Confused about lung function tests
I'll try to make this short. About 10 years ago I started wheezing while playing tennis and having trouble breathing with extreme exertion and dr started me on bronchial dilator and steroid inhaler, which helped. . My chest X-rays have shown hyperinflation for about 20 years– I am 62. Former smoker but stopped around age 27. Smoked about 10 years. Three years ago I saw my pulmonologist and my 02 was at 87 walking around his office. Went through pulmonary function tests, stress test with echocardiogram , overnight pulse oximentary test and all showed normal. So nothing new was added but still used inhalers daily. I continued playing tennis but with breathing difficulties. Last November I decided to stop tennis because breathing was getting too difficult. Rescue inhalers never seemed to help. Xrays have continued to show hyperinflation. Fast forward to January '19 and saw new pulmonologist due breathing problems with exercise. Again, in her office my 02 was at 87. After being put on 02, it came back up to 98. She prescribed home 02 and a number of tests, high resolution ct scan, overnight pulse ox, echocardiogram and pulmonary function tests. So far, all have come back normal including the ct scan which showed no air trapping or small airway disease, everything normal except coronary and aortic calcifications. Basically normal which surprised me since I've been told for years I have mild copd. Will wait to see what overnight pulse ox shows. My 02 is still dropping to the high 80s upon exertion but not always and it goes back up pretty fast when I sit down, within 5-10 minutes. Currently I'm not using the oxygen until I find out what's going on. So I am wondering why the xrays and ct scan show different info and now wondering if I gave copd at all. And clueless about why 02 is dropping and why I heave upon more than usual exertion. Maybe it's exercise induced asthma but again, the rescue inhalers don't help me when I can't breath well.
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@tiss — I'm sorry that you are having such a rough time with your breathing. It must be very disconcerting! As a lung cancer survivor I really know how this feels. Are you sure that you inhalers don't work? Has your O2 been measured before and after you inhaler? Rescue inhalers do take a moment or so to work, esp if you need one out exercising. Have you waited long enough for it to work? What do you doctors suggest?
CT scans pick up many more details than chest Xrays.
I hope that you will reconsider using your O2 at home. If you limit you O2 intake other organs can suffer and the results might not be what you want to look forward to.
I'm so sorry you had to deal with cancer. Horrible. I guess I shouldn't be complaining and be more patient until all test results are in. I'm just wondering if I've been misdiagnosed for years. But, I think my dr is good so I'll wait to see what she says at our next visit.
@tiss– Thank you. I agree, you have to wait to see all of your test results. You can do it!
So all of my tests have come back in the normal range. Echocardiogram, PFT, overnight pulse ox, and ct scan which only showed some coronary and aortic calcifications. See the dr on Thursday. Still have no clue why I have intermittent oxygen drops.
mine does too I was in an airplane dropped to 70% fought hard to keep it up
go home says at 93%
I go to bed it drops to 85% then back up
hard to breath pain in my chest
I know there is something wrong
Based on what my first pulmonologist told me, everyone's oxygen level drops while they are sleeping. So I wouldn't be too worried about it dropping while sleeping. You may want to discuss with yours the level that it is dropping to though. When I was first put on oxygen, it was only for when I was sleeping, go anywhere and going upstairs. I was able to go around the house (if I remained on one floor without) at first without anything.
There are special guidelines for people with known respiratory issues in regards to flight. The combination of a pressurised compartment and lower levels of oxygen on planes, around 5 percent lower than at sea level outdoors, can lead to a variety of problems for us. Because of the reduced oxygen levels on the plane it wouldn't have been too strange that your blood oxygen levels were reduced but probably not to the degree which you described. I have extrinsic respiratory failure, involving failure of the respiratory muscles, but I think that the majority of people experience intrinsic failure because of some kind of lung disease. From my own experience lung diseases are fairly easy for doctors to identify but extrinsic problems aren't.
@barry98888 Barry, I took notice of your comment about failure of the respiratory muscles and I was wondering if you are laboring against fascial tightness surrounding these muscles? The fascial system encases everything. It is connective tissue that holds the muscles together and it can get too tight which restricts movement. I have done a lot of myofascial release work with my physical therapist, and she releases my respiratory diaphragm. I have tightness on the left side of my body that extends from my neck through the rib cage and to the pelvis which makes one side of my lungs not expand enough because of the tightness. I'm wondering if you could have a similar situation and if a physical therapist could help you?
Here is our MFR discussion where you can learn about this therapy. Look at the first pages for lots of links to information. There is a provider search at http://mfrtherapists.com/
Neuropathy – "Myofascial Release Therapy (MFR) for treating compression and pain"
The other thing I would mention is if there are issues with the Phrenic nerve somewhere and it isn't functioning? This nerve innervates the muscles for breathing perhaps in part. There are patients who have had nerve transfers to replace the Phrenic nerve.
Here are a few links about Phrenic nerve issues:
Have you heard about myofascial release therapy? Do you think this may help?
Thanks for the suggestion Jennifer. Three years ago I had my gall bladder removed because of gall stone induced jaundice. Because of medical claims that I was faking illness I had previously experienced six years of what I now know were symptoms and test results of repeated gall stone induced liver issues. That led to my brother recalling that he had observed my skin having turned orange before my health collapsed, likely indicating that I had experienced acute liver failure due to toxic work exposures and exertional heat stress. Within a few days I experienced heat stroke at work and never recovered with the commencement of claims that I was faking. It seems likely that the combination of liver inflammation, gall bladder inflammation and adhesions, and ascites, have caused upwards pressure to restrict the movement of my diaphragm. As I have tested positive for autoimmune myopathy, myositis, I have general muscle weakness throughout my body but have speculated on issues similar to those you have discussed. The phrenic nerve is actually attached to the liver so the problems there are likely to have exacerbated respiratory issues. The problem with getting anything diagnosed has all been in trying to get physicians to investigate because of the original claims that I was faking, made by a physician who refused to accept that his diagnosis and treatment had failed regardless of other physicians opinions and statements. I have been told that I can't afford to actually receive treatment for my condition until it is actually acknowledged because of all of the legal aspects to my case.
@barry98888 I'm sorry things are so complicated for you. You may not need a diagnosis to try myofascial release and if it helps, you'd be better off. Some doctors understand it and others dismiss it. It may not affect your case, but I guess that's a question for your legal counsel.