smoking forever, immediately.

[withie]

                                              
Sorry wrong heading over results these are the correct ones thankyou once again Withie


                                                PredLL          Pred UL      Act1     %Pred  
  

FEV1                        (L)               2.67             3.91        3.00           91
FVC                          (L)              3.12             4.53         4.72          124
FEV1 % FVC             (%)                                               63.49
FEF 50                      (L/s)             2.51            6.12         2.12          49
PEF                          (L/min)        351.8            529.0      419.0           95
FEV1/VCmax % pred  (%)                                               76.32

VC                          (L)                3.26               4.64         4.72         119
RV                           (L)                1.55              2.70          4.15        195
TLC                          (L)                5.23               7.21         8.87        143
RV % TLC                 (%)              27.08            46.20         46.79        128
ERV                         (L)                  1.00              1.00             <<        <<
ITGV                         (L)                    2.31            3.95          4.15         133
ITGV % TLC               (%)                 43.69         63.15        46.79         128
R tot                    (kPa*s/L)               0.30            0.30           0.34          113
SG tot                (1/ (kPa*s) )            1.04             1.04          0.62           60

VA                           (L)                      6.07            6.07         5.42              89
TLCO SB   (mmol/min/kPa)                  7.68           11.52        4.47              47
KCOc        (mmol/min/kPa/L)               -0.62            3.70        0.81               53

[withie]

Here they are then thankyou
                        PredLL             Pred UL         Act1         %Pred      Act2

FEV1                        (L)               2.67             3.91        3.00           91
FVC                          (L)              3.12             4.53         4.72          124
FEV1 % FVC             (%)                                               63.49
FEF 50                      (L/s)             2.51            6.12         2.12          49
PEF                          (L/min)        351.8            529.0      419.0           95
FEV1/VCmax % pred  (%)                                               76.32

VC                          (L)                3.26               4.64         4.72         119
RV                           (L)                1.55              2.70          4.15        195
TLC                          (L)                5.23               7.21         8.87        143
RV % TLC                 (%)              27.08            46.20         46.79        128
ERV                         (L)                  1.00              1.00             <<        <<
ITGV                         (L)                    2.31            3.95          4.15         133
ITGV % TLC               (%)                 43.69         63.15        46.79         128
R tot                    (kPa*s/L)               0.30            0.30           0.34          113
SG tot                (1/ (kPa*s) )            1.04             1.04          0.62           60

VA                           (L)                      6.07            6.07         5.42              89
TLCO SB   (mmol/min/kPa)                  7.68           11.52        4.47              47
KCOc        (mmol/min/kPa/L)               -o.62            3.70        0.81               53