could anyone help me interpret these?
My doc says I have very mild asthma (based on 13% reduction in FEV).
But the 50-75% numbers are very low, they are affected severely (up to
3-fold change) by steroid/nebulizer treatments. I wonder what the
FEF50-75 ## mean (small airways?) for the asthma diagnosis, and why
don't asthma docs ever mention them to me. My peak flow (proportional
to FEV1?) never changes, no matter how bad I am feeling.
test after prolonged Advair treatment (for reference):
FVC 5.69 L (~95%)
FEV 4.44 L (~100%)
FEV/FVC 0.78
FEF 25-75% 4.59 L/sec (~100%)
FEF 50% 5.91 L/sec (~100%)
FEF 75% 2.53 L/sec (~100%)
test with no inhaled steroid for 48 hrs prior to tests
Pre-nebulizer:
FVC 6.57 L (115%)
FEV1 4.21 L (97%)
FEF25-75% 2.47 L/s (54%) - a ~50% reduction compared to steroid case
FEF 50% 3.69 L/s (62%) - a ~30% reduction compared to steroid case
FEF 75% 0.80 L/s (32%) - a 3-fold (!) reduction compared to steroid
case.
NOTE: I had similar (low FEF) numbers before I have developed any
asthma symptoms at all (obtained during a routine, non-asthma related,
doctor visit).
Post-nebulilzer:
FVC 6.79L (119%, 3% increase)
FEV1 4.86 L (110%, 13% increase - the only # discussed by my doc)
FEF25-75% 3.52 L/s (77%, a 43% increase)
FEF 50% 4.79 L/s (81%, a 30% increase)
FEF 75% 1.21 L/s (48%, a 52% increase)
Any help would be greatly appeciated. I can only see my doc once a
month, and I can't call/email him.
00doc - 29 Nov 2006 17:57 GMT
On Nov 28, 5:08 pm, runcyclexc...@yahoo.com wrote:
> could anyone help me interpret these?
>
[quoted text clipped - 37 lines]
> Any help would be greatly appeciated. I can only see my doc once a
> month, and I can't call/email him.
When looking at obstruction, such as in asthma, there are a few
measures that are relevant. The FEV1/FVC ratio is one of the older
measures used (especially on old machines that didn't gieve the FEF
numbers. The most relevant is the FEF 25-75 which reflects the medium
sized airways.
FEF= forced expiratory flow and the number refers tot he percentage of
the way through the breath you were. FEF 25 is the flow after you were
1/4 done and FEF 75 is the flow when 3/4 empty. The large airways empty
first and then the smaller ones.
The FEF 25-75 that was 50% was very abnormal and since it reversed
after a neb (more than 20% increase) is diagniostic of reversible
airway obstruction, the most common of which is asthma.
It would appear that the Advair reversed the changes seen on the
earlier reports.

Signature
00doc
00doc - 29 Nov 2006 17:59 GMT
On Nov 28, 5:08 pm, runcyclexc...@yahoo.com wrote:
> could anyone help me interpret these?
>
> My doc says I have very mild asthma (based on 13% reduction in FEV).
One other thing:
Asthma severity isn't really graded by the PFT results. The current
guidelines use the frequency and severity of symptoms and the amount of
medicine needed to control them to grade the asthma. if you are on
daily Advair you are at least a "moderate persistent" asthmatic.
--
00doc
runcyclexcski@yahoo.com - 04 Dec 2006 02:18 GMT
00doc - thanks a lot!
I finally reached my doc on the phone. he knows about the low (30-50%)
numbers for FEF50-75, and that's why he originally has put me on the
advair. And since Advair did help somwhat, but did not eliminate all of
my symptoms (the general congestion at rest and after food, severe
shortness of breath during exercise, and no response to albuterol), he
thinks that something else is going on besides the asthma.
Interestingly, I've always had the abnormally low FEF50-75, inlcudling
the period when I was running and nordic skiing competitively, and
never had any trouble with breathing.