Just a quick update and info from you please would be appreciated
After Spirometry test Nurse said I had copd stage 1, then said he had done his maths wrong and it was stage 2. Put on inhalers which were changed with Doc on visit to her.
Went for review after month, nurse read my records and said I had Asthma, I queried this with Doc on my last visit and she told me to go and see a certain Nurse. She said it certainly wasn't Asthma and more likely to be copd but would have a word with the respiritory Doc and phone me back. He said it wasn't Asthma and more likely to be copd. I can get some of my readings of the test through emis, but not sure what I am looking for, can someone please throw me in the right direction
Chrissie x
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chrissie789
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Chrissie this sounds like where I am at the moment. I am getting different opinions from different doctors. My main concern has been a sudden onset of dry wheezing and shortness of breath after a bout of flu. This is not clearing up despite inhalers and short course steroids. Blood shows no infection. I was a long term smoker, now age 53 and stopped smoking two years ago. I felt reasonably fit until flu, walking dog most days for a couple of hours. I was due to have Spiro today but the nurse said she cant do it until at least six weeks after antibiotic course so postponed. my peak flow is good and pretty stable around 430 so think that is not consistent with asthma? my fev1 was 98% with the hand held test at gp last week, but feel so unwell. They don't think heart. I had a ct scan in April for sus pe after an op, it was neg for that tho. I asked again about that scan and they have come back to me to say mild emphysemus changes. They think asthma is an overlaying factor?? Also over the past year or so I have mentioned symptoms such as racing heart, shortness of breath (sporadic) and was always told typical menopause symptoms, and stress?? Chrissie, what symptoms are you having and what stats ?
Hi Sara I must say after reading your post I can identify the racing heart breathing probs shortness of breath and iam now menopausal some docs agree it's that others say it's lung disease, very confusing,
Just the latest update first, I developed a bad cough, with some odd sneezing fits and my breathing problems got worse, made an appointment to see the Nurse, who got a Doctor to come in and examine me, The Doc said I had a chest infection, they put the mask on me to inhale and gave me some anti-biotics and steroid tablets to take.
I did mention to the nurse, I was original told I had COPD Stage 1, then the nurse said he had done his Maths wrong and he did the figures and said I had stage 2. And another nurse said it was Asthma which at a later date I was told by a Nurse she had spoken to the respiratory Doctor who confirmed it wasn't Asthma and possibly COPD.
This Nurse then said there is no such thing as stage 1 stage 2 etc you either had it or you didn't. I just bit my tongue at this point and I just asked if I had it. She said I am down as undiagnosed at the moment and I would know more on my next spirometry test in October 2016
Anyway, this is all the info I could get re the spirometry, I imagine the Nurse changed the figures to the correct ones
Peak flow after bronch 273/1min
Expected FEV1 2.21
Expected FVC 2.61
FEV1/FVC 68%
% Predicted 94%
FEV1/FVC after bronc 2.81
Not sure if this is bad but it was mentioned Blood pressure135/83 possible pre-hypertension
Pulse rate 98
Your comments would be appreciated, I seem to get more info from you guys than the nurses
Do you have the actual report or just the above numbers? The expected numbers you show above are the reference number and are what would be expected from a person of your age and weight but without lung disease. There should also be your actual numbers in two columns, one pre-bronchodilator and one post-bronchodilator and those are the numbers that are used to determine the stage you are.
Ideally if you could simply get a copy of your spirometry report then you would have all of the figures you need and they should give it to you if you ask. This is a link to show what it would look like and what it would contain.
If you only had a spirometry and not a full pulmonary function test than you will only have the numbers shown on the top of the form that the link above takes you to. The lung volumes and difusing capacity shown on the bottom of the form would not be included.
If they will not give you the full printout then I would ask for the FEV1 and FVC both predicted or expected as well as your results and the percentage of predicted both for pre and post bronchodilator. Do you recall if you did your blows and then they gave you an inhaler and then you did them again? If so then they should have the pre and post numbers I mentioned above but if you didn't use an inhaler than you will only have one set of numbers which is a mistake if they suspect asthma may be partially or fully responsible for your problems.
It is also nice to know your PEF and a few of the other numbers that are shown on the actual report as then you can see if you have small airway obstruction which is quite often the case with COPD.
I think some doctors and nurses really don't understand the spirometery results that well while on the other hand many nurses trained in pulomonary issues will be much more versed in the results than a family doctor.
Thank you so much for all the info you have been a great help. Yes I did the blows, had the inhaler, then had to go outside and wait half an hour and go back in and blow again
Hopefully I will be given the info tomorrow, I must admit it is getting quite depressing now every time I go I get different answers and nothing confirmed
I'm not a doctor but I did a lot of reading and research and have a reasonably good understanding of spirometry results and would be more than happy to help you with them and really hope they give you the complete report.
Thank you, I must admit it was a shock when they told me I had COPD, well not at first because I didn't really know what it was, it wasn't until I got home, the info the Nurse gave me didn't really explain a lot, it wasn't until I googles it I was in shock, but thankfully found this site which has been the most helpful thing so far, hopefully I will get a full report tomorrow
Be cautious when googling as there is a lot of misinformation and horror stories out there about COPD. Nutrition, maintain a healthy weigh and exercise can help a lot. There is no cure but I believe it can be managed much better than what it used to be.
Just a quick update saw a different Doctor today, I did ask for a print out of the test and he kindly printed it out. He said he wanted a quick look through, he also said it didn't appear to be Asthma and more likely to be COPD or another Lung condition.
On every spirometry report that I have seen all of the different tests are listed down the left side like
FVC
FEV1
FEV1/FVC
FEF25-75%
PEF
But there are several more as well.
To the right of the different tests are several columns. Usually the first column is the unit of measure and then the next column is the reference or expected or predicted and it contains numbers which represent the results one would expect if you were testing an individual with no lung disease or issues, or “normal” results for a person of your age, weight and gender. The next column would be your actual results for that test before using a bronchodilator and that column could be titled actual or reported or pre and that would be one of the important numbers in analyzing your results. Next to that would be a % column which would tell the percentage your results is of the normal result so if for example the normal or expected column for FEV1 was 2.2 and your actual result was 1.1 then the percentage of predicted would be 50%. Next to that there is a column which could again be called actual or reported or post and is your results after or post using a bronchodilator and should generally be higher than the pre one. If there is a significant improvement that at least part of your problem may be asthma.
So the important numbers are the normal or expected and then your actual results both pre and post bronchodilator for FEV1 and FVC and PEF although knowing all of the numbers is helpful as well, so hopefully those numbers are the report you have.
Sorry for the delay in replying internet connection problems, hopefully these are the figures you need (If this message only gets half completed, apologies, I will continue as soon as internet connection is working
Sure. You can send me a private message with all of the numbers or post a picture of the printout of your results, or you can post them here or start a new thread, whichever you prefer.
Well I can understand why there is some confusion about whether you have COPD or asthma as the numbers are not really definitive, at least from my knowledge but a pulmonary specialist should be able to sort it out.
I believe the diagnosis for COPD is a reduced FEV1 and an FEV1/FVC ratio of less that 70% so you qualify based on those two items alone, but there are often other things they look at for confirmation like x-rays and sometimes CT scans. Your results are presented a little different from what I am used to but it appears your FEV1 is 94% of predicted which is very mild and if you did another spirometry tomorrow it could be normal as your FEV1 can vary from day to day. In addition the predicted or expected is generally the average of a large group of people without lung disease so some will normally be above and some will be below the predicted number, so at 94% it is likely within the margin of error. The reduced FEV1/FVC being below 70% is because your FVC is 117%, which could be for a number of reasons and may just be the way you are and that is why they take both the FEV1 and the FEV/FVC into consideration before making the diagnosis, so while you technically qualify as having COPD your FEV1 is just barely reduced. If you had another spirometry tomorrow your FEV1 could be normal and then the reduced FEV1/FVC by itself would not be enough to make a diagnosis of COPD unless an x-ray or CT scan confirmed COPD. Your PEF is 77% of predicted which is obviously reduced but is more indicative of asthma. PEF is also reduced with COPD but generally your FEV1 would be reduced more if your reduced PEF was a result of COPD rather than asthma.
So I don't know that I was much help and hope I didn't confuse things more for you but your numbers are mild enough a definitive diagnosis is difficult without the training of either a nurse that specializes in pulmonary or a doctor who again specializes in pulmonary. Usually the numbers are more definitive and again that is likely why you seem to be getting conflicting answers from different people you have talked to.
Have you had either x-rays or a CT scan and if so what were the results or perhaps you haven't had either but they are scheduled?
Many many thanks for your reply, what you have said makes more sense to me now than any of the Doctors or Nurses have told me so far
I haven't had a CT scan and nothing mentioned or scheduled about having one.
I have had a chest x ray earlier this year which showed up as my lungs were enlarged, it was then the Doctor arranged for me to have the Spirometry Test.
I believe now they are just going to carry on with the inhalers for me until next October when I have another Spirometry Test
I think I have had 4 chest x-rays in the last six or so years and three said lungs were hyperinflated which is consistent with COPD but the last one I had this summer said they were normal and I am moderate COPD. The doctor told me two different people read the x-ray and one might say they are hyperinflated and the other one not. So your lungs may or may not be enlarged or hyperinflated but again if your FEV1 is at 94% of predicted that is about as mild of COPD as you get. Do they by chance show the FEF 25%-75% as that may show whether there is small airway issues.
Jackdup: Those percentages to which you are referring to are not FEV1 but are 'FEV1%' and whilst it's not clear in your earlier link, 'FEV1%' = Fev1/FVC see wiki below.
FEV1/FVC ratio (FEV1%)
FEV1/FVC (FEV1%) is the ratio of FEV1 to FVC. In healthy adults this should be approximately 70–85% (declining with age).[11] In obstructive diseases (asthma, COPD, chronic bronchitis, emphysema) FEV1 is diminished because of increased airway resistance to expiratory flow; the FVC may be decreased as well, due to the premature closure of airway in expiration, just not in the same proportion as FEV1 (for instance, both FEV1 and FVC are reduced, but the former is more affected because of the increased airway resistance). This generates a reduced value (<80%, often ~45%). In restrictive diseases (such as pulmonary fibrosis) the FEV1 and FVC are both reduced proportionally and the value may be normal or even increased as a result of decreased lung compliance.
A derived value of FEV1% is FEV1% predicted, which is defined as FEV1% of the patient divided by the average FEV1% in the population for any person of similar age, sex and body composition.
I am confused by what you think was wrong in my post? There is an FEV1 value and that is used to calculate the FEV1% of predicted. You start with a reference or predicted FEV1 which is what the average of a number of people of your age, sex and height can forcefully exhale in the first second and then your actual FEV1 is calculated as a percentage of that reference or predicted FEV1 which is your FEV1% and is used to determine your stage of COPD. In addition to confirm COPD they expect to see an FEV1/FVC percentage of less than 70%. I am unclear about what you feel in my previous posts were incorrect?
You state
Jackdup: Those percentages to which you are referring to are not FEV1 but are 'FEV1%.
I reread my posts and unless I missed it I believe in every case I mentioned FEV1 percentages it was always stated FEV1 percentage of predicted and never did I mention the actual FEV1% was an actual result but always stated it as a percentage of predicted. An FEV1 by itself is almost meaningless without having a predicted or reference number to compare it to and then your actual FEV1 is compared to a predicted number and that comparison is stated as a percentage or predicted and that is your FEV1%. I can say my FEV1 is 2.22 but that number is meaningless unless I have a reference number to compare it to, so if the reference number is also 2.22 then my FEV1% is 100% of predicted but if my predicted or reference number is 3.70 that my FEV1% is 60%.
You state
whilst it's not clear in your earlier link, 'FEV1%' = Fev1/FVC see wiki below.
FEV1 (not FEV1%) is used in the calculation of your FEV1/FVC ratio but that ratio is not the same as your FEV1%. The FEV1% is your actual FEV1 expressed as a percentage of the reference or predicted FEV1 or what an average person of your age, sex and height would be. FEV1/FVC is a ratio comparing your FEV1 to your FVC and not to a reference or predicted number.
You can have an FEV1% of 67% which makes you moderate and your FEV1/FVC ratio could be .60 or 60% or .45 or 45%. FEV1% and FEV1/FVC ratio or two completely separate calculations. Once you have calculated your FEV1/FVC ratio you can compare that to a predicted value as well and express that as a percentage of predicted.
Your FEV1 by itself is all but meaningless if you don't have a predicted or reference number to compare it to but your FEV1/FVC ratio does not need to be compared to a predicted or reference number to meaningful as generally they know what percentage of the total air in your lungs you should be able to breath out in the first second of a forced exhalation which is what that ratio reflects.
You don't need to re read your post. It's the Canada COPD that differs from the wiki, even though it refers to it.
Read the wiki, read your link - note the differences in the "Fev1%" definition... They can't both be correct and, as it happens, the wiki is correct as Fev1/Fvc ratio is the important (the diagnostic) measure .
That measure is about whether you can blow out 70% of YOUR lung vital capacity in 1 second, not whether you can blow out as much as someone else of similar age size and sex, which is what FEV1 percentage of predicted is.
So there would be no way of ever being diagnosed as having mild COPD as mild is 80%-100% but by definition FEV1/FVC has to be less that 70% for COPD to be diagnosed. On every website I have seen COPD is diagnosed by having a reduced FEV1 AND FEV1/FVC below 70%. The stage one is at is determined by the FEV1 percentage of normal/predicted, not by a percentage of FVC and here is a wiki link as well as a couple of other links that all same the same thing, COPD stage is determined by a person's FEV1 percentage of predicted or normal for a person of your age, height, and sex etc.
I was concerned that someone coming home with a spirometry report from a doctor, who did not explain the results, might see the comment about the FEV1/FVC ratio being used to determine what stage they were rather than FEV1% of predicted.
Chrissie is a good example. Her FEV1% of predicted is 94% making her pretty mild and that number could be within the margin of normal however taking her FEV1/FVC ratio, which is 68%, into consideration, it is below 70% which is essentially a confirmation. but again it is so close to the 70% it may leave some doubt, however someone reading the post that FEV1/FVC is the FEV1% used to classify the COPD stage may look at the spirometry report stating 68% and think they were moderate, when in fact they are very mild and there could be some question as to whether they actually have COPD at all.
It would have been nice if Chrissie would have had the FEF 25%-75% as that could well be the first signs that it is in fact COPD as it seems that can be where the first changes become more evident.
Anyway I think we were both essentially saying the same thing.
Fev1 (Forced Expiry Volume) is the volume of air that you can blow out in 1 second.
FVC (Forced vital capacity) is the volume of air that can forcibly be blown out after full inspiration.
Normal = should be able to blow 80% (arguably, 70% in some nation criteria and GOLD) of your total (FVC) capacity in 1 second.
Fev 1 is measured in litres ( so 2, 3 or 4 or thereabout usually expressed to 2 decimals, so '3.46 ltrs'). If big number 25, 40, 60, 80 etc that is % of predicted (expected from 'normal lungs').
Men have significantly bigger lungs, and so different norms, than women. So:
Predicted numbers is an average of normals of your sex, age & height, that include big people with small lungs and small people with big lungs.
So taken by itself Fev1 could look 'obstucted' because your blow is less than average... but you could have smaller than average lungs thus actually be normal!
Whilst someone else could blow 90% predicted but have bigger than average lungs and actually be obstructed. And this is where your results appear to point.
So they need to take into account the size of your own lungs hence the ratio of blow(FEV1) to volume (FVC) where Fev1 divided by Fvc (FEV1/FVC) = 75%, arguably, is bottom of the normal range, or top of the obstructed.. depending on age, and depending on history, smokers (&ex) with symptoms very likely to be deemed obstructed. Confusingly, in some areas outside UK this is sometimes known as 'FEV1%'
There is another measure that tells where the obstruction occurs. I fail on the last quarter of the FVC blow (FEF 25-75) which indicates small airway obstruction. See links
Come on guys your both brilliant 😤 and thanks for been on this forum.
Andy.
hi i'm 63 yrs old in June and 5ft 11inch tall, female. Please could you help me with my recent Spirometer results. My weight is 8st 3lb
FEV1
BASE 1.56 2.66 241
BASE 1.67 2.43 245
BASE 1.58 2.31 205
FEV1 1.67 70
FVC 2.66 89
PEF 2.45 58
FEC/FVC 63 83
FEF25 2.26 36
FEF50 0.80 22
FEF75 0.24 22
FEF25-75 0.64 21
FET9.9
in reply to
Hi, what did you want to know? You can ignore those beginning with FEF. They relate to the function of the very smallest branches of your lungs, which in anyone with bronch will be poor. The most significant reading for bronch is the FEV1
ps you can put your details in here & get a calculation of what % FEV1 you have, compared with someone with undamaged lungs.
Are you really 5'11" and weigh only 8st 3lbs?
in reply to
sorry i am 4FT 11in
Hi I want to know if you can tell how bad my lungs are. Also the stage I am at. Thank you
in reply to
Sorry 4th 11
in reply to
I'll try to help, not sure I can! Phew, I'm glad you're not a foot taller, you'd have been seriously underweight
Unfortunately your results sheet is in a different form from mine. It looks as though your FEV1 is 1.67 and your FVC 2.66. But, putting those figures into the spirometry calculator gives you an FEV1 of 84% of "normal", which is excellent for someone who's had bronchiectasis since age 17 (I peeked at your profile.) How are you, do you feel your lung function is really good?
i have chest infections all the time. i also suffer from Aspergillus and have mucous plugs. i feel tired and unwell most of the time. i have had a third of one lung removed and half of the other in 2003. I'm really worried about my lungs as get breathless on and off, i feel my lungs are getting worse. thankyou for your help although i don't feel my lungs are good
in reply to
I agree. It's not possible that your fev1 is 84% (wish it was.) Maybe someone else can shed more light, or you could phone the helpline tomorrow & ask them?
What is being done about your aspergillosis, are you on anti-fungals?
in reply to
Ps the no. is 03000 030 555
in reply to
i take Voriconazole 200mg once a day, ive just started azithromycin 1 every other as my preventative medicine also nebulize Colomycin antibiotic as preventative. My treatment for infections have also just changed to Amoxicillin 2 x 500mg 3 times a day sometimes steroids. also a few inhalers. also Nebulize Saline 4 times a day to help cough up Mucous plugs
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