June 13, 2008 Learn to read your PFT, and enjoy 'some' sunshine, it's good for you.
Posted Jun 18 2008 6:08pm
My "lungs a La Carte" a nice baby jogger stroller is what I use for walking events. It rolls smoothly along. I use 2 to 5 tanks of oxygen, all depends on the length of the event. 3 miles to 13.1, a Half Marathon. I require 12-15 Liters per minute to move as fast as I am able. Remember, I am doing these events at 5200 to 10,800 ft in altitude. To think 5 years ago I had difficulty walking slowly for 15 minutes!
Just getting it ready for the upcoming Sunday 5 K Stadium Stampede.around Denver's Invesco Field at Mile High. A fund raiser for St. Joseph's hospital in Denver, Colorado. The current, continuing, and alumni members of their Pulmonary Rehab group, the Huff 'n Puffs, walk a 1 K challenge even in wheel chairs or with canes & walkers. Every year there is a good turnout of patient's the largest being 125 one year. This will be my Fifth year participating in the 5 K- I'll be the 'baby of my age group (70-75) . Last year 4th in my age group of 65-69...and that was competing with normal folks for 3.1 miles. Not having other health issues , mild/mod COPD--along with determination to keep moving makes a difference. Most folks even in good health avoid exercise...oh so foolish. It is the best way to help stay healthy...in my opinion, and I'd say holding my pulmonary numbers steady for 5 years is some proof that moving is good for you.See what Johns Hopkins has to say below.
MiddaySun Holds The Key To Good Health [sounds contradictorytorecent warnings to stay out in sun10 AM- 2 PM?Read to understand]ScienceDaily (May 26,2005)��� Scientists at The University of Manchester have today unveiled new research which claims that going out in the midday sun, without sunscreen, is good for you..."we are not advocating people do not protect themselves with sunscreen, but if you put sunscreen on before you step out of the house you will not reap any health benefits provided naturally by the sun. After a short period of unprotected exposure you should cover up or put on sunscreen to avoid sunburn."http://www.sciencedaily.com/releases/2005/05/050526091912.htm
Sunless Tanning Agents Provide Continuous SunScienceDaily (Nov. 13, 1998)��� WICHITA, Kan. -- Researchers have discovered that the chemical reaction of your skin with the active ingredient in sunless tanning agents offers continuous and unique protection from the sun, regardless of a person's activities.http://www.sciencedaily.com/releases/1998/11/981113081639.htm
Vitamin Supplement Little More Than 'Snake Oil,' Researcher ClaimsScienceDaily (Jun. 13, 2008)���A popular vitamin supplement is being advertised with claims that are demonstrably untrue, as revealed by research published in the open access journal BMC Pharmacology.http://www.sciencedaily.com/releases/2008/06/080611220431.htm
:"FEV1forced expiratory volume in the first 1 second of expiration
FVCforced vital capacity
FEF25-75forced expiratory flow in the middle 1/2 of an expiration
TLCtotal lung capacity
FRCfunctional residual capacity
DLCOdiffusing capacity for carbon monoxide
VAalveolar volume (basically the same as the total lung capacity)
DLCO/VAdiffusing capacity corrected for alveolar volume"
The first component of a PFT report is spirometrywhich mainly provides a measure of flow. This defines whether or not the person is obstructed. We define obstruction as an FEV1/FVC ratioof less than the 5th percentile of the values obtained for normals. This value varies according to the age and height of the patient but is generally between 68-77%.
In patients with a low FEV1/FVC ratio, we define the severity of obstruction as the absolute value of the FEV1, the lower the FEV1 (as a percent of predicted), the worse the obstruction. Thus, the American Thoracic Society now recommends that we define severity as follows:
FEV1/FVC < predicted AND FEV1 > 100% of predicted normal varient
FEV1/FVC < predicted AND FEV1 < 100% > 70% of predicted mild obstruction
FEV1/FVC < predicted AND FEV1 < 70% > 60% of predicted moderate obstruction
FEV1/FVC < predicted AND FEV1 < 60% > 50% of predicted moderately severe obstruction
FEV1/FVC < predicted AND FEV1 < 50% > 34% of predicted severe obstruction
FEV1/FVC < predicted AND FEV1 < 34% of predicted very severe obstruction
"This definition is not without its pitfalls; for example, if a person is both a little bit obstructed and fairly restricted, the FEV1 may be very low causing you to overestimate the relative role the obstruction is playing in the overall picture of impairment."
"We consider obstruction reversibleif there is a 12% or greaterincrease in the FVC or FEV1after a bronchodilator challenge. We use an albuterol inhaler as our standard but the PFT laboratory will do the challenge test with ipratropium bromide (Atrovent) if requested.
"We define restriction"���.snip���"The worse the restriction, the lower the TLC. Thus we grade theseverity of restrictionas:
TLC < 80% > 70% of predicted mild restriction
TLC < 70% > 60% of predicted moderate restriction
TLC < 60% of predicted severe restriction
���.SNIP���.A couple of other measurements worth noting are the functional residual capacity (FRC) and the residual volume (RV). An increase in the FRC indicates hyperinflation. An increase in the RV indicates air trapping."
" Diffusing Capacity:
In the simplest sense, the diffusing capacity is the ability of gas to cross from the air, across the interstitium, and into the blood���big SNIP���.. The corrected value is referred to as the DLCO/VA and a normal value is considered to be 80% or more of the predicted value.
Because carbon monoxide binds quite readily to hemoglobin, the fewer red blood cells in the blood, the less carbon monoxide will be taken up. We therefore correct the diffusing capacity for hematocrit so that an altered diffusing capacity will reflect an altered lung gas transport rather than an altered hemoglobin level. Thus, we report diffusing capacity as Hct-adjusted DLCO/VA.
In summary, if you only had one number to look at to assess the diffusing capacity, look at the Hct-adjusted DLCO/VA."