Confused about Spirometry

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Hope some of you can clarify as I didnt ask the people in the hospital. Due to an investigation into my heart ( LVH and Hypertension stage 2 ), they did an xray and could see the heart but saw a problem with my lungs - raised left diapragm. Having already had a cancer ( prostate ) and with a family history of cancers and being an ex smoker they referred me to hospital. Sent to see the hospital consultant who said I may have a paralysed left diaprgam but he wanted to do CT scan and also Spirometry. I took a copy of the Spirometry results on my mobile phone camera and entered them into the online calculator here on patient.info. Am now confused. Why different results when sitting or lying down.

The consultant did ask me if i had the same SOB lying down as walking, but I said I hadnt noticed. When they did the spirometry they did tests with me sitting and then did tests with me lying down.

The hospital results are attached. I have also attached the results of the calculator. The calc says I am normal when sitting down, but the hospital machine says 'Posible Restrictive Disorder'.  The calc says 'consider copd' for the lying down test, the hospital result for this says ' Severe Obstruction'.

I would have thought both results would have been the same sittling or lying down.  Am waiting for the next meeting which will be in a couple of weeks as the MDT team dont meet to consider my CT scan until end of this week.

Does anyone have any thoughts about this? Any advice on what I should be asking when I next go to hospital?

Am 55, ex smoker ( gave up 8 years ago ) used to smoke 20 - 30 a day, started when I was about 12. Up until last year used to climb mountains, now am getting out of breath when walking on the flat, never mind struggling up stairs or tying my shoelaces.

 

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12 Replies

  • Posted

    Hi Eddie am sorry to heat that my mum as COPD I know she is really bad in the morning but through the day it eases a bit I think of say when you got the flu or a cough your not to bad in the day time but as soon as you lie down you can get to sleep for coughing so my be the same with this

    but other than my mum having it am not that sure about it as. I just heard of COPD when my mother in law had it three years ago now my mum

    has it now she has lung cancer I think the company that make cigarette

    need to stop cos there killing people hope it all works out for you can

    you let me know how you get on good luck Susan xx

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    • Posted

      Susan

      Many thanks. I will let you know how things go and I hope your mum is ok. I know when I was diagnosed with my prostate cancer two years ago it was hard to take but with medical advances all the time things can only get better as they did with my cancer; hope the same goes for your mum.

      I remeber giving up cigarettes myself and when I did the NHS 'quit nurse' was so pleased and said my lungs were great. I was so happy thinking I had stopped and my lungs would be ok. I joined a gym, started walking and climbing mountains at weekends. This lungs business is a bit of a kick in teeth for me. Just hoping that its not a bad result and the medical people can 'fix' me. Bit worried and confused though with the tests.

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    • Posted

      Hi Eddie that's funny cos there a guy I know who also gave up

      and a few months later he was in hospital with a slight heart

      attack and then had the flu then he had something else but he

      said when he was a smoker he was never off work ill and never

      had even the cold till he stop smoking GOOD LUCK XXXX

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  • Posted

    Spirometry will always differ depending on sitting, standing etc. For consistency most tests are done sitting. Of course your results will be different.

    good luck.

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  • Posted

    Thanks for the replies everyone. Update.

    Went back to the hospital and saw the consultant to go over the CT Scan and the Spiromety. He started the conversation by saying nothing to worry about. Then he proceeded to tell me how my lungs are damaged, probably as a result of years of smoking or even a disease I may have had as a child thats now catching up on me. He told the story of the lungs being like a tree with leaves. You need the leaves to gather in air, you start losing leaves later in life. Unfortunately I have already started losing these. Once the leaves are gone, they dont come back. It was rather a nice way of saying things.  He didnt mention medical type diseases such as COPD, etc What he did say was that the spirometry results showed a restriction and that I was probably taking in half a litre less air than normal. Also that I was not breathing out as much as I should based on what I was breathing in. All not very technical/medical.  Hum - my spirometry had said Restrictive for sitting down and Severve obstruction in the lying down test - he didnt mention this.

    As I have a raised hemi diapragm and my left ( the same ) is paralysized I asked about that. He said there wasnt much that could be done for it.

    He did ask me if i snored and I confirmed this . He said they will do a sleep study on me for apnea.

    Other than that.

    His course of treatment :

    I need to lose at least 2 collar sizes around my neck.

    I need to reduce my BMI - lose weight overall, maybe about 2 Stone.

    I need to walk at least 30 mins a day ( though I do go walking in the hills every weekend - about 10 miles )

    If I have sleep apnea and I get a mask, this may also help with the paralized diapragm.

    Nothing else they think they can do.

    So I will continue breathless tying shoelaces and walking upstairs, pushing trolley or carrying my case or laptop bag. Struggling to do jobs around the house or in the garden. Falling asleep whilst working or on phone calls.

    Now all this is being done on the NHS. I have private insurance. I am thinking that I should go and get a second opinion on all of this via my private healthcare.

    For info:  FEV1  1.79 Predicted 4.05

                   FVC    2.69 Predicted 5.24

                Ratio      66% Predicted 77%

     

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    • Posted

      Eddie,

      Now you have stopped smoking your situation will improve somewhat. Inhalers will help you feel better and ease the breathlessness.

      Do what the doctor says, it will get better over time. If you go to a private consultant they may spend more time with you or give you more of an opportunity to discuss your concerns. That's all.

      It does read like the Doctor you saw gave you good advice.

      You will feel better.

      Ck.

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    • Posted

      Many thanks. I stopped smoking about 8 years ago. I thought I was fine. All this has started in the last few months. In the last 8 years I got fitter and took up hill walking and mountaineering as a hobby. Every year I I climb Ben Nevis in the easter and most weekends I could be found in Snowdonia. I now have trouble just climbing up the stairs in my house. On the flat I am ok. I am only 1 stone heavier than I was 4 years ago. Something just isnt right about all of this.
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    • Posted

      8 years off the cigs. Hmmm.

      With the significant decrease in FVC it could be borderline for a mixed restrictive / obstructive pattern.

      Apnea could be involved. I would wait till after the sleep study before deciding what to do next. You will most likely see a Pulmo again at that point anyway.

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  • Posted

    Private healthcare considered, you might as well get the use out of it at this troubling stage in your life.
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  • Posted

    Many thanks. I will wait for the study before planning the next move,.
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  • Posted

    Well another update for those following my thread.

    ​I was diagnosed last week with stage 2 COPD following spirometry. Pre inhaler test 53% post 60%. I also still have the paralized diaphragm . Been referred for Pulmonary Rehab and waiting for appt. Have still got severe Sleep apnea and on cpap. Have had multiple lung infections and new chest xray is worse than last years. Had surgery this weekend for ulna nerve and had respiratory complications. Have been advised to also have my c spine checked as a new mri shows problems at c4 c5 c6. Consultant says it might have impacted my phrenic nerve that may be what has caused the left diaphragm paralysis. Worrying in case it spreads and i lose the other diaphragm. Ventolin is no help and i have been put on Spiriva for now. Trying to keep smiling whilst i get this sorted out. Hopefully there is something that can be done to stem the decline.

     

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