Dr Hive: lung function results

[sangtarah]

Dd had this test done in the peds office last week. They used a unit about the size of a laptop. The first nurse didn’t know how to operate it, so she got back-up. The first try through the machine was on the wrong setting, so these are results from the second try. 

Dr says it doesn’t look good, and increased her meds, but didn’t explain all the info. Any help for me? Any experience with a portable test machine? 

[almondbutterandjelly]

I believer that is a spirometry machine.  It looks like they have a Predicated column "PRED" which is probably where they think she should be in terms of age and weight.  She does not seem to have reached those numbers.  

I'm not positive I'm reading this right, but it seems like she is breathing at 60 percent of her lung capacity.  That's not good.  They like 81 percent and up.

Do you have a peak flow meter, so you can track her breathing at home?  I would get ask the doctor for one if you don't have one.  

Edited September 24, 2018 by perkybunch

[Jean in Newcastle]

Are you going to a pediatric pulminologist?  Did they give an actual diagnosis?  Is it asthma?  We got so much better info from our asthma specialist.  (I can't interpret the results but I trusted their results and explanation because they were so experienced.  And it sounds like they aren't at your pediatrician's office.)

[Ailaena]

Here’s tons of info about interpreting the test results from a clinical standpoint 

https://www.aafp.org/afp/2014/0301/p359.html

[sangtarah]

2 hours ago, Jean in Newcastle said:

Are you going to a pediatric pulminologist?  Did they give an actual diagnosis?  Is it asthma?  We got so much better info from our asthma specialist.  (I can't interpret the results but I trusted their results and explanation because they were so experienced.  And it sounds like they aren't at your pediatrician's office.)

 

2 hours ago, perkybunch said:

I believer that is a spirometry machine.  It looks like they have a Predicated column "PRED" which is probably where they think she should be in terms of age and weight.  She does not seem to have reached those numbers.  

I'm not positive I'm reading this right, but it seems like she is breathing at 60 percent of her lung capacity.  That's not good.  They like 81 percent and up.

Do you have a peak flow meter, so you can track her breathing at home?  I would get ask the doctor for one if you don't have one.  

 

She has had an asthma diagnosis for several years now, but we have never seen a pediatric pulmonologist. Her condition has deteriorated over the last year, and they keep increasing her medications, but we don’t know why she has gotten worse. This is her first bad function test ever...partly I wonder if it’s error on the machine; I noticed it says she is seated, for instance, but she was standing. 

We’re just puzzled, and wondering what comes next. 

[almondbutterandjelly]

I think it might be time to see a specialist.  In my area, an allergist would be the doctor to see.  Allergists are asthma specialists because the two go hand in hand.

[eagleynne]

Speaking as a former respiratory therapist you guys really need to see a pulmonologist. Those results do seem to indicate asthma, but a portable spirometry set-up like you describe is not really that accurate. Your daughter needs to have a full PFT pre- and post-bronchodilator. That will really tell you all what's going on. A pulmonologist will also be able to tailor her meds more effectively.

[kbutton]

I vote allergist or pulmonologist. A relative who works in medicine likes to say that most peds and GPs know enough about asthma to fill a very small thimble, lol! He gets really annoyed when a GP tries to manage asthma.

I had one PFT (in a little booth) when I was first diagnosed, and I've had intermittent spirometry since then. I have very well-controlled asthma post allergy shots and learning my own symptoms (the peak flow meter was a JOKE for me, and even my allergist tossed up her hands at the completely inconsistent results I would get). Spirometry can be wonky if the person giving the test doesn't know how to give the person being tested super, super good cues. 

Anyway, all that to say that you need someone knowledgeable to get a baseline and then also to give good cues. 

It could also be that you need different meds, a different combo of meds, allergy meds, better techniques for taking the meds, nebulizer vs. inhaler or some combo, better knowledge of triggers and symptoms,...you get the idea. An allergist or pulmonologist will be much more informative.

[Arcadia]

Asthma and eczema runs on my side of the family. I would get an allergist referral because knowing the triggers has been so useful for me and my relatives. Stress is also a trigger.

In my case, ventolin inhaler (Albuterol, salbutamol) didn’t work well for me as a daily preventive medicine but salbutamol tablets were useful enough as standby medication. If I am sick, I would need the nebulizer. 

When I was a kid as well as in college, lap swimming was really helpful to reduce the need for medication by improving pulmonary and cardio function. I didn’t swim as much from 7th to 12th grade and I should have. 

[mominco]

2 hours ago, eagleynne said:

Speaking as a former respiratory therapist you guys really need to see a pulmonologist. Those results do seem to indicate asthma, but a portable spirometry set-up like you describe is not really that accurate. Your daughter needs to have a full PFT pre- and post-bronchodilator. That will really tell you all what's going on. A pulmonologist will also be able to tailor her meds more effectively.

I would do this!