My appointment with the Respirologist

Spirometry Results

1. Values were lower today as compared to those on Jan 14, 2004


2. Actual FEV1 (L) today was 1.25 L as compared to 1.47L It decreased from 38% of normal to 33% of normal


3. Actual FVC (L) today was 3.42 L as compared to 4.09 L. It decreased from 85 % of normal to 72%


4. FEV1/FVC (%) today was 37% as compared to 36% .


5. FEF 25-75% (L/Sec) today was 0.44 as compared to 0.40. It increased from 11 % of normal to 12%.


6. FEP Max (L/sec) today was 51% of normal as compared to 61% .


7. Expiratory Time (sec) today was 10.16 sec as compared to 13.73 sec.

My conclusions

1. There are three different processes going on that are contributing

to my poor lung condition

• Aspiration owing to my moderate to severe swallowing difficulties which has caused my bronchiectasis.


• Bronchiectasis lung condition makes you more susceptible in getting lung infections.


• My COPD caused by my prior 12 yrs of heavy smoking has limited my reserve lung capacity to fight pneumonias as compared to a normal person and will further decrease an amount every year to a point where I will require oxygen.


• My ability to fight and recover from pneumonias will further decrease accordingly as my FEV1 decreases or as my reserve lung function decreases.


• The conclusion to be drawn from all this is if I get pneumonia the resulting consequence could be quite severe as compared to a normal person.


• The unfortunate reality for a person with COPD lung disease is that every year the spirometry results decrease . Your well being gets worse. You get shorter of breath and ones ability to fight pneumonias gets worse. The need to be on oxygen gets higher.


• The FEV1 reading will decrease by 5 % of normal every year. Below 25% things get worse and one’s ability to fight pnuemonia gets worse.

TUBE FEEDING
There are three medical professionals recommending a JPEG tube at this time: my Speech Language Pathologist , my physiatist and my respirologist. They are two against it , my gastroenterolgist and myself.
ANTIBIOTIC PRESCRIPTION
My respirologist filled out a prescription and I am to fill it out when I feel the need arises Ie: more shortness of breath, fever, the colour of my sputum changes from yellow to green and difficulty in coughing and breathing.
LUNG HYGEINE
Is the most important thing that I can do for my lungs
PROGNOSIS
My respirologist stressed that my gasterenterologist does not know my complete story as to whether or not I should have a feeding tube.
My COPD will get worse every year and eventually I will have to be on oxygen. The downward slope of my COPD deterioration has been normal as compared to other people who have COPD.