FVC - supine versus sitting

Status
Not open for further replies.

Drewsmom

Active member
Joined
Feb 2, 2014
Messages
68
Reason
CALS
Diagnosis
07/2015
Country
US
State
usa
City
dixie
Just curious if any PALS have had both measurements. My Pals had his checked and it was good -84% while sitting. It was not checked while supine. This seems weird to me. Is that typical for FVC to only be checked while sitting?
 
VA did only sitting. When testing me for DPS, Cedars-Sinai did a test 50% reclined: put a tube into one nostril, leaving the other open, then had me inhale. I failed that, as my phrenic nerves no longer work. The doc said diaphragm is 50% of breathing upright, and 80% of breathing when prone. I use bipap whenever I lie down.










5
 
my husband has only been tested sitting up. he always fails his tests because he cant seal his lips anyway.
 
Just curious if any PALS have had both measurements. My Pals had his checked and it was good -84% while sitting. It was not checked while supine. This seems weird to me. Is that typical for FVC to only be checked while sitting?

Had it done sitting, all was well. (at least ALS well!)
Had it done laying on my back, not so good. Got the bipap without a sleep study this way, and it was a big help.
 
My husband can't seal his lips either,we haven't been able to kiss for awhile now,oh the little things we take for granted.
 
The closest to "supine" measure in a clinic for someone unable to transfer w/o a lift would be raising the legs and reclining the back of the wheelchair to mimic lying down. Some clinics do it but it's obviously not very comfortable. BiPAP should be based on symptoms anyway, not an often-flawed number.

If you want to see if there's a dramatic difference, use an oximeter at home when the PALS is seated, then lying down. Reduced SpO2 or, more likely, increased pulse, could reflect increased respiratory effort while lying down [and in some pts is actually the reverse]. Or use an inspiration spirometer in both positions. These self-tests can also be used to fine-tune how high you raise the head of the bed and/or tilt if you have that ability.
 
Thank you for bringing this up. I keep saying that hubby's breathing is much harder when he sleeps, despite improved function when he's tested--always sitting up. I'll ask for the test to be done with him laying down next time. I've tried raising the head of the bed when I hear him laboring, but he's been sleeping with his feet raised to reduce swelling, and since he turns to his side frequently (something that is becoming more difficult), I can't really do that for him for very long. Oh thing simple things we often don't think about...
 
Neuro wanted Xrays of my stiff, painful shoulders yesterday. I was looking at the Xray table and wishing for my bipap when the guy had me stand upright, which is very painful. He gave me a stand to support myself with a hand while he took the pix.
 
Nuts, not sure what kind of bed you have but no reason not to have both head and feet up; that was Larry's position unless he needed the urinal, in which case we tilted the whole bed and lowered the feet.

I understand that your DH wants to turn to the side, but eventually he will be supine, so you might try a night in the ideal back position, to see if the improved breathing, which should help him sleep more at a time, compensates for the less flexible sleep position.
 
lgelb, we're using an adjusable sleep number bed, so he can elevate his head and legs, but he's always slept like a rotissary, turning several times an hour. That is changing as it becomes more difficult to move around in the bed (possibly one cost of having muscles cut for his back surgery), and now that his back pain has been relieved he's more comfortable. He's recently accepted that sleeping on his side is coming to an end, which has me wondering how soon we should ask about a lateral turn mattress.

We have this little routine: when he's ready to sleep, he tosses out all but one pillow and lowers his head. When the snoring wakes me (and recently it even started waking mom, who slept down the hall), I sneak around and raise his head. I've also found the pillow slipping behind the head of the mattress when it's raised, forcing his head back, which makes matters worse. He's so tired lately that he doesn't wake when I tug and reposition it. LOL, the doc asked me if I wanted something to help me sleep and I declined as I find myself being very helpful during the night :)
 
I always slept on both sides and my stomach - until I got the bipap a year ago. Since then I have slept flat on my back all night, every night. I have a pee call and Riluzole after about five hours, then promptly back to sleep on my back. I have taken to raising my knees awhile if I wake before dawn. I get up rested and relaxed.

There's nothing like a correctly adjusted bipap and full face mask for sleeping and napping.
 
If you want to see if there's a dramatic difference, use an oximeter at home when the PALS is seated, then lying down. Reduced SpO2 or, more likely, increased pulse, could reflect increased respiratory effort while lying down [and in some pts is actually the reverse].

Are the cheaper oximeters (like sold at drugstores) accurate enough or do we need one from a medical supplier? My PALS's pulse has been regularly shooting way over 90 for prolonged periods and he's frequently short of breath so I want to monitor his SpO2. Thanks for the info.
 
I have two off ebay for $30 each, and they are follow the expensive ones closely. A nurse got hers for $20 off Amazon. You can even detect missed beats.
 
Thank you, Graybeard! Good to know. The ALS manual from MDA mentioned $300-400. Ouch!
 
Got one at wahlgreens for 40 dollars acouple years ago . It is just as accurate as the fancy one the resp therapy people use. And it fits in the palm of your hand so its easily portable.
 
Status
Not open for further replies.
Back
Top