Pulmonary Function Test & Chest Pain/breathing Problems

[jump]

I know some of you here have had PFTs and I was wondering what your experiences were.

I had a pulmonary function test because I have chronic chest pain, and it's specifically worse when I take a deep breath, or if I have to do something that requires a lot of breathing, like talking a lot or exercising. It's present every single day and it really bothers me because it's so uncomfortable. I also frequently feel like I'm having trouble catching my breath, and I often have to stop in my daily activities to sigh or take a few deep breaths.

The "problem" is, I can breathe fine. It just hurts. I'm glad of this, but it's making getting help for it difficult, because my doctors keep checking my oxygen levels and saying, "Oh, it's fine." I CAN take deep breaths, it's just painful when I do.

During the PFT, I felt very lightheaded and dizzy, and the pain was worse. After a few rounds of deep breaths/exhalations, I started to feel very fatigued and unwell, like I needed to lie down. After they gave me a nebulizer and did more deep-breathing, I felt EXTREMELY lightheaded, faint, and I started to tremble uncontrollably all over. My face got very flushed, which doesn't happen to me very often. I felt so unwell I was worried I wouldn't be able to drive home, and I had to lie down in my back seat for a while. The trembling and exhaustion continued for several hours. I think this reaction was caused at least in part by having to take so many deep breaths.

The thing is, I'm pretty sure the test itself came out normal. The tech kept saying my results looked really good. Which brings me back to this problem of, I CAN breathe well enough, but breathing deeply seems to set off all these reactions in me that I kind of feel like shouldn't happen if everything is, indeed, normal.

Does anyone have any insights? Why might be happening to my ANS when I breathe deeply that could cause these negative sensations? If my lungs themselves are fine, what ANS reaction might be causing me to feel like I can't catch my breath?

And for those of you who have had the PFT, did the nebulizer make you feel really sick, too???

[firewatcher]

Jump,

My PFT came out better than normal! But if what they gave you was albuterol (usually is) it is a strong ALPHA-agonist=brings on an adrenaline rush. Hyperventilation will cause brain vasoconstriction and even fainting. If you give me albuterol now, I shake so badly you could use me to tamp sand! My PFT made me very symptomatic.

[masumeh]

Hi,

I had a pulmonary function test about 7 years ago, beginning of my POTS adventures. At the time, I did not know I had POTS, just diagnosed with syncope. But I had suffered a pulmonary embolism with the pregnancy that set off the POTS sympotoms (EBV/mono infection was simultaneous). So, when I still felt short of breath several months post-miscarriage, I returned to my pulmonologist. He conducted a PFT, just to be on the safe side. It was normal.

I remember feeling light headed and like I was about to faint. The technician kept telling me, rather irrately, I was not breathing deeply enough. I tried to cooperate, but it was frightening to be locked in a transparent refrigerator with a nose plug and huge, sterile-tasting tube thing in my mouth...also, it just felt like a pre-fainting sensation. When I told her I have syncope, she was like, "Oh, nevermind. Don't push yourself."

Probably if I had followed her instructions thoroughly, I would have fainted. Hyperventilating can lead to siezures also, and I just found out I have epilepsy, so maybe that was a pre-seizure feeling too? I don't know.

As for your painful breathing, did you check out the possibility of a diaphragm hole? My sister-in-law has that, and they caught it with a simple x-ray. She gets pain sometimes, and it is sometimes referred pain, if I remember correctly, to her back. I can ask her what it feels like, exactly, next time she calls.

Also, did you check out asophegeal pain? I used to get spasms of pain, and I couldn't breath in or it would hurt like crazy...turned out to be asophogeal spasms. It really did not feel like GI-track related...felt like a heart attack. But the meds to stop spasms fixed the pain instantly. So I think it was a correct diagnosis.

Good luck.

[flop]

Deep breathing - this stimulates the vagus nerve and can make you feel very dizzy or even faint (sometimes kids deliberately hyperventilate to make themselves faint for a "laugh").

Nebuliser - this is usually Salbutamol, a med that stimulates the beta-2 receptors in the lungs. For people with asthma it relaxes the airways and helps the airways open up to improve breathing. It also stimulates beta receptors in the heart which cause a fast HR and palpitations, for many people it also causes a tremor.

Having to do deep breathing and have a nebuliser is a sure way of making you feel yucky! The salbutamol wears off after a couple of hours so hopefully by now you are feeling back to normal.

If it hurts to breathe then you may have a musculoskeletal cause for the pain (muscles / bones / joints). I once had something called costochondritis which was really painful on coughing / taking a deep breath - the joint between a rib and my breastbone was inflammed. I found that because if hurt to breathe that I was taking little shallow breaths, this meant that I got out of puff easily and had to stop to take a few deep painful breaths. Perhaps your doc or a phyisotherapist could take a careful look at your ribcage and see if there are any inflammed joints causing your pain?

Hope you feel better soon,

Flop

[bizbiz]

Hi,

I dont mean to deviate from jump's original post, but I just wanted to ask a quick question...

If your PFT came back bad, what sort of illness/s would that be suggestive of?

[Ernie]

Hi,

Emphysema, asthma.

[ajw4790]

Hi,

All the different breathing tests or having to take many deep breaths etc. tend to all cause an increase in symptoms for me. I haven't had a PFT etc. but it would probably be normal. It is not the pulmonary system that is misfiring/causing the issue it is the ANS.

[delphicdragon]

I hate PFTs! I also hate having to breathe deeply when the doctor is listening to my lungs. I get SO symptomatic, that I have to sit down for a while after. Usually, my POTS is pretty well controlled but deep breathing is a real killer. Plus, I have to have regular PFTs due to my asthma. *Grumble*

Sara

[all4family]

Hi Jump,

I actually fell out of the booth on my second pft. I started to tell the tech I was dizzy, then proceded to fall forward on her! luckily I didn't faint, though I came close. Both of my tests had something that was a little off on part of them, but I guess it wasn't a real worry for them. Though it doesn't make breathing any easier for me! My oxygen level at the hospital the last time I was there was 90% when I was sitting up. But when the top of my bed was lowered it went up to 100%! What this means I have no idea!

I really hear you on the issue with talking! The last time I tried talking while standing for more then 3 minutes I hit the cement! I have trouble catching my breath too. I also felt really bad for quite some time after the tests.

I wish I had the answer why, but my thought is that our ANS is not adjusting our heart rate when we stand, and exercise, and breathing deeply would normaly raise our heart rates, and activate our nervous system. Well if we are activating it it would tire us just like exercise. Ok..that's my thought on the matter...don't know if it is true, but it makes me feel a little better about it.

Yes the nebulizer made me feel worse light headed, and I don't feel like it helped me. As a matter of fact I think it made no difference on the test before, and after I took it.

[jump]

Thanks, all of you!!!! These responses really helped me a LOT.

I had a chest x-ray, too, and sure enough, everything came back normal. My doctors' response was, "It must be something skeleto-muscular, don't worry about it." But I was never really worried it was something sinister (I've had it for years now), I was more hoping to find some relief. I've tried the treatments for costochondritis and they didn't help, but I'm thinking I might start looking into alternative medicine techniques, when I have a little extra cash.

Mostly I just feel better knowing a lot of you have these problems too, because then I feel more comfortable saying it's probably just something related to POTS/ANS dysfunction. For me, this pain started very specifically after a virus, and came on several years AFTER my POTS developed -- so part of me thought it probably wasn't related. But now I'm figuring it is.

I think you guys are right, I think because it's painful, I tend to take little breaths, and then I have to stop and "catch up" with a few deep breaths. And then too much deep-breathing makes my ANS go wacky.

Strangely, I feel ok with having hit the end of the road in terms of figuring this out with my doctors. The pain bothers me, but I feel like now I can shift my focus from trying to diagnose it and solve it to trying to live with it and manage it.

Thanks again!

[lotsicker]

I think the breathing problems are definately caused by the HR. My BB helps bring my HR down and I notice that I am not quite as short of breath. I also find that on very difficult days we breath harder, looking for that deeper breath to fill our lungs. This makes my muscles sore the next day as they have had to work harder. Its possible the muscles are just overworked and sore ALL THE TIME because its such a struggle to breath. Maybe look into some yoga or streaching to help the muscles relax??

[mjan]

May I ask what your treatment is for costochondritis?

This kind of pain..which keeps me from breathing deeply has lead to all kinds of problems. Not sure how this relates to ANS problems but will listen to those here who know.

All I know is that this kind of pain for ME comes from my rib cage..one side or the other.. OR.. all around which grips SO tightly that it literally takes my breath away. I cannot lay on my side..as this seems to trigger it or on my back.. THIS always seems to trigger the worse spasms of my life. So I take Methocarbam which is a non drowsy muscle relaxant with 3 ibroprofin and that seems to help. When they thought I had MS (last 4 yeas) they called it the MS HUG.

Let me know what you think...but it was my rheumy who measured my rib cage while taking breaths and said that I do not ever take in deep breaths.. and I have what seems like asthma..but its more coughing due to irritation which also contributes to shallow breathing.

Best to you.. hope you get answers.

Jan