Expert: Bailey - 1/26/2007

Question

Dear Bailey,
Thank you for your reply... my doctor said it was a good reading that it was o.k. that i did not have emphesema  but i was very nervous that day, i usually get above average results.
I wonder if you could answer another question for me....At times i wake up in the morning with congestion in my tubes yet there is none in my lungs it seems to be in my oesophagus or top of chest...what would cause the congestion to be there?....I also feel like I have a lump in my throat yet wwhen I went to the E.N.T. he said it was o.k. that it was clear ..nothing nasty there.what could cause this feeling of a lump? I think I have tonsil stones and is there any way to get them out? is there something that I can do at home to get them out?...my ears seem to block up which makes me feel strange and they start ringing....what causes this to happen? ...Thank you again and I hope you can help me here as well. God Bless and look forward to your reply.
Star.-------------------------------------------
The text above is a follow-up to ...

-----Question-----
Dear Bailey,
      I wonder if you can tell me what these readings mean please...they are a spirometre reading which I had done but I am not sure I understand them so I would appreciate it if you could explain what they mean and which is the most important level to take notice of.
 Age 52       Height 151cm
        Actual     Norm    %Norm      Abn

FVC       3.31      2.63      126
FEV1      2.26      2.20      103
FEV1/FVC%   68%       84%      81       *
FEF25-75% 1.37      2.25       54       *
PEF       4.26      5.36       79

NORMS:Knudson 1983      (VS35P32)

Measurement corrected to BTPS.
Good FVC maneuver.

-----Answer-----
Hi Star,
 The FVC number is your Forced vital capacity which is the maximum volume of air that can be forcibly exhaled. FEV1 is the volume of air expelled in the first second. The FEV1/FVC% is shows the percentage of air you are expelling in the the first second compared to the total amount of air you expel and should generally be over 75%.

FEF 25-75 is the average forced expiratory flow rate during the middle of the test and gives an indication of the condition of the lower airways.

PEF is the most amount of air that you can expel in a certain sustained amount of time.

Some of your actual results are lower then the norm but overall it looks like you did good on the tests. You have to look at each individual part to get the whole picture of what is going on so each thing is important. From a patients position though, the focus is generally on the PEF number. There is a device called a peak flow meter that is used by patients with lung problems to keep track of this PEF number and it generally provides a good indication of your total lung function and any potential problems.

Hope this clears it up for you, if not let me know if you have any other questions!

Take Care,
Bailey

Answer
Hi Star,
Have other respiratory conditions been ruled out for your symptoms? Have you been monitored for the possibility of asthma or reactive airway disease (RAD- a condition similar to asthma.)

If you have regular lung function tests and the results are usually good, then that will point away from it being any respiratory problem. Your symptoms would make me question a condition called vocal cord dysfunction. In general, doctors do not know much about this condition so it is not usually brought up. I am not extremely familiar with the condition myself but there is quite a bit of information about it on the Internet if you go to google and do a search. Might be something worth looking into.

Tonsil stones can create a feeling of a lump in the throat as well. Have you asked your ENT about this? He should be able to confirm a diagnoses of tonsil stones. Treatment you could try at home would be to gargle frequently with warm salt water. There is also a mouthwash you can try, I believe it is called Alkalol. Other then that, antibiotics or surgery may be necessary.

As for your ear problems, this could be from a wide variety of inner ear problems. This is outside of my expertise but an ENT should be able to narrow down the potential causes for this.

Hope this helps!
Take Care,
Bailey