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COPD (Chronic Obstructive Pulmonary Disease)

CT Scan of Emphysema - Fev1 97%..?

04/26/2010

Question:

I`m in Europe (as a soldier)38 yrs old and I had a cough over the winter. The cough progressed... went in for some antibiotics, got an x-ray. There was a haze.

So as a precaution the Dr. sent me for a ct scan. Good news the haze went away but `showing signs of emphysema`. Of course the radiologist is french and that`s a loose translation of the findings... so

I go in and the Doc`s away the Physicians Assistant is there and we chat and he sends me down the hall for spiromtry.

So I do the test twice... both times all of the percentages are 97% and above even the fev1/fvc ratio thing...all of the numbers... but on the graph showed a slight obstruction... below mild.

Needless to say I got scared and as an vet of Afghanistan where I didn`t think I could get any `scareder`, I was wrong. I quit smoking on the spot. It`s been almost a week.... and I decided to `see` how my fitness was. I walked 5km first day briskly... with no ill effects and then I did a 3km jog. I haven`t ran for a few months so it hurt but no problems.

My questions... Do CT`s accurately show the amount of emphysema? Obviously a `good catch` as the PA says, but do the PFT results make sense? ...Could I have had this emphysema for years before this or could it be recent?

I`m still pretty scared, and I see a Pulmonoligist in a couple of weeks. I`m asymptomatic...

The PA told me to relax and everything will be ok...?

I can preserve the lung function I have after quitting cigarettes the emphysema is unlikely to progress. (other than normal degradation)

Al

Answer:

Thank you for visiting NetWellness and for your question. Spirometry is the standard for diagnosing chronic obstructive pulmonary disease (COPD). Emphysema is one form of COPD where cigarette smoke (or other toxins) damages the small air sacs in the lung. In some people this may show up by CT scan early with areas of lung that are damaged. The lung function test may be normal at first but if people continue to smoke it will decrease. The best thing to do is to quit smoking as you have done. Your pulmonologist should be able to address your questions further after reviewing your case. Thank you for your service.

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Response by:

Michael E Ezzie, MD Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University