October 27, 2008 Is it possible to raise a baseline COPD FEV1 26% with exercise?
Posted Oct 27 2008 1:47pm
MY Pulmonary Function test numbers improved tremendously in 2004, how could that happen? My simple patient answer - as I understand it:medications can change your basic numbers. They can improve you functioning. Take away the meds and you return almost to basic level. Maybe a little better if you have improved breathing muscles and ability to expand the lungs for deeper better breathing. (I did stop meds to see if numbers dropped-they did).
For a more technical, medical explanation: because I had such a fantastic change upward of FEV1. Mark W. Mangus, Sr. BSRC, RPFT, RRT, Pulmonary Rehabilitation Coordinator Christus Santa Rosa Health CareSan Antonio, TX ), he has given me permission to quote him, gave a very interesting answer to these questions:1. Is it possible to raise a baseline COPD FEV1 26% with exercise? 2. Does an FEV1 of 96% preclude a COPD diagnosis?
"As to your first question, the answer is "It depends. . . ." Folks' with severe deconditioning can have enough muscle weakness that their FEV-1 is reduced because of that weakness. As they re-condition, they can gain FEV-1 simply because of improved strength of muscles of ventilation. In the baseline instance, their severely reduced FEV-1 does NOT reflect the actual/potential mechanics of lung function - - - that is - - - the ability to move air in and out under maximum conditions. We recently had an example here on the list that would fit this scenario wherein a person reported an increase in FEV-1 of approximately 25 % that was NOT attributable to asthma. Then there is the example of acute, reversible asthma, wherein a person can lose as much as 70 % of their FEV-1 during an attack that is THEN regained when the attack is resolved.
So, "Yes.", it IS "possible". What is 'likely' rests with the individual and those conditions that establishtheir initial FEV-1 and how it is ultimately influenced by whatever interventions are applied.
An FEV-1 of 96 %, while certainly making a difficult argument for ANY obstruction does not necessarily preclude any and all possibilities of COPD. There are those who fall into one standard deviation of the normal range of folks whose measurements fall outside of the predicted values for the various pulmonary functions measures, half of which fall out on the "high end". If my normal FEV-1 is actually 115 % of predicted and I blow, say a 90 %, I can indeed have evidence of mild obstruction, even enough to give me symptoms when I push to my maximum exertional capacity. When looking at my other measurements, they can still fall within the high end of "my" norms, but represent obstruction when compared to my elevated baseline . The bottom line is FEV-1 alone isn't unequivocally definitive. But, it is 'safe' to say that most folks who sport a 96 % FEV-1 do NOT have "clinically significant obstructive lung disease".
By the same token, one who blows a 65 % FEV-1 doesn't "necessarily" have an obstructive disease! It takes more analysis of measures like FVC, TLC, RV,
FRCand the like which, if ALL found to be relatively similarly decreased, point to restrictive lung disease. One with 65 % FEV-1, 70 % FVC and TLC of 75 % of predicted can likely be found to have a DLCO in the 20's (%) and be profoundly symptomatic and hypoxic. In such an instance, they can be in far worse shape and have more breathing difficulties - - - that CANNOT be compensated by using pursed-lips breathing or any of the tactics that work for those with COPD - - - simply because their symptoms are driven by hypoxia - - - hypoxia which cannot be resolved with most standard oxygen systems or under 'usual' conditions of therapeutic intervention. SO, all is NOT what it may appear to be."
Get it? As you re-condition, you may gain FEV-1 simply because of improved strength of muscles of ventilation. Keep moving and improving, use it or lose it. Yesterday I walked 2 miles, hi flow tank on my back. A lovely day to appreciate the leaf color, and a test to see how my legs felt after the 13.1 miles done a week ago, it felt firstname.lastname@example.org
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