Breathing test results 'uninterpretable'
 

I am putting this in a separate thread so it doesn't get lost.

I have been told the results of my breathing test are 'uninterpretable' because I was not able to 'perform the task asked of me'. When I asked the Dr to explain this he said:

'It's like taking a blood test but not having any blood to analyse'.

I asked does this mean there was an absence of air in the test. I added that I am not able to breathe out forcefully as they had asked me to do, trying to do so caused me to become very breathless and faint, and did this not indicate anything?

He said no it is not due to an absence of air, the test is 'uninterpretable'.

I asked: 'Is it worth re-doing the test'?

He said: 'There is no value in re-doing the test and we will not be repeating it'. He added that my oxygenation levels on the pulse ox were normal and that this is 100% reliable.

So, it's been explained to me that it's possible my breathing issues are due to 'chronic muscular tension', which appear to be situated in the inter-coastal muscles of my lower left rib cage.

I wish that the test results had come back normal as this would be far more re-assuring. I trust they know what they're talking about. My breathing has been better recently but I don't know what I would do if it got worse again as it was two months ago. Should I just sit it out? They seem to think that there is no risk in doing so.

Please note it is firmly believed I do NOT have MG but Athlete's Overtraining Syndrome. Forgive me for posting here but you have been so knowledgeable I would really value your advice.

Can anyone help me to understand what this result means?

Well, you haven't given any results to comment on! ;)

Oxygen saturation - what was yours? - can be deceptive in MG. It's good to know your normal and when it and you are headed downhill though.

Do you have a pulmonologist? Who ordered the breathing tests? A neurologist? Do not trust a neuro with pulmonary issues. You have to see a pulmonologist. And, at this point, I wouldn't tell the neuro about the pulmy and vice versa. To me, it sounds like you're being red flagged as a patient with nothing wrong.

Have you been seeing doctors in an HMO? Can you find a pulmonologist in a separate facility or private practice?

I'm fairly unsettled by what your doctors have been saying. Overtraining "might" cause all of your symptoms but something isn't adding up. None of us can tell you what's going on. You have to see doctors and hope they treat you with respect.

Annie

Ummm that sounds nuts to me...whenever I can't breathe on the test that is a sign that my muscles are too weak to do what is asked of me! Was this a full pulmonary function test? There are many different components to that.

The ones that test your muscle strength at any given time are the NIF and FVC. However they do a bunch more tests on a pulmonary function test, which is usually done in Respiratory and is done by a Respiratory therapist. You can get copies of the results of the test.

This is a very bad comparison.
Most reasonable physicians would repeat the test.
If It was truly impossible to draw blood they would be very concerned why and check it out.
You don't order a blood test for fun, but because you truly need to know the results of the test.
Yes, sometimes it requires sitting by a patient's bed for an hour or more, because they veins are destroyed by treatment they received, but you don't just give up.

I have been ill with significant respiratory involvement for quite a few years. The only time they were totally unable to measure my vital capacity was when I would have died hadn't I had my own respirator.

All the other times I had very low values, but they were measurable and interpetable. (given that they were seen by a competent physician).

The tests I had which were seen as non-interperparbable were always easy to interpert once they were done properly or interpreted by a competent physician.

For example:

In my first sleep study I had "unexplained" rapid breathing and a "normal" CO2 of 50. In my second sleep study (which was done by a respiratory neuromuscular expert) I had significant CO2 retention due to respiratory muscle weakness. (the numbers were quite similar to those of my "normal"/ "unexplained" test).

During an ischemic lactate test (which was normal) I had unexplained generalized weakness and breathing difficulties. This was due to a well described myasthenic phenomenon.

It's very hard to answer this question without seeing those results.

I would too.

I personally wouldn't. They shouldn't be content with "no results" or results they can't understand. They should have put more efforts into getting those results.

This makes it even more unreasonable that they could not get you to blow into their machine and have interpertable results.

Sometimes tests can make you feel very unwell. Still, they have to be done properly. You can't analyze someone's blood if he doesn't cooperate with you when you try to draw it. If you are able to breath on your own, and at the same time can't blow into a device they ask you to, it appears that you are not co-operating not that you are having true breathing difficulties.

When you look at a flow-volume loop, it is very easy to see if the person has done it properly or not. Regardless of the underlying pathology, by the end of each cycle (inspirium/expirium) you should reach the same baseline point.

There is a test called MVV in which you have to breath into a tube as deep and fast as you can for less than a minute. When I had it done during one of my exacerbations it nearly got me into full blown respiratory crisis. My oxygenation went down during the test from nearly 100% to 90% and it took me a few hours to recover. Yet, this test was what convinced my pulmonologists that I require respiratory support and had I not put my efforts into doing it, they would have more easily accepted my neurologist's opinion (at that time).

Thank you very much for your responses.

Annie, I don't know what my oxygen saturation was, they didn't tell me, they just said it was fine. The breathing test was arranged by a neurologist after my bout of bad breathing in early November. At that time I was waking up several times a night gasping for breath and during the day couldn't speak more than three words at a time, even sitting down.

I did not get my 'pulmonary function' test until mid December, by which time my symptoms were much improved. So much so, when I arrived for the appointment I doubted they would find anything. I was therefore quite surprised when I became so out of breath trying to do the test.

The test itself first involved blowing into a hand held tube contraption as fast and hard as I could. While I say I wasn't able to do this, I mean I wasn't able to do it well. I tried my hardest and I'm sure there was some air there! It wasn't like there was nothing, it was just hard and exhausting. They gave me a few minutes between each one to recover. Then they attached the tube to a sort of square machine and asked me to do it again, and then finally with a peg on my nose (the hardest). She was writing some numbers down, in the 60s, and then in the 40s.

While I accept that it could be muscular tension, it is some seem incredibly weird, given that it has been there, fluctuating for three years, at the bottom of my left rib cage, that that is the case. I do pranyama breathing exercises every morning and during the days my breathing was bad my ability to inhale and exhale became less and less very quickly. I had the sensation of something folding on the left side. I've slept upright ever since. I'm so used to it now I don't notice it's there – it has become my 'normal'. I still can't blow my nose or cough very well though!

I will look into seeing a private pulmonologist, but that means I have to persuade those around me, who I depend upon for getting about, that this is what needs to be done.