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Dr. Andrew Rynne

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What causes breathlessness, upper abdominal pain and cough?

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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14049 Questions

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Posted on Tue, 7 Mar 2017 in Lung and Chest disorders
Question: Let me first start off by explaining my symptoms which I will number below.
1. Feeling breathless
2. Lower chest and upper abdomen feels tight
3. Constant urge of needing to gasp for air
4. Cough that seems to be becoming more of a concern the past day. My parents have had a cough for the past days.
5. Breathing through nose feels restricted and tough/heavy
6. Having to yawn to try and catch my breath
7. Breathing through nose sounds noisy like a whistling sound sometimes

I am a 23 year old white male
Weight: 161lb
Height: 5'10
Sex: Male

Doctor my main concern with my pulmonary function test is from what I have read up on is that if your FEV1/FVC is 80% or lower then that is a sign of an obstruction disease which if I remember right is either Asthma or COPD. I understand that I am 8% above the "normal" but it just does not seem comforting. Im not even sure what the XXXXXXX FEV1/FVC range is... cause I know the XXXXXXX FEV1 range is between 80-120% but how is that possible since some people are getting higher then 120% and the same for FVC? Ive seen people in the 130's and the high 120's.. how is that possible? Does that mean the higher the number the more healthy your lungs are? How do these numbers work?

Doctor no one in my house has ever smoked and I have never smoked my entire life. I should also be clear that I have never done any drugs. I was born and raised on Long Island, New York for 20 years before moving to XXXXXXX I landed a job here in XXXXXXX as a firefighter and after a few months of working on this job is when I started developing these symptoms. As a kid growing up I was around people who smoked which made me a victim of second hand smoke. At the fire station I'm surrounded by dust that accumulates from the ground outside and gets into the station, chemical fumes that we use for cleaning such as 409, Windex, Pinesole, Lysol and Febreze (not sure if these cause COPD). Im also constantly around engine fumes that come from the exhaust overtime they are started up and I am also of course around smoke from fires when we do have one but of course I am wearing my mask that is "supposed" to protect me.

History of family medical history
1. Heart Disease
2. Diabetes
3. Hypertension
4. Sleep Apnea
5. Alzheimers

There is no family history of asthma or COPD that anyone is aware of and there is apparently no lung issues that run in the family other then sleep apnea.

Tests that have been performed are listed
1. Chest X-ray (which was normal) 6 months ago
2. Blood Test ( Which was normal) 6 months ago
3. EKG (Which was normal) 6 months ago
4. Pulmonary Function Test (Normal) 6 months ago

I also did an Alpha 1 Genetic Test for my own research just in case that I developed COPD from a genetic link but the test results came back negative.

My main concern doctor is that I am developing early signs of COPD that the doctor misdiagnosed or maybe the symptoms are worsening cause the COPD is reveling itself? Ive heard of people developing COPD overnight and I'm afraid me being around all these fumes is causing my lung problems and had me develop a serious disease. Im honestly trying to figure out what could be wrong with me cause I am otherwise a very healthy person who workouts 6 days a week, takes a multivitamin and fish oil pill daily while meal planning all his foods for the week. I do have about 2-3 cups of coffee every morning which I'm cutting back on. Any advice would be great doctor cause I'm worried that i might get diagnosed with asthma which is easily mistaken for COPD. Thanks Doc
doctor
Answered by Dr. Kaushal Bhavsar 10 hours later
Brief Answer:
Your PFT is normal.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the detailed history and reports you have attached.
Your PFT report is normal.
There is no upper limit for FEV1/FVC ratio.
Normal Lower limit is 80%. Below this considered as obstructive Airway defect.
Above 80% is considered as normal.
High ratio (more than 120%)is seen with
1. High FEV1 (higher amount of air exhaled in first second). This is seen with healthy lungs.
2. Lower FVC. This is seen if person has not expired for atleast 6 seconds - false low FVC).
So in your case nothing should be worried about as your PFT report is absolutely normal.
Since you are also having nasal symptoms, please let me if you have consulted ENT doctor or not.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kaushal Bhavsar 8 hours later
Hello Doctor,
Thank you for responding to my post. When I first saw a pulmonary doctor about this and he did a pulmonary function test on me he said the same exact thing that all my results are normal but he never really talked me through my results which is why I I went and found a new pulmonary doctor. About 2 months ago I did another Pulmonary function test and the FEV1/FVC dropped from 88% to 86% which was a concern for me cause that was a 2% decrease in such a short amount of time. Im worried that me being at the fire station is causing my lung problems but I'm not sure how I can know for sure.

1. Doctor I'm a little confused cause you said that the upper limit of the FEV1/FVC is 80% and anything below 80% is considered an obstructive defect. The reason I am confused about this is cause I always thought the FEV1/FVC ratio is considered obstructive when it falls below 70% and then pulmonary specialist would look at the FEV1 percentage to stage the disease. Correct me if I am wrong doctor cause if this is not the case then I'm only 6-8% above that "normal" limit and that is not a comforting feeling.
2. Doctor if you notice in the graph on my pulmonary function test that after I'm down inhaling and i start exhaling, the loop seems to cove in slightly and I thought this is a sign of an obstructive defect.

The reason why I am so concerned with all this is cause my breathing is labored and its not comfortable. Im constantly short of breath and gasping for air to try and bring in that air. My neck muscles are constantly tight.

No sir I have no yet consulted with an ENT doctor but I think i might set up an appointment.

doctor
Answered by Dr. Kaushal Bhavsar 24 hours later
Brief Answer:
Sorry for my mistake.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.. Sorry for mistake. Yes, you are right.
For FEV1 /FVC ratio, cut off is 70%.
For FEV1 %, cut off is 80%.
So your report is normal and no need to worry for this.
Also 2% decrease is not significant so don't think too much about it.
I don't find any obvious abnormality in your graph.
And yes you should definitely consult ENT doctor.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 12 hours later
Hello Doctor,
Thank you for responding back. No worries on the mistake doctor. Why is it that I had a 2% decrease in my ratio in such a short amount of time and doctor why is it that people have FEV1 of over 100% and FVC of over 100%? I feel like my pulmonary function test is pretty low for my age and indicates that a future obstruction is coming if that makes sense. I keep so worried that these chemicals at work I'm breathing in and the fumes are going to decrease my lung function really quick. I'm just trying to figure out what could possibly be causing my symptoms cause no doctor seems to have an answer..I hope I don't sound mad cause I'm not, I'm just really concerned that I'm being misdiagnosed and doctors are missing something.
doctor
Answered by Dr. Kaushal Bhavsar 2 hours later
Brief Answer:
At present you are not having any disease.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
2% difference is not significant. This can be due to technical errors so don't stick to 2% decrease.
See spirometry is totally effort dependent test. If you practice more, you will get good values.
If you don't blow more, you will get lesser value.
For you, I will suggest to go for regular six monthly spirometry to see if there is steady decline or not.
If your values remain in normal range then no need to worry at all.
Hope I am clear now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 42 hours later
Doctor I'm understanding that according to my pulmonary function test a few months ago indicates that I have no diseases but what I am not understanding is if this is the case then why am I still struggling to breath comfortably? I'm not trying to sound rude by any means when I say this but its really annoying after a while that breathing through my nose feels constricted and it doesn't feel like the air is moving as freely as it should which leads me yawning to try and catch my breath or gasp for the breath and majority of the time its unachievable and I have to keep trying. Its just really discouraging that no Doctor has any idea what could possibly be wrong.

I understand that the spirometry test is all about effort but no matter what I don't see how there is anyway of increasing the values if you put everything you had into the first time. When they ask you to blow out and theres barley anymore air then its hard to keep blowing more if that makes sense.

My question is what would be considered a steady decline and if this does happen what actions would I need to take? I really do not want to have to worry about developing COPD or any lung disease while waiting for my 6 months. For all I know I could develop COPD way before than when I could of somehow avoided what ever exposure it was that caused it.
doctor
Answered by Dr. Kaushal Bhavsar 2 days later
Brief Answer:
If there is steady decline in PFT then you need to shift your job.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Sorry for late reply as there was some technical problem.
I respect your symptoms and feelings a lot.
In my opinion, you should first consult ENT doctor and get done clinical examination of nose to rule out any nasal pathology.
I suggest you to undergo PFT every 3 monthly. If values are stable for 2-3 PFT s then no need for further PFT.
But if values are declining then you need to get done HRCT thorax to rule out lung diseases. In that case you may need to change your job.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kaushal Bhavsar 2 days later
Thank you Doctor I will do that.
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Please close the conversation and rate my answer.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's always encouraging for doctors to hear positive feedback from patients.
I am glad that my advice is helping you.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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