So I went to the Pulmo a couple days ago and had full PFT's. I posted here a couple times prior.
Anyway, my FEV/FVC was 69, then to 71 post Albuterol. So not much change. FEV1 105%, maybe 108 post. Again not much change. Airway resistance normal. DLCO normal.
But my lung volumes not. TLC, RV, TLC/RV ration all increased. The residual volume (RV) was 318% of predicted. For this reason he checked me for Alpha 1. I am 43, smoked about 10 years, never heavy, but that does not matter now. The final report says minimal obstructive disease with overinflation. I know that FEV looks at the larger airways, so can be unaffected by air trapping like I have. And boy do I. That is a static measurement too. I tend to be hyper aware of my breathing and for a "mild" obstruction, my symptoms don't match up. So I do believe how I breath impacts it. Whether physio or psychological. Maybe both. But when I try and do anything physical, I notice I get more out of breath now than I did even two months ago. I have dyspnea all the time, better since I started Spiriva two days ago. I am six puffs in so far and he said give it a month before I see any difference, if at all. I was on Dulera and Flovent in the past and did nothing. My symptoms were not as bad then. Thats what scares me, how I feel like I am worse. 6 months ago I had normal spiro for the most part, FEV1 always high. Again, that is irrespective of hyperinflation.
So my doc said he didn't see much to be concerned about. Yes volumes high and checked Alpha 1. Said he has been doing so for years and out of thousands maybe a handful were +. Whether I do or not, I have what I have. He told me he would be happy with my results. I asked about meds and he was reluctant, when I pointed out the hyperinflation, he gave me a month sample of Spiriva. Yes I live in America, so samples of expensive medicine a good thing. Since I was on Dulera, Flovent he said no point and I agree. He also said he didn't see much from a cardiopulmonary standpoint for my SOB. Hmmmm. I mean to me hyperinflation means Asthma or Emphysema. I had the former but always from allergies or exercise. Not severe Asthma, but I did smoke, so maybe I damaged the alveoli that way or the latter. I can appreciate his reluctance to slap a dx on me, does not benefit me at all. Doesn't change the management, which is meds if you need them. In theory, I am Gold stage 1, which means mild and Albuterol as needed or a LABA. Spiriva is approved in the US for mod-severe. Tho I know many on here and in america, like myself who are "mild" are taking it. Not too mention studies have shown it to be beneficial early on. We will see. If it can get rid of some of the trapped air and improve my breathing I am all for it.
I mentioned some other things and he told me we can look as hard as I want and he will find something wrong with me eventually. I actually like his style, said if it was serious he would tell me. So I got the sense further testing, like an Echo or VQ scan would be for to evaluate my sob from a cardiac standpoint or maybe small pulmonary emboli. Overall he was not too impressed, aside from the lung volumes.......even then not so much. No CT scan, which is fine, even if I have something on CT like Emphysema, does not change the management. Did the inhaler thing, no help. Though in the past, albuterol did the trick. Not so much now. Supposed to see him in 1 month.
Anyone else on here with "mild" copd, and hyperinflation? I feel like everything about what is going on with me doesn't fit. My age, smoking hx, god FEV1, normal DLCO, normal airway resistance. No cough. I did wheeze but stopped after the Spiriva, Yet my lungs are full of air. Some air trapping yes, but I have a lot. Like I should be much further along. Like much worse function. Not to mention I would expect the DLCO to be low if the emphysema was bad and that those numbers would coincide more with the air trapping.
Of course since I learned of the hyperinflation, my abdomen feels tense and full, but this does not happen overnight. COPD takes awhile to show itself, so now my abd feels that way after seeing the results. But the volume numbers are real.
Confused? So am I.