Spirometer Results

[Cliff Etzel]

Well, after having batteled an upper respiratory infection in July, I haven't been able to shake a nasty, wheezy type cough I have had since that time. Went to see my doctor and she felt it necessary to do a chest x-ray and spirometer test to see if I was asthmatic.

She came back a little bewildered. She said for a man my age my results shouldn't be what they were. I asked if they were bad - she said no. I was off the chart!

She showed me the spirometer test and I could'nt make sense of it - maybe one of the medically inclined members of the forum could enlighten me on this.

I have attached the results of my spirometer test in acrobat form - could someone enlighten me on this?

PS - the chest x-ray was normal, but I was diagnosed with mild asthma. Doctor prescribed Advair for 30 days - could anyone comment on their experiences with this medication as well?

Thanks...

 

[Vodouch]

Helo,
I am just a biologist, so my medical knowledge is limited, but as far as I know:

FVC - Forced Vital Capacity, max volume of air you are able to expire
FEV1- Forced Expiratory Volume in first second, volume of air expelled in the first second of a forced expiration starting from full inspiration
%FEV1 percentage of the total volume expired in first second(should be over 75%)
FEF25-75%-Forced Expiratory Flow Rate , in litres per second, average rate of expiration at the middle part of FVC (in time - volume expired from 2/4 to 3/4 of total elapsed time)
PEF- Peak Expiratory Flow Rate, max value in litres per second
FEV3- Forced Expiratory Volume in Three Seconds, usually close to FVC
FET-Forced Expiratory Time

I think thay usually look mainly at PEF to find if you have obstructed airflow. You had PEF almost twice they expected, pretty impressive

It is all I know about this subject, hope it helps,
Petr

 

[Ward2]

I'm not a Doctor, but I played one when I was younger.

Hello Cliff,

Here's what the chart says:

FVC or Forced Vital Capacity (complete exahale after full inspiration), measured in (L) liters was an average of 147.00% higher than predicted (under the 'pred' column), presumably by some statistical model (chart) based on age, height, weight, & race. So, 5.57, 5.47, & 5.44 is the volume of air you exhaled, which is 147% higher than they expected. The FVC is usually normal or slightly decreased with obstructive lung disease (asthma).

FEV1 or Forced Expiratory Volume in (1) second (maximal expiratory effort), measured in (L) liters, was an average of 134.00% higher than predicted. This would also be reduced with obstructive lung disease.

%FEV1 - this is the PERCENTAGE of your vital capacity expired in the first second of maximal expiration. A healthy percentage is around 70%, don't ask me why it says 78.41 was predicted.

FEF25-75% or Forced mid-expiratory Flow Rate (average airflow rate during midportion of FVC), measured in liters/second (L/S). This is reduced in obstructive lung disease. These last two, in combination with the rest of your exam, are probably why you received the diagnosis of mild asthma.

PEF or Peak Expiratory Flowrate (maximal flowrate achieved with maximal expiration), measured in liters/second (L/S). You're way over the top on this one.

FEV3 or Forced Expiratory Volume in (3) seconds. It's usually close to the FVC in healthy people.

FET or Forced Expiratory Time (total period of maximal expiration), measured in seconds (S). I believe this and the MVV (Maximal Voluntary Ventilation) measure respiratory muscle strength, but are dependent on effort. That's why there isn't a predicted value there.

Simply put: Your respiratory system is way above average for your age, height, weight, and race. I guess they don't have any models based on actual vital capacity Et Al.

Hope that helps,

Ward

PS I'm really NOT a Doctor, this is just info & my opinion.

 

[donmoore]

sickness in Eugene

Cliff,
I can’t help you on the spirometer test, but after living in Eugene, OR from age 2 to 35 I have some other advice. Move!!! Haha!

I tried very hard to exercise living in Eugene, but I would get anywhere from 4 to 12 colds a winter. One year I had step throat 6 times! Upper respiratory infection are so common in Eugene, it’s not even funny. Pediatric doctors make their living off upper respiratory, ear infections, and asthma, there. Ever wonder why there are so many doctors in Eugene and Springfield?

At age 42, my fitness is now the best it's ever been. I lift more weight, run faster, and have more stamina, than I did in my 20’s. It’s amazing what fewer colds can do.

Eugene has its good points, but I would rather visit in the summer then live there.
Good luck,
Don

Go Ducks Go!

 

[Cliff Etzel]

Frustrated...

Tell me about it - problem is - my wife likes her job and doesn't want to move - me personally - I would prefer to move somewhere warmer with ocean breezes that call me to go diving.

As well, I really can't afford to move - the economy here has just been horrid, so work has been very scare for me for the last several months.

Oh well... :head

 

[donmoore]

Cliff,
I hear you about wanting to move to a warmer place by the sea. That was my dream for years, but I was stuck in a family owned business and couldn’t go.

Most business in Eugene are family owned, so to get a good job you either have to marry into the right family or be a doctor or lawyer. What do you and your wife do? People here say the job market is bad, but compared to the opportunities in Eugene, it was heaven for me.
Don

 

[Cliff Etzel]

A no win situation right now

MY wife works in the mortgage industry, and I have been a photographer/writer for over 15 years now and a web developer for a little over 5.

Can't afford to leave - can't afford to stay.

Yeah - I know what you mean regarding Eugene - feel like I am stuck in a no win situation right now and want to get the h3ll out! But we just bought a home and my grandson was born 2 weeks ago and well... You know the story... :head

 

[sharmyou]

just a humble opinion

I am not still a doctor, I am a medical student at present, so my opinion is just here "pour parlez" and my no means is intended as desrespect to your doctor's diagnosis.

By the way you described your complaints, I wouls be more oriented to a diagnosis of unresolved bronchitis, rather then asthma. I think that asthma would have manifested itself earlier in your life, not as a complication of on URI (upper respiratory tract infection) or LRI.
With asthma you would have SUDDEN onsets of respiratory difficulty, with whooping cough. You describe your cough as chronic, so I believe that it as the case of Bronchitis.
Is it a productive cough, that is, do you spit mucus?

My advice is that you consult not a general doctor, but a Specialist in Pneumology, because these trivial things can sometimes progress to bronchopneumonias.

Andrea

 

[Cliff Etzel]

Thanks to all who have responded to my post - it has helped greatly.

The Advair is doing a great job of helping me out. The coughing is basically gone and I am able to do my deep breathing/stretching for the first time since coming down with this.

Still lingering a bit, but it appears the mold spore count (which is ever present where I live) is up quite high and sems to be affecting me even with the Advair.

I have also started using my Powerlung again, and that is helping greatly with improving my breathing as well. I would recommend it to anyone who is having similar problems to look at utilizing it in conjunction with any type of asthma/breathing challanges.

Take care and I'll see those who will be at DEMA in October.

 

[DeepThought]

Cliff Etzel:

I have also started using my Powerlung again, and that is helping greatly with helping my breathing as well.

Hmm, pardon my newbieness, but what's a 'Powerlung'?

 

[Cliff Etzel]

Originally posted by DeepThought
Cliff Etzel:

Hmm, pardon my newbieness, but what's a 'Powerlung'?

Check out my review I did awhile back for Deeperblue at http://www.deeperblue.net/article.php/88/18

I think it will answer your question.

 

[TMcKee]

If theres one thing i've learned about life..."you are never stuck." You let outside forces influence decisions and that is what stops you. Its called logical thinking. I do it way too much. Heres an Idea, move on down to Gulf Coast areas and start some things here. Hell, spear-fishing is just being noticed in the rigs here. No White Sharks, just some Makos in certain areas, and a few Tigers. Jump in on some photography, start a free-diving school down here! There are folks who are getting more and more interested.
Alabama
Florida
Louisiana
Texas
Mississippi

Its a diverse area.

TMCKEE

 

[donmoore]

Gulf diver?

TMcKee,
Where are you located? I looked up your membership and tried to e-mail you, but apparently you didn't elect that feature. Sorry guys for taking up using Cliff’s thread for this.

There doesn’t seem to be many Gulf divers on this board. Rigdvr is the only one I know of so far. You can e-mail me at donmoore@yahoo.com (Junk mailers don’t waste you time, I have never bought anything from a spam message and I never well!) I spearfish out of Port Aransas, TX, have a boat, and would love to dive with some one.
Don

 

[fpernett]

Better late than never

Hi Cliff,
I'm an Internal Medicine specialist and a Pulmonary Medicine Fellow, I was on vacation and today read your thread.
I disagree with your Doctor.
Asthma is a reversible airway obstruction, so you have to document reversibility of that obstruction. Your results are normal for me: The FEF 25%-75% (very well explained in some reply) isn't bad, that value need to be below 50% of predicted to be of clinical importance. The normal result, in fact, doesn't rule out asthma, that's why is important to found if there is variability in your PEF values. The actual classification of asthma is: mild intermittent, mild persistent, moderate persistent and severe persistent. With a normal spirometry only can be mild, to know if is intermittent or persistent we rely on PEF variabilty and symptoms.
Your spirometry should be done before and after you inhale a short-acting bronchodilator. If that result is normal you should undergo a challenge test (metacholine or exercise) to rule out that diagnosis.
Is important to really know if you have asthma because it means a change in life style (you are thinking in change of city).
Advair is fluticasone (a corticosteroid) and salmeterol (long-acting bronchodilator) if you have mild intermittent asthma just need a short-acting bronchodilator to control symptoms, and if you have mild persistent asthma you should use a inhaled corticosteroid (alone) and the short-acting bronchodilator to control symptoms.
I don't know if you have asthma, because I never make you a physical examination, but my advice is that you look for a Pulmonary Medicine specialist consultation.
You are feeling better know, because of drug, but it doesn't mean that you should keep using it on a life time fashion

 

[TMcKee]

donmoore

Hey man, I mailed you this morning.

TM