Skip to main content

Pulmonary function test results: surprise!

I met with my pulmonologist, Dr. Vilensky, on Thursday to go over the pulmonary function test results and discuss the bronchoscopy. He confirmed that my results improved dramatically compared to last October. I actually was surprised to learn how much I had improved on each of the key measures. 

  • FEV1 (forced expiratory volume) measures "the air you exhale in 1 second. A low FEV1 suggests a breathing obstruction."*
    • May 2023: 91% (vs. 73% in October 2022) (The percentage indicates my result compared to the expected result for a woman my age.)

  • TLC (total lung capacity) is "the total volume of air in the lungs after a maximal inspiration." 
    • May 2023: 83% (vs. 72% in October 2022 and 69% in June 2022)

  • DLCO (diffusing capacity of lung for carbon monoxide, aka diffusion) "is the extent to which oxygen passes from the air sacs of the lungs into the blood." It's an indicator of the extent of lung damage. I believe this indicator is what helps explain my shortness of breath on exertion and lower O2 saturation.
    • May 2023: 68% (vs. 49% in October 2022 and 41% in June 2022) 

I was really happy to see these improvements. 

Regarding the lung biopsy, Dr. Vilensky and Dr. Villaruz discussed it and decided the risks outweigh the benefits. I would have to stop my blood thinner medication for 48 hours and because of the kind of tissue sampling Dr. Vilensky would have to do, there's a risk of collapsed lung and bleeding. The information they would get would not change my treatment, and since there's no active scarring taking place there didn't seem to be a strong reason to do the biopsy. So for now I will have to sit with the uncertainty of now knowing what caused the scarring: the cancer itself, pneumonitis resulting from Tagrisso or something else, COVID, or ??? This reminds me of my favorite quote from Suleika Jaouad's memoir: "To learn to swim in the ocean of not-knowing—this is my constant work."

The good news is that my lung function is slowly improving and the scarring/fibrosis has stopped.

*Sources: https://www.healthline.com/health/fev1-copd 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229853/ 

https://en.wikipedia.org/wiki/Diffusing_capacity_for_carbon_monoxide 

Comments

  1. Leslie CJune 3, 2023 at 4:49 PM

    Wohoo! This is such good news! Thank you for sharing.

    ReplyDelete
    Replies
    1. AnonymousJune 3, 2023 at 7:36 PM

      Great encouraging news-still impressed by your squats with a 20 kg bell?!

      Delete
  2. DoloresJune 3, 2023 at 4:50 PM

    Woot ! That is the best news !

    ReplyDelete
  3. AnonymousJune 3, 2023 at 5:03 PM

    Really, really good to hear this Esther! (Henson)

    ReplyDelete
  4. Charles MifsudJune 4, 2023 at 4:17 AM

    Great news indeed! A formidable swimmer!

    ReplyDelete
    Replies
    1. Esther PrinsJune 5, 2023 at 9:07 AM

      Yes, I'm very happy with the news. Swimming is not my forte (and would be impossible with the portable concentrator), but biking is going well.

      Delete
  5. Kristen GraceJune 4, 2023 at 4:39 PM

    Hooray for happy surprises! (Having trouble with Google Workspace account confusion, so I hope this works). Sending love from Ithaca

    ReplyDelete
  6. AnonymousJune 5, 2023 at 8:15 AM

    I am so thrilled and happy for you! 😄🌸💓🌺

    ReplyDelete
  7. IreneJune 5, 2023 at 7:18 PM

    Wow, wow, wow...praise God!! This is such encouraging news, Esther. Thanks so much for sharing what all those acronyms mean and putting medical jargon into easily understandable terms for us lay folk. :)

    ReplyDelete
    Replies
    1. Esther PrinsJune 6, 2023 at 2:33 PM

      Thank you, Irene. Yes, it's a lot of acronyms!

      Delete
  8. IreneJune 5, 2023 at 7:19 PM

    PS--LOL, and I love how you cited your sources...you are eternally the good scholar/academic. :)

    ReplyDelete
    Replies
    1. Esther PrinsJune 6, 2023 at 2:33 PM

      I can't use direct quotes without citing. It's deeply ingrained!!

      Delete
  9. KaiJune 6, 2023 at 7:08 AM

    What wonderful news…!!! Here’s hoping for that continuing trajectory Esther! You’ve really been through it and that makes numbers like these especially sweet.

    ReplyDelete
  10. LauraJune 7, 2023 at 6:58 AM

    Such great news! What an answer to prayers!

    ReplyDelete

Post a Comment

Popular posts from this blog

Healthcare costs and insurance woes and victories

Those of you who have read this blog from the beginning may recall my posts about how inexpensive healthcare is in Germany compared to the US. I now have additional proof. I've been receiving "explanation of benefits" statements from Aetna detailing the cost of my hospital stays and other healthcare services since the end of July. Close your eyes and guess how much these amount to. Higher. No, higher. Still higher. Well over $200,000. Of that, I have paid maybe $100 plus some $20-30 co-pays for doctor's visits. Add to that my cancer and blood thinner medications, which would cost about $16,000 per month without insurance. I have no idea what people in my situation do if they are uninsured or under-insured. My recent interaction with one of my German doctors illustrates another stark difference. Before leaving Germany, I had asked my doctor what to do if I received bills from the LungenClinic after we had moved and closed our Deutsche Bank account (all bills in Germany...
15 comments
Read more

A failure of institutional care

I just hit "send" on this letter to my dean and associate dean. Mic drop. I've never sent such a scathing letter, but it's definitely called for in this situation. I'm not expecting anything other than a "Oh, that wasn't how we intended to make you feel; our hands were tied" email. Dear Dean Lawless and Associate Dean Lloyd, When I wrote to Professor Land [my department head] to see if I could get a course release this fall due to having lung cancer plus complications from pulmonary embolism and COVID, I had no idea what I was in for. When faculty friends in other colleges have had health crises (ones that don’t warrant a full-semester medical leave), their department head or dean has simply said, “Don’t worry about teaching this semester. We’ll figure it out.” I figured the same would happen in my case. To be blunt, the way that my case was handled was a colossal failure of leadership. As my husband and I have shared my story with colleagues at PSU ...
26 comments
Read more

regular update

I had my regular oncology appointment in Pittsburgh yesterday. Dr. Villaruz said the scans look good and everything is stable. Although I don’t have much scanxiety nowadays, it’s always a relief to get good news. Just to be sure that my understanding was correct, I asked her why I’m not a candidate for surgery. It’s because of the cancer’s growth pattern. The one nodule that’s visible on the CT scan could just be scarring; she’s not sure if it’s a tumor. When I was diagnosed, I was told the lung cancer was “lepidic.” This means that the tumor cells were growing along the lining of the alveolar structures (air sacs).* That’s why my lungs looked like they were draped in cobwebs. You can’t do surgery in enough places to get all of it. Thankfully, Tagrisso swept out those cobwebs – and continues to do so. We go back in December for a regular appointment. *Lepidic spread tends to be slow-growing, with minimal invasion of nearby tissues, less chance of metastasis, and overall better progno...
10 comments
Read more