Anyone know about spirometry tests?

[PMTIsMe]

Its just that my GP wants me to have one but the nurse who will do it has commented that there is no point since I have had both anti-biotics and steroids in the last few weeks which will make the results meaningless. Is the nurse right? Or can it throw light on stuff anyway? I have some breathing issues going on we are trying to get to the bottom of. TIA!

Spirometry

To assess how well your lungs work, a breathing test called spirometry is carried out. You will be asked to breathe into a machine called a spirometer.

The spirometer takes two measurements: the volume of air you can breathe out in one second (called the forced expiratory volume in one second or FEV1) and the total amount of air you breathe out (called the forced vital capacity or FVC).

You may be asked to breathe out a few times to get a consistent reading.

The readings are compared with normal measurements for your age, which can show if your airways are obstructed.

You will then be given an inhailer with steroids in, wait for about 20mins then repeat the test.

so yes. It would be worth waiting until all traces of steroids are out of your system before the test.

Hope this helps.

6 weeks is fairly standard to wait to do spirometry after antibiotics and/or steroids

Yup, any spirometry done within about 6 weeks of oral steroids would need repeating anyway.

The steroids would give an artificial result so the results couldn't be relied upon.

Antibiotics are less of a problem than the steroids.

Ah poo. So dont know why GP is saying its urgent then!!

Tho that said, the steroids didnt improve anything.

Who knows. Thanks for replies.

Probably worth booking it for 6 weeks after you finished your steroids, and at least then you know the results will be accurate.

Also worth avoiding smoking for 24 hours before spirometry; are you on any inhalers? Some ideally should be stopped for 4-36 hours before.

Was hoping for a diagnosis sooner than that sidge Im not a smoker. I am on a brown inhaler the doc gave me. Not asthmatic so far as I know but we are fumbling around in the dark as to what the issue is.

Hi pmt have you had a chest x-ray?

You can do a basic spirometry at any time - the shape of the reading shows normal, restrictive or obstructive lung disease.

You only need to use the ventolin and do the second 20 mins later if the venrolin (solbutamol) is likley to reverse the result - it won't in obstructive disease.

HOWEVER

LucyFarinelli gave a very good example of simple spirometry (AKA vitaligraph), but there is another more detailed study that is sometimes called spiromentry - it takes longer but again the trace of the way you breath shows the type of disease you may have.

Rather than have a nurse do a basic spirometry you might want to go to the respiratory department at your local hospital - they can do a lot more tests, looking not just at whether your lungs are obstructed or restricted (obstructed means something like mucus is blocking your breathing, restrictive is like asthma where thre is a spasm in the tubes in the lungs) but can look at how well gasses pass from your lungs iinto your bloodstream.

Yes haswalnut - Im waiting for the x ray result, should be any time now.
Thanks for the detailed response sashh - I suspect my GP may refer me if I dont improve or if her tests don't reveal anything obvious.

pmt keep us posted about the chest x-ray, from what I remember, My Dads x-ray was clear, no lesions, cancer, fibrosis etc, but he still had to have a spirometery test to see if there was any copd present,and naughty naughty man still continues to smoke.

sashh that's not accurate.

Asthma and COPD are both obstructive disease - obstructive doesn't literally mean there is a physical obstruction like mucus. It means the passage of air flow in and out of the airways is obstructed usually due to some sort of change to the airways themselves.

Restriction shown on spirometry is usually due to fibrosis, scoliosis, obesity for example.

Reversibility will occur in obstructive disease such as asthma and can also occur in COPD but is less likely to reverse with salbutamol significantly. If someone has been on steroids you can't really do reversibility properly (which is the gold standard for diagnosis) as they have already potentially been 'reversed' with the steroids. So the readings you get with post-steroid spirometry can't be relied upon as true readings; they can give you some indications as to what's going on but can't really be used for diagnosis.

You're right in that surgeries can't offer gas transfer analysis like respiratory labs/clinics can but most will have modern spirometers that offer more than basic vitalograph readings. Ours can analyse FVC, FEV1, FEV1/FVC ratios etc as well as giving a time/volume and flow/volume graph. A suitably qualified and experienced HCP can interpret the values to aid diagnosis.

GP is saying it's urgent as they have year end targets to meet, which is how they get their money to pay staff, rent etc. GP practices everywhere are frantically contacting Pts who have not had their annual reviews and check ups/blood tests etc as most of these have a 90% target, and it is hard to get 90% of the population to take things like Asthma seriously if they feel it is controlled.

Hi pmt have you had your chest x-ray results yet? hope your well.

Thanks for asking Haswalnut. Im feeling loads better and breathing better. All the results came back normal - which is great since rules out the serious stuff, but odd since don't know what it was all about! Doc is guessing it may have been an asthma/infection combo. Very unpleasant whatever it was!

pmt thats great news, have you still got your spiromertry booked then? yes I guess it must have been an infection or something.

Had the spirometry too, also normal, despite feeling like I was going to expire on the floor!

Peak flow has gone up by 100 but still rather low for me so that is improving ever so slowly for some reason. Other than that hopefully all ok, thanks