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Good morning everyone,
I posted on here a couple times. Most recently as of couple days ago. I had PFT's due to some SOB and wheezing since January. I quit smoking as of then. Maybe a 1/2 pack or less for 10 years off and on. Not that it matters now. Anyway, the Pulm seemed underwhelmed by my complaints of constant dyspnea, we are not talking only with exertion. Early on I would say my dyspnea was unchanged with exercise, almost didn't notice it a much because I expected to be out of breath. But a couple weeks ago, when I first posted I became worse out of the blue, more dyspnea, fatigue, felt like worse wheezing. So I left Alaska early to be seen.
My FEV1/FVC was 69 initially and 71 post, so not much difference, same with FEV1, stays over 100. On the loop, there is some kinking saying obstruction. My airway resistance is normal. The big one for me was my TLC, RV, all the lung volume measurements were high. RV 318% of predicted. Oh and DLCO was normal. He drew an Alpha 1 based on that. But overall he said he did not think there was much going on cardiopulmonary wise to explain my SOB. Said " I am not seeing much here", that if it was serious he would tell me so. Told me we could keep looking and he would eventually find something. Offered to do an autopsy on me if I wanted. I asked him about meds, I had been on Dulera in the past and Flovent, neither did much. I asked him about the RV and he agreed on Spiriva, which I am six puffs in and maybe a difference. He said give it a month before it starts working. The wheezing gone and when I did wheeze it was always expiratory and hard to auscultate on exam. I could always here it when I breathed out. Maybe some with forced expiration. But this last time he didn't hear any. If not for Spiriva it would have been Albuterol PRN only. Let's face it, if I was dx with COPD I am mild, stage 1. And that is Albuterol or a LABA. Spiriva for mod-severe, tho many people are on it as mild. He was not sure why I had hyperinflation or if smoking contributed. I am 43 and I don't fit the bill it seems. I trust him, what he has to say, he has been doing this awhile and I don't feel like pursuing things if he is not on board. He wanted to send me for VQ scan, ECHO, Holter monitor and a cardiologist. But that is because I had complained of some recent tachycardia with minimal activity. Again, it seemed to be more to allay my fears than his. He says no reason to do CT, which I agree somewhat. I think he believes much of it is in my head. But I know how I feel and just a couple months ago I was doing much more, and now I feel worse. I know that hyperinflation can be a big problem as far as SOB, even with normal airways, or maybe not. He does not seem to think so, and I could have had this even as far back as Jan, or before. I know it can be quite variable. Just feel like, other than the inflation, things don't add up. I would expect my DLCO to be down, or worse spiro numbers. Am I crazy here? Maybe overly aware of my breathing and making things worse? I know that I am anxious which does not help. I know tough question. Realize you are all not docs but looking for insight. Just seems like 318% is real high, and how I feel out of proportion to my diagnosis of "dyspnea of unknown etiology".
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