Lung Function Tests Results

[Possegal]

i had a dr who i really liked who would help me through my asthma episodes who told me once "you know as well as i do, all that wheezes is not asthma, and all that is asthma does not wheeze".

i'm a coughing asthmatic myself, with cold weather and viruses being my two worst triggers, then exercise (worse obviously with cold air) and smoke. i don't wheeze, but i do notice a sort of constricted sound to my breathing when i run, only when i run though, no other exercise. if that makes sense.

and yes, the only way to truly know about a nodule is to biopsy it. but that is a more intrusive way to look at it than you may need to do. i know this as i've said before, my sister is battling lung cancer right now so i'm right there for all the tests, etc. plus, i work in that field. anyway, usually with a lung nodule (benign ones are usually a result of some sort of infection or inflammatory response) there are characteristics (CT and PET) that indicate it is not cancer and then whether or not the size of it changes over time is indicative of benign vs malignant. yes, they will follow for 2 yrs before saying 'no worries', but if it is a malignancy, it would grow rather fast. so another CT that says, still there and still the same size, will be really good news. plus, the uptake of the nodule on PET tells a lot, and yours clearly did not have the uptake pattern of a malignancy.

i guess that is a lot just to say - i can imagine how scared you are, no one wants to hear there is something in their lungs and no one knows for sure what it is. but it sounds like the dr has done a lot to distinguish if this nodule has any of the characteristics of a malignancy and it doesn't. easy for me to say 'rest easy', but it sounds like you are in good hands. i spend a lot of time reading a board by a lung cancer specialist and i've seen him answer questions to people with a nodule on x-ray and CT and saying these same things to them, and he should know. though i also see the anxiety in these patients and feel tremendous sympathy for them, so you aren't alone if you are feeling anxiouis about it all and still unsettled despite the doctor's assertion that things look fine.

so, the lung tests. when you do them we can get a lot of information. they should have had you do things like breathe in and out normally and then breathe in taking in as much air as you can, exhale normally, exhale all the air you can. from that we get all sorts numbers and the ones that he was talking about to you were
FVC - this is forced vital capacity, it is how much air you can force out of your lungs by exhaling as strongly as you can - here you've inhaled as much as your lungs can hold and now are forcing out all the air that you can (keeping in mind that you can't force it all out, there is always air left in your lungs, this is called residual volume)
FEV1 - forced expiratory volume in 1 second and this number is how much of that air comes out quickly, in the first 1 second.

normal would be that you can force out 70% or more of that volume of air you forced in, within the first second. a lower percentage would be indicative of some sort of obstructive or restrictive disease and other numbers, i believe, would eliminate one or the other. and sounds like your dr has said it is an obstructive disease like asthma.

i wouldn't discount the ability of the stress over all of this to wreak some havoc on your feeling of shortness of breath. sounds like your gameplan is a good one. i may go ahead and get an inhaler and then do the experiment myself, similar exercises with and without a puff beforehand, see if i feel any differently while working out. but i'm a lab rat at heart, and always happy to be my own N of 1 in an experiment.

the nodule could be impeding some lung function, depending on its location and size. but it doesn't sound like the dr thinks that or he wouldnt' be suggesting exercise-induced asthma as the diagnosis. but i don't know for sure. nor would i begin to diagnosis on the net since i'm not an MD or a pulmonologist, just a phd pharmacology research scientist who happens to know more than i'd like about lung masses and who spent a few years teaching spirometry (though i'm way rusty on explaining those things). and i see while doing my lengthy writing you answered what i thought, that the dr doesn't think this is impeding anything. i'm guessing you were having some shortness of breath problems and went to get it checked out and the nodule was found while working you up for why you were having SOB?? am i right? this is one of the arguments in the community against the idea of routine scans to check for lung cancer, similar to a mammogram. you will find way too many benign nodules that will put patients through tremendous anxiety and possibly very intrusive follow-up tests, just to be told never mind, you are fine. i'm sure you can speak to that anxiety better than i can! and while i do really understand the logic behind not doing routine screening, i also hope to God there is something developed soon that helps us screen and catch lung cancer in its early stages, since the fast majority of LC patients find the cancer when it is either locally advanced or metastatic, and that is not when you want to catch it.