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Asthma

Asthma and PFTs

02/28/2008

Question:

I am a 48 year-old female, 5`0, and 220 lbs. I do smoke less than a half a pack a day. I am working on quitting. I was diagnosed in 1996 with Asthma, after PFT`s (Pulmonary Function Tests) etc. and have been on multiple types of inhalers and meds. I have always had frequent exacerbations, requiring ER visits. In 2007, I finally quit working, due to this. My current physician ordered PFT`s, and I was to not use any inhalers for 24 hours, ( which is impossible), but I tried. By 10:00 pm , my husband had to take me to ER, where I got the usual rescue treatments, Decadron IV, breathing treatments, O2, etc. My PFT`s were done 2 hours later, and were NORMAL. So, I am confused, because I still am on the same meds and inhalers, even though PFT`s showed no asthma and I can`t breathe without my meds. So why were the PFT`s normal?

Answer:

It is difficult to say why your PFT's were "normal".  The goal of asthma therapy is to try to get your breathing as close to "normal" as possible.  This is done by monitoring your daytime and nighttime symptoms as well as how many puffs of the rescue or quick relief medication you need.  Another way to monitor your breathing is checking a spirometry.  Generally a spirometer check is a good idea anytime your asthma medications are changed; your asthma is getting worse; or at least every 1-2 years.  Spirometer checks help your doctor see trends in your breathing function.  Most of the time the spirometer check is performed while you are on your asthma medications.  It is best if you can avoid using your rescue/quick relief medication for 6-8 hours prior to the test.  Sometimes the test is done before and then after rescue/quick relief medicine to see how much response you have to the medicine.

In people who smoke, there is a possibility of having chronic obstructive lung disease (COPD) along with or instead of asthma.  Obtaining a full set of breathing tests (PFT's) instead of spirometry can be helpful to make this diagnosis.   

I applaud your efforts to stop smoking.  The sooner the better.  Many people discover they have significantly fewer exacerbations of their asthma once they quit. Ask your provider for help in quitting.  There are several new medications and smoking cessation programs which can improve your success. 

I also encourage you to loose weight.  Asthma is associated with obesity. 

If you continue to have problems talk to your doctor.  There are other conditions such as sinus problems, acid reflux, vocal cord dysfunction and sleep apnea that can worsen your breathing symptoms.  If any of these problems exit it is important to get them treated.

For more information:

Go to the Asthma health topic, where you can:

Response by:

Cathy   Benninger, RN, MS, APRN, C-AE Cathy Benninger, RN, MS, APRN, C-AE
Clinical Assistant Professor
Director, OSU Asthma Center Educational Program
College of Medicine
The Ohio State University