Avatar universal

Moderate-stage COPD or moderate obstruction from COPD?

I am hoping for a medical pro to help translate some LFT results, as the lung function test consult from the Pulmonology nurse practitioner was pretty splash-and-dash. The clinic was about 1.5 hours behind schedule and the visit was under 10 minutes. The provider sped through the results ("Oh, you didn't know you had COPD?") then handed over some printed material on COPD, some instructions on Rx and OTC meds, and was off. There is no additional appointment for another 6 months.

The NP's message was moderate-COPD without signs of emphysema ("good") but with lung hyperinflation ("want to see that reduce").

But the NP didn't seem to do any specific COPD stage assessment. Definitely not BODE stage testing (e.g., walking test) and perhaps GOLD staging, but the FEV and FVC are all above 100% of reference values, so that seems like it would point to mild COPD (and just moderate obstruction)? There doesn't seem to be an underlying disease diagnosis or desire to determine one. The patient, my spouse, is young and has no cough or a bit of post-nasal phlegm but nothing major, Chest X-ray was clear. An echocardiogram showed some minor stuff but nothing significant. No hospitalizations or exacerbation type events. She'd been feeling the shortness of breath and such for about 9-12 months prior to diagnosis.

Demographics: 40 yo female, caucasian, 42.61 BMI (I'm unsure if the history suggests possible obesity hyperventilation syndrome, but no arterial blood gas has been performed and I don't think HCO3 has been performed with recent blood panels to screen for that). Family history of COPD (mother) and 20-25 pack-years of smoking (quit 5 years ago), second-hand smoke exposure as a child, seasonal allergies, no diagnosis of asthma but was prescribed an inhaler a number of years ago. We live at a higher altitude (about Denver height).

Sorry to lean on the folks digitally. We have asked to be added to one of the pulmonology clinic's MD cancellation waitlist but it doesn't sound promising in terms of getting seen any-month soon. This is quite a scary diagnosis to absorb with so little information and with SO being just 40 years old. The only thing she was told about progression and prognosis was "don't look at mortality data on the internet."

Symptoms/Related Issues: Shortness of breath, especially in mornings and after climbing stairs or walking on an incline (does walk, treadmill, or other exercise daily). Sought medical help after months of poor sleep in addition to SOB and overnight pulse oximetry showed hundreds of desaturation events (over 30 per hour). Was put on 2L overnight oxygen during diagnostic testing and remains given LFT results (has a hard time with the oxygen due to stuffy nose)

LFT Results:

FVC: 5.68 liters pre-inhaler of albuterol (131% of reference level); 5.52 liters post-inhaler (127% of reference value)
FEV1: 3.69 liters/105% reference pre-inhaler, 3.69L/105% ref post-inhaler
FEV1/FCV: 65% pre-inhaler, 67% post-inhaler (ergo, moderate obstruction/COPD)
FEF25-75%: 2.10 L/sec (47% ref) pre-inhaler, 2.27L (51% ref) post-inhaler
PEF: 8.31 L/sec (114% ref) pre-inhaler, 8.80L/sec (120% ref) post-inhaler
FET100%: 12sec pre-inhaler, 11.45sec. post-inhaler
FIF50%: 1.32 L/sec pre-inhaler, 1.72L/sec post-inhaler (this one was the only big inhaler change at 31% increase)

TLC: 7.08L (123% reference)
VC: 5.68L (131%)
FRC PL: 3.85 (130%)
ERV: 2.44L (212%!)
RV: 1.40L (78%)
RV/TLC: 20%

DLCO: 22.5 (88% of reference value)
DL Adj: 20.7 (81% ref)
DLCO/VA: 4.20 (84% ref)
DL/VA Adj: 3.86 (77% ref)
VA: 5.37L (96% ref)
IVC: 4.21L (108% ref)

Raw: 2.84 (93% ref)
Gaw: 0.352 (108% ref)
Vtg (Raw): 3.70
Raw f: 65 BPM

In addition to clarity about current state, the other questions are the common ones - what might this mean for progression, life expectancy, etc.? After spending a lot of time reading through journal articles and abstracts, one thing that seems pretty clear is that there are very few longitudinal or retrospective studies or literature reviews about COPD groups under age 65.
0 Responses
Sort by: Helpful Oldest Newest
Have an Answer?

You are reading content posted in the Chronic Obstructive Pulmonary Disorder Community

Didn't find the answer you were looking for?
Ask a question
Popular Resources
Find out what causes asthma, and how to take control of your symptoms.
Healing home remedies for common ailments
Tricks to help you quit for good.
Is your area one of the dirtiest-air cities in the nation?
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.