Lung Function Tests

Before the Radiotherapy (RT) starts, I need to have my heart and lungs checked out. This is to put down a benchmark, to see whether and by how much their performance is affected by the treatment. If they are affected (and they probably will be) there's no fixing them, it'll be permanent. So the purpose of the tests isn't so that the medics can some how return my vital organs to their pre-treatment state, because they can't. It's more so that other patients' treatment can be amended, if necessary, in the light of my experience.

I find this all a little bit worrying. I realise that in the modern NHS, improvements in many areas are generated through studying what went wrong in the past. I get that dosages in RT are based on previous experience: in the past some people have probably been given doses that weren't strong enough and so didn't work, and others have been given doses that caused major problems. As a result, today's dosages are reasonably well tolerated by most people. Still, when it's personal, it feels a bit, well clinical. Which of course it is.

Lung Function
There is a narrow, airless corridor in the heart of UCH with chairs all along one side and doors and a small trolley along the other. This is where patients wait for blood tests. The trolley is for a signing in book, so patients can be seen in order. There are usually more patients here than chairs, and the patients aren't routinely told about the signing in book, which makes for confusion. When a patient turns up in a wheelchair, there's not enough room and furniture has to be rearranged. This makes for short term chaos.

At the far end of this corridor, next to the end wall and the water cooler with no cups, is the Lung Function laboratory. My heart goes out to the people who work there.

There's 2 doors: Lung Function and the Sleep Laboratory. A note on the Lung Function door tells you to knock and wait, which I did. A man opened the door and appeared surprised to see me. I explained why I was there, and showed my appointment letter, and he told me to sit down and wait. A few seconds later he came out of the room, squeezed past my legs and disappeared into the Sleep Laboratory. A moment later, he came back the other way. Then another chap came out of the sleep lab, squeezed past again and disappeared into the lung function lab. This was all starting to feel faintly silly.

When I finally got into the surprisingly roomy Lung Function lab, the chaos and confusion disappeared and quiet efficiency reigned. I was to have two different tests, both involving a sequence of breathing in and out and holding my breath. The first measured the expansion of my lungs; the second, the efficiency of my lungs in passing oxygen into and carbon dioxide out of my blood stream.

Lung Function: Spirometer

The technician seemed a nice chap. His role, apart from the technical aspects of manning the equipment and monitoring the tests, was explain the particular sequence of breathing, then talk me through the tests. He did this by sort of acting out what I was doing.

"Breathe in, in in in in in in....and hold - hold - hold - hold - hold - a bit more, just a bit more......and out, sharply, keep going, keep going, keep going, and.... relax."

All the time breathing in, and holding, himself. I guess his lung function is pretty damn good, after doing that for twenty-odd years.

Spirometry: FVC and FEV ₁ = 107% over predicted
and  a FEV1/FVC  of 85.1%  !!!

I asked about the second test, measuring the efficiency of my lungs. How does that work? Apparently they use proxy gases, at predetermined proportions, and by measuring the mix of gases exhaled that can tell how well the lungs have done their job. The proxy gases are helium for oxygen and carbon monoxide for carbon dioxide.

I couldn't help myself. I tried to fight it, but it just had to be said.
"So you know if my lungs are working really well if my voice goes up two octaves and my lips turn blue?"

"Er, no, that won't happen, we only use a small amount mixed with air..."
Oh dear, I'd thought it was funny, clearly I was on my own. To my shame, it didn't occur to me until the next day that I probably wasn't the first to crack that joke, and after 20 years it had undoubtedly worn a little thin. Oh well.

Echocardiogram

Back to the Heart Hospital for this one. I didn't know what to expect as unusually I hadn't done any research, but it was just an ultrasound. Pretty pictures,though.

 

Echocardiogram of my heart

RT starts on Monday 3rd September. I'm dreading it. Mostly, the drudgery and stress of the commuting: 3 - 4 hours a day, 5 days a week, getting increasingly exhausted from the treatment. But, I'm starting at 2 pm, so should be able to miss both rush hours. Also, I'm not looking forward to feeling rough for several weeks, but I know it's all in a good cause.