Can FEV1 improve after stopping smoking

[gocat]

My husband had a FEV1 30% January 2011 when discharged from hospital after an exacerbation. He stopped smoking then This year January 2012 when admitted to hospital following a not so bad exacerbation his FEV1 was 49% when discharged.

So what I would like to know is it the stop smoking that has resulted in this wonderful result or do results fluctuate like blood pressure does?

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Did you talk to doctors at the hospital that have all the notes about your husband for answer to this when they know more about how he is after being bad where is normal for your husband to get back to when he is not bad.

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Hi gocat

You are discovering that fev1 is not set in stone - and I am happy to see your discovery is due to experiencing an upward trend

Variations in fev1 can happen for a number of reasons. The first is of course due to having the right medication for you and having a good reaction to it. This is what is meant by a 'post meds' fev1 ie. the spirometry was performed when the patient had been using their inhalers. Most spirometry is done this way, except for the very first initial spirometry at diagnosis which is usually performed 'pre med' to get a 'baseline' and then 'post med' to measure any 'reversibility'.

Secondly, when first diagnosed we have usually been ill and almost immobile for some time. Our breathing muscles, particularly our diaphragm, can be so weak that we can barely perform a forceful blow out. This too may affect the earlier spirometry and so impact on the initial fev1 figure.

As far as smoking goes - it is usually said that stopping smoking will not improve lung function - and strictly speaking that is true. However, if the lungs are very congested due to smoking it may be the case again that the first spirometry was 'weak' because the congestion made it difficult to give a good strong blow.

A spirometry reading can vary not just from day to day, but even at different times of day. These variations are usually small though, giving differences of just a few percent to the fev1. They are due to such things as how long it is since the patient took their morning inhaler, how tired the patient is and even the skill of the nurse in carrying out a good spirometry test.

Other things that may affect fev1 over a period of time are exercise - particularly such that strengthen the abdomen, diaphragm and accessory muscles, this may add a percent or two - and weight gain/ loss. Many seriously obese people who do not even have lung disease will register an fev1 in the mild disease category, purely because their lungs and diaphragm are being 'squashed' and restricted . Note too that a meal should not be eaten just prior to testing as this can affect it too.

As regards exercise, it is not so much that exercise will always improve fev1 - but it may do when starting from a point where there has been little exertion for a long time due to illness or similar.

I would expect, all things considered, that your husbands fev1 should safely stay around 49% for some time - though it may falter in either direction by a percent or two up or down due to 'natural fluctuations' as described above.

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Hi Gocat

FEV1% does fluctuate, and for sure stopping smoking is going to help that as does regular exercise. FEV1% is affected by many things, a cold, flu, an exacerbation, air born pollution, hayfever etc etc. When we are stable, not smoking, exercising regularly, eating well, air quality is good and breathing is easy our FEV1% is going to be so much better.

I congratulate your husband and you for the support you have given helping and achieving good FEV1% results.

Keep up the good work.

[gocat]

Thanks for your replies.

I guess after the first test, it was a week or two after a severe exacerbation whilst the 2nd on was after a not so severe exacerbation so that two accounts for the improved FEV1 as well as the stopping smoking.

But its not all good really as he wont excercise. Never wants to go out. Very poor appetite and drinking of alcohol has increased since stopping smoking

Is due to see GP nurse soon, so hopefully still will test him and see what his FEV1 is now.

[copdliving in reply to gocat]

Drinking alcohol will affect his breathing.

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Exercise is absolutely essential and could help to increase his FEV1 even more. Ask your doctor about pulmonary rehabilitation. It worked brilliantly for me, rasing my FEV1 from 27% to 33% and keeping it there. If he wont go out because he is embarrassed about his lack of fitness you should consider having something at home. Pulmonary Rehab staff will recommend easy home exercises. In the end it will protect his quality of life.

[gocat]

Thanks for replies. Yes he has attended 2 courses of PH. One in Feb 2011 and one course this feb 2012 after each hospital admission for exacerbation. I really noticed an improvement in him as these 2 course progressed but he failed to maintains the excercises after the course has finished.

And yes he knows alcohol no good for his breathing as well as his health but difficult to get him to stop. The hospital is aware of his increased drinking.

Would like him to make an appointment with the GP nurse (as he has been asked to) and hope they check his FEV1. And if it's dropped, might be the push he needs to do more to excercise etc.

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Zolton, hard to advise you on this, in some circumstances one drink might be ok, take into account certain medications with alcohol may interact and you may find yourself incapable of being in full control of the scooter. Check with your doctor concerning medications you are prescribed.

Also a quick web search will reveal that there are quite a few cases of people being charged when drink driving a mobility scooter.

Maybe get someone to drive you or get a taxi to and from.

Happy jubilee weekend.