Testing done to check for COPD or Asthma

[Lilsparadise]

I've been having problems with breathing, choking & at times vomiting in my sleep.  I had a CT scan of my upper chest & dr. found a prominent thymus, tracheal diverticulm & left-sided heart enlargement.  I also have sleep apnea, constant chronic sinus problems & was told that I have allergies & CHF & possibly asthma.  So my doctor had me do Pulmonary Testing and here are the results:

                                                 PRE                  POST
TLC                                            84%                    
TGV                                           90
RV                                             44
VC                                           105
RV/TLC                                      51    


FVC                                         100%                   99%
FEV 1                                        91                      92
FEV 1/FVC                               102                    105
FEF 25-27                                  53                       61
PEF                                           87                       98
FEF 25                                      82                       94
FEF 50                                      51                       63
FEF 75                                      37                       49
PIF                                            71                       71

FEF50/FIF50                          56.60                    76.43

R 0.5 (raw)  (cmH2O*S/1        146%
sRaw 0.5  (cmH2O*s)             228%
eGaw 0.5                                44
DLCO SB                               98
DLCOc SB                             98
DLCO/VA                              172
DCLCOc/VA                          171

PI MAX           65.42
PE MAX         83.08

My father passed away almost two years ago from Amyloidosis & it scares me because with the many problems that I'm having, my father also had and my blood work mimicks his.

[zodiacqueen]

Well, I really hope that you did the research on the upper airway obstruction-it's important that you see this for yourself and print it so doctors will know to take you seriously.  You are right-many are idiots and totally dismiss us!  ={

That heterogenous mass means that the thymus has tissue of various thickness-thin in some areas and thicker in others.  This is very very strange that you have a thymus anymore.  Babies have one that will show up on x-rays until they are 5 yrs old.  Adults that thymus gland will shrink and becomes nonfunctional.  It helps babies until their own immune system kicks in!  

Have you had a thyroid test done yet?  An underactive thyroid gland will cause it to enlarge.

Girl, you need to get very pushy first thing in the morning about looking into this further.  Write me a private message if you feel like replying back.  I don't like everyone seeing what I write!

Take care!

[Lilsparadise]

Thanks a lot for all your help and support.  I really do appreciate it 110%!

On my CT is states that I have Thymus swelling & thymic hyperplasia.  I had this done at the Veterans Hospital.

Here's what it says:  This is some hetergeneous appearance of portions of the thyroid gland.  There is soft tissue density seen in the anterior mediastinal region which could represent residual thymic tissue or thymic hyperplasia.  Subcentimeter mediastinial lymph nodes are noted, no significant hilar lympadenopathy seen on this contrast study.  There is evidence of a right paratracheal air cysts. Main differential diagnosis would inclued a small tracheal diverticulum.  

No definate evidence of pulmonary masses.  Liver, spleen, pacreas, gallbladder, adrenals top of the kidneys demonstrate no gross focal lesions.  There is minimal calyectasis noted on the upper pole of the right kidney.

Impression:  
1.  There is soft tissue density seen in the anterior medistinum which represents thymic hyperplasia.

2.  Hetergeneous appearance of they thyroid gland ultrasound is highly recommended.


I had a CT scan done while in the Navy 10 years ago, because the doctors thought something was wrong with my thyroid, because the left bottom side of my neck was swollen and still is!  The results of that CT scan are:

I was looking for the papers, I have misplaced them somewhere with my VA paperwork.  But on it, it does't mention my thymus, but it states that it's broken neck muscle tissue that it beside my thyroid gland.  But it shows its in the same place where they saw the thymus tissue or air cysts.  The size has gotten bigger from when I compared the two CT's.

I have another CT & a stress test results that I will give to you in a little bit.  I'm about to bath my 2-1/2 year old and put her to bed.  Again, I thank you for everything!

[zodiacqueen]

Hi sweetie, I am so sorry that you're going through all of this BS!!  Your doctors have NO business what so ever to dismiss you as they have been!  There were most definitely some abnormalities in your PFT's (lung function test).  

TLC                                            84%                    
RV                                             44

FEF 25-27                                  53                       61
FEF 25                                      82                       94
FEF 50                                      51                       63
FEF 75                                      37                       49
PIF                                            71                       71

Thes values are NOT normal at all and must be checked out!  Well, the TLC and the FEF25 are on the low side of normal.  The FEF numbers represent the flow volume loop of the lung function test that you took.  Please do an on-line search of pulmonary function tests, and especially flow volume loops.

Your TLC is on the low side of normal as well.  That shows a restrictive problem in your lungs.

Didn't you get a chest CT?  You must get the results sent to you.  You'll have the radiologists' opinion on what's going on in your lungs.

I read the findings of your echocardiogram.  The doctor wrote that there was only slight enlargement of your left ventricle.  The findings said that everything is normal in your heart besides the slight enlargement.  

You really really need to push harder to get someone to take you seriously.  Something is most defintiely up with your lungs.  Once you do the research on pulmonary function testing and flow volume loops.  Actually it's a variable upper airway obstruction that your FEF numbers show.  You need to push the doctors and get nasty if you have to.  Copy some of the info that you see when you do the research and bring it with you to the doctors!

[Lilsparadise]

I have a copy of all of my test results and neither the cardiologist, the pulmonary doctor nor my primary doctor discussed anything with me and I've had all of these test months ago through the VA hospital and these doctors are not trying to work with me at all.

When I used to tell my primary care doctor about my shortness of breath and pain below my left breast and my rib cage, he would tell me it's heartburn and give me medicine which didn't work. I know what heartburn is, I have three children and had serious heartburn with all three.  Or I would tell the many of doctors I was seeing about certain things and they'd tell me, "Oh, you're young, it'll go away and you'll be ok." But as I read more on CHF and LVH, I'm like, these are the problems that I've been telling these doctors all along.  So I'm just distraught and sickened with those doctors.  How long am I to wait for those doctors to go over the results with me?  They've been done months ago.

Here are the results of my ECHO:  Mild LV posterior wall thickness, Mild Concentric Left Ventricular Hypetrophy, Mild IV septum thickness.

                    ECHOCARDIO RESULTS:
AORTIC ROOT                    3.4 cm
LEFT ATRIUM                     2.5 cm
IV SEPTUM                        1.2 cm
LV POSTERIOR WALL        1.2 cm
LVID (SYSTOLIC)                2.9 cm
LVID (DIASTOLIC)               4.1 cm
LVOT                                 1.9 cm

LEFT VENTRICLE
Normal left ventricular size & function
Mild Concentric left ventricular hypertrophy
Estimated left ventricular ejection fraction - 60%

LEFT VENT. WALL MOTION, LEFT ATRIUM & RIGHT VENTRICAL:  Normal size & function.

RIGHT VENT. SYSTOLIC PRESSURE - 33mmHg & pressure is normal
RIGHT ATRIUM: Normal chamber size
AORTIC VALVE: Normal
  - Dopper info:  Velocity aortic valve maximum 1.2 meters per second
  - Left ventricular outflow tract - 1.0 meters per sec.
Normal aortic valve velocities
No aortic regurgitation

MITRAL VALVE:  Normal mitral velocities
  Doppler info:
  - E - 0.7 meters per sec
  - A - 0.8 meters per sec

PULMONARY VALVE: Normal velocities & no regurgitation
TRICUSPID VALVE:  Normal valve & Trace tricuspid regurgitation

EFFUSIONS:  No percardial effusion
PULMONARY VEIN:  Normal pulm. vein flow pattern

[zodiacqueen]

Hi, do you know what the results are or are you waiting for them to go over the results with you?

If you don't feel like waiting, ask for a copy of the radiologist's report directly to you-you might have to sign for them!  It's always a good idea to get copies of every test that's been done and keep it in a folder at home.  I think it's too much to expect the doctor's offices to keep copies of tests that have been done!  LOL  How sad is that????

[Lilsparadise]

Thank you for responding to my post.  Your insight is very helpful.  I just seem to have a bunch of IDIOT doctors who fail to do anything with the results of my ECHO, EKG, CT or Pulmonary Test.  I've had these test months ago and yet neither of my VA doctors have done a thing to do anything with me.  I'm just so frustrated right now!  Again, thank you!

Lilsparadise

[zodiacqueen]

From the looks of your results, you don't have asthma because your FEV1 is normal and there was very little improvement after using the inhaler and retesting.  You have a decreased FVC, which shows some sort of restrictive disorder.  

I hope that you're seeing a pulmonologist (lung doctor), because your test results need to be investigated.  And, you could ask to have your CT scan analyzed by a radiologist specializing in pulmonary conditions.  They might find something that the other radiologist didn't!

Good luck!