Spirometry and diagnosis confused.

[Gazza01]

Hi. I am a little confused and could do use some thoughts from people in the know.

A year or so ago I had a ct scan for a heart issue which showed emphysema.

My GP wasn't too bothered and said its nothing to worry about. You have given up the smoking now so that's the main thing. I was also on asthma medication so he said you are on the right medicines so you only need to come and see me again if you have a bad episode. I guess he meant a chest infection or something.

Anyway I wasn't really happy with that so went back for a second opinion with a different GP and was told the same. Basically anyone who has smoked for any length of time will have some emphysema. I said at that point that I was using ventolin several times a day. So they agreed to Spirometry. I have had that a couple of weeks ago and although the nurse seemed positive and said you have some blockage but you have asthmatic tendencies as you have a lot of reversibility (320ml) So, between that appt and going to see the GP 2 weeks later for his diagnosis I had a look at the Spirometry print out on my medical records. I was pretty scared by it as it showed my fev1/ fvc was only 47%. Although at the bottom of the 2 graph pictures it did say mild blockage. I then saw the GP and he said I have it mild. And that I had done the right thing by quitting smoking and exercising every day. I then said that I was a bit worried by the fev/ fvc ratio score and he said don't be. There are so many variables involved that some of these numbers are not what we go by. We have a number that we go by. ( he didn't say what it was) he also said that with emphysema your chest gets stiff. Which I knew because you lose the recoil in the lungs. And that some people can just blow better than others. He told me again that he is diagnosing me as mild and that with my no longer smoking I should be ok. He changed my inhaler to a dual ( seritide) this was partly down to me as I had tried fostair for a while and it made me a bag of nerves. I came out of the surgery really quite relieved, but as the days have gone on I've started to worry about that 47% ratio again. I know it is generally lower for emphysema than for bronchitis because of the lack of recoil but I cant get my head around it all.

I am 55. I quit smoking 8 months ago. I exercise every day which did even before I started to have issues. I weigh around 10 stone maybe a bit more since quitting the ciggies. I eat home mostly home cooked food, with the occasional takeaway curry.

I have never had any chest infections and as long as I have a little ventolin ( which I was taking every 4 to 6 hours as I read this was a starting dose for some people with copd. I can exercise as good as most my age if not better all without shortness of breath or wheeze. I guess these thing are part of the diagnosis too. Your thoughts please good people.

Thank you.

[stone-UK]

Hi

The ratio Fev/FVC only indicates if you condition is Obstructive or restrictive.

It’s the FEV1 which indicates severity

With the reversibility test being more positive you are problem more Asthmatic with a possible emphysema overlap.

As you are already doing all the right things with regard to stopping smoking, sensible diet, and exercise, I would not dwell to much on the figures.

I would surmise you Fev1 is in the higher numbers, if told you are mild.

[Gazza01 in reply to stone-UK]

Thanks for that Stone. I know you are well regarded on here. So that has helped. Cheers mate.

[skischool in reply to Gazza01]

If it's any further comfort Gazza,i also crunch the numbers on occasions and have a good basic general knowledge of emphysema as i have more than a fair share of it and i totally agree with Stone's comments.concentrate on how you are effectively managing your condition at the moment and you will live to a ripe old age.

Best wishes Ski's and Scruff's

[Whitechinchilla in reply to stone-UK]

Thank you once again. Your replies are really appreciated.

[hypercat54]

Yes I agree with stone and ski's. Do you know your FEV! score? That is your lung function. For you to be diagnosed as mild it must be a lot higher than 47%. I am mild and my doctor told me something else would get me first such as old age! x

[aberdeenman]

hi you did the right thing stopping smoking keep off the fags and you will be fine, I wish I had listened to my doctor when he first told me stop smoking about 10 years ago but I didn't listen and it was in 2014 I had my first spirometry test and my fev1 was 18% classed as very severe and was told straight off that I would need a double lung trans plant. but I would need to stop smoking, it took a while but I eventually stopped smoking and was told I needed to be off the fags for a year before I would be assessed for transplant so I did, I was taken in last year for a week of tests, every test you could think off, then they referred me to the transplant team at Newcastle, but when I was in hospital with another infection my consultant told me that Newcastle weren't going to take me on there list for a transplant because they felt I wouldn't make it , was hard to take as I can walk very little now without being out off breath, my fev1 is now 12%. but I have recently moved into sheltered accommodation which gives me a new lease of life as I will be able to get out and about. so you just need stay off the fags that will stop it getting worse you don't have much to worry about, even try get on pulmonary rehab that helps a lot ive done it twice already im just waiting go on it again, not manage as much as last time but every little helps. hope this is of helkp to you.

tam

[syntax]

I was told one cigarette can be enough,plus being in bars where people smoke,to

start C.O.P.D. off. From there you either get lucky and it stays in one area,or not so

lucky (me) and is spread over the lungs. ???

[jackdup]

You should ask what your FEV1% of predicted is. As your doctor said the FEV1/FVC ratio is not what they use. If you are mild your FEV1% of predicted is likely about 80% or at least close to it.