Help on PFTs. ABG and Chest X-rays, CTS and VP scans.

[madmax33]

Any input on CF and how some test work, and what they mean. Is A Low Diffusion test related at all to CF? If so what does this mean? I have good FHV. But low Diffusion has been a issue. Recently a LOW CO2. any thoughts? Does a Ventilation Perfusion test, (done for a possible PE) any relation to CF. It came out 75%+ of PE. Does not look good, but the ER released me and said not a PE. I have two collapsed lungs, (partial) By Ct, also had this back in February of this year. I have a plural effusion also. Is this related in any way to CF? Diagnosed with Ammonia, and pleurisy and sent home. Any one have severe chest pains with this kind of diagnosed? I am also showing consolidation, Possible mucus plugs, and mucus plugs up by my thyroid. thanks for any input.


Ran my story under newly diagnoised, and it is long. Not sure where to post quite yet and looking for some answers and advice.

 

[eternaloptimist86]

Haha hard to follow that but I'll give it a try.

A diffusion test is gas exchange in the lungs.. How well it removes carbon dioxide and exchanges oxygen. When you have a PE, you may have the ventilation but you don't have perfusion which leads to low O2 levels and decreased diffusion.

The CT you had was looking at your pulmonary arteries and checks for blockages. The VQ scan tells more information because it does the ventilation part too. I don't know what he meant by no PE because 75%+ sounds like a pretty large one to me!

I'm taking you meant FEV1, that is the volume of air you breathe out in one second which is often lower in CF due to thick mucous blocking airways.

The ABG they took is from an artery, so fresh blood that should be well oxygenated and hasn't been to tissues yet. This looks at oxygen, carbon dioxide (CO2), your metabolic balance. Your body wants to maintain a balance. I wouldn't necessarily worry about a low CO2, when it starts climbing is an issue --> respiratory failure.

A pleural effusion is fluid in the pleural space outside the lung. It could be related to the pneumonia. Usually they don't do much for that unless it becomes larger, they a chest tube goes in to drain it.

And yes, pleurisy is a *itch.. I had it last February and it felt like someone was stabbing my chest every time I breathed in!

 

[madmax33]

Sorry about writing that all together. Also I am not doing well. Yes you are correct and what I was thinking. I am at a loss. By all means, I would have thought with the ER Visit and I also had a High D-dimmer test. Then the VP. And they released me. Last test was a Droppler they did on one leg (Right) From just the knee down. It came out negative so the Dr released me. That calf was also swollen and hurting and had been for some time. I feel very much I had a PE and have just been lucky to survive it.

It is scary as I have found it you have one you are very likely to have a other. This has been a major stress and issue.

Yes My FEV is good. To consider CF, It is all the other symptoms' I have had. I have Chronic Asthma all my life. I also have Chronic Bronchitis more often in the year then not! I have malnusoption disorder, stomach problems, have pancreatic and have been on enzyme's since 2010 now. I have always had trouble keeping on any weight. I was a very sick kid and in and out of the hospital as a child. Many signs would lead me to think CF. I have osteoporosis. In my early 40's. IBS, Gastritis, Fatty liver. None of this has ever made any since of where I got this and why. Just many illness's and always tend to not feel well.

I also had a bronchoscopy, which the Dr referred to my lungs as covered in a white thick sticky mucus. This was a few yrs ago and on 7 or 8 antibiotics which would not get rid of the infection I had. He chalked this up to asthma. I do now by the recent CT, also have mucus plugs. Many. I have been under treated from the asthma and continues infections I have had for yrs now. If I have CF for some reason my lung function is still good. Seems so weird as I am so SOB.


PE is just a other problem I can very well be dealing with. I have dealt with the pleurisy and so SOB since that episode which was in Feb of this yr. I also know you can have a plural effusion after a PE. Often times it is Secondary. Just cannot get any Dr where I live to even follow up on this. It was recently that I had the CT, and I do not know the after affects if a CT is done later, but it broke up if it would even show. But my daughter and I feel that once they released me and probably never should have, makes it harder to get any Dr to acknowledge it now. This is a small town. My research and anything I found with the test I had at that time, it should have been treated as a PE with no question and they should have started to treat me. Thanks for your reply.

 

[madmax33]

Can someone with knowledge on the PFTs help me out here. I have several questions in regards to this test. I am wondering what a FEF 25-75% , that this means. At 57% of predicted. Also low Diffusion results? A lower on the airway resistance test of the Gaw at 55 of predicted. My FEV1 is 99%. So any help here . to many numbers here, and Seems the FEV1 is the one I see always the main factor for your breathing. Need help. Also have a Low CO2 on abgs along with 3 other test out on that test..

 

[jshet]

I am no where as experienced as most people on here, but i would say that a FEV1that is 99% is an amazing number forsomeone over the age of 50. My son is 17, and his number is lower.
I am sure others will reply and maybe be more helpful.

 

[madmax33]

Thank you . yes I am confused totally. I have treatments for my asthma and also have seen many older adults with almost a 100 lung function. Meaning the FEV1. so seems it affects the order adults which are being diagnosed later in life different and why they have been able to live longer with no CF treatment what so ever. I was hoping some one could explain more what the other low PFT reading mean?

If that could give a positive or negative of CF, I would think then, why do the Sweat test, genetic testing or any of this, Why not just look at someone's FEV1 to diagnose it or out rule it? Right. Everyone is different and I am trying to make sense of all of this, what each test means.

CF is CF from what I understand. There is obviously a difference in children who have been diagnosed at birth and those past 40, 50, 60, and up know being diagnosed. I have seen quite a few post on here, where people say they have almost 100% lung functions. Thanks for your reply.

 

[2005CFmom]

My understanding is that the FEF 25-75 is what you are able to blow out during the middle of the blow (the middle 50%). I've been told that it is an indicator for the smaller airways and the FEV1 is an indicator of the large airways. At least with my daughter if her 25-75 drops it indicates she is just starting to get sick or has some inflammation. When she recovers her FEV1 normally improves before her 25-75.

 

[madmax33]

Thanks again. I really appreciate your input and taking the time. I just never have been able to make sense of these readings. So being diagnosed with the ammonia recently and pleurisy, maybe this is why. Now I am not sure what that 25-75% means and if that meant mine is in the middle. My readings is I was at 50% of predicted value. My predicted value is 2.59 and I blew 1.48? it is 57%. Thanks

Do you know what airway resistance is?? The Gaw on mine is 55% , pred 1.03 and blew 0.56. So yes I wish I knew what all of this means and related to my lung functions!! I just do not feel well at all, and have had a feeling of I am suffocating and do not know why. Been so fatigued and SOB. It is beyond me and I want a answer.

So odd to me for the yrs of these test, (this is why I have never learned about the other readings) If the FEV1 is good, I am told your test are great!! I hope they find a cure soon, and god bless you Mom with your children and dealing with this horrible disease.

 

[2005CFmom]

I don't know what airway resistance is, sorry. But the 25 - 75% is just the name of the score for the middle part of your blow on the lung function test. I think they measure your exhale for 6 seconds. The 25-75% measures the amount of air exhaled from 1.5 seconds to 4.5 seconds. The FEV1 measures the amount of air exhaled during the first second. So at 57% predicted on the 25-75% indicates that the small airways are inflamed or restricted in some way.