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Best thing to do for SEMEN ANALYSIS lab report.

Resolved Question:

Hi,

Can you please kindly explain to me my Lab Test Report for Simen Analysis?
Can you give me also an advice?

What the best thing to do?


Category: Pulmonologist

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Category: Allergy and Immunologist
Dr. Jacob George Pulinilkunnathil is online now

Expert:  Dr. Jacob George Pulinilkunnathil replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I do believe you are probably more fit than I am.
PFT all values are normal.
The missing values are the duration of the test.
For a PFT to be acceptable, I should see the curve, the ascent without hesitation, and the duration should be already 4 sec minimum, 6 secs is acceptable.
Taking for granted that your PFT must be meeting the acceptable criteria , I also conclude you are normal.
The 25- 75 ratio which was 49 and later bounced back shows mild small airways obstruction.
It can be asthma or copd.

To diagnose as asthma, we need a reversible PFT.
So in short, I believe your lungs are normal, and cannot attribute to your symptoms.
I suggest controlling gerd with prokinetics, and for lifestyle, return back to exercise, and remain active.
I prefer to exclude all causes of shortness of breath before labeling it anxiety. In my list, a treadmill test in my cardio department followed by an angiogram if necessary should be done, before I label it as asthma.
As to your question whether anxiety can cause this feeling - answer is yes. Anxiety can mimic most symptoms.

Hope I have answered your question. Do revert in case if any further clarification needed.
Regards
Dr. Jacob George P
MD IDCCM FCCP


Patient replied :

Thanks for responding, I will attach the Last PFT Test from July for you to see. And a complete schedule of Prior Pfts. I will try to scan them in to send if you like. You will see that the results are as I mentioned.
I failed to mention that a year ago April, I had a Cardio Stress Test and nuclear stress test. It was Clear. The cardiologist rescheduled for 5 years later.
I have been under a lot of stress the past few years due to personal life issues, bad job, and tending to my mother as she died from COPD. Lack of exercise and high stress have added to this condition of chest tightness and hard to breath. To what degree if any that my small airway obstruction is the culpret to the physical side and not psychic part, I wish i knew. Please review the two page spreadsheet of my PFT's to see if they indicate anything.
I am sure I will ask the one final question after this one to get my best answers and what I paid for. I do appreciate your help.
Oh, I am in Nebraska, and yesterday I had returned home to find a lot of snow to shovel. Before I started shoveling I was feeling like i would suffer shortness of breath. Can a quick thought of panic to this situation cause breathing to become difficult that fast.? I want to say yes.


Expert:  Dr. Jacob George Pulinilkunnathil replied 3 Days.

Hi,
Glad to see you in good spirits .
I went through your mail, and attachments. You have done the test over 09 seconds which is pretty good. So Pft is acceptable and normal. You do have an element of small airway disease, that probably causes 10% or less of perceived breathlessness. I would start you on inhalers/ ask to continue inhalers for small airway obstruction.

'Feeling I would suffer clearly' sites by itself that it's a feeling, and not physical.. Though cold air can precipitate asthma. I tend to think otherwise here.
I enjoy conversing with patients as long as they realize that I am helping them by clearing their doubts so am looking forward to be hearing your doubts.

Regards


Patient replied :

I have a semi complicated question to possibly close this up. The two of us have come to a couple of issues we agree on
1. I have small airways obstruction to my breathing
2. I have high anxiety and panic, more specifically GAD that causes constant issues when not addressed.
Over the past few months I have been able to bring my Anxiety and Panic down quite a bit. But I have some lingering symptom/issues that I would like addressed.
In counseling I was informed by a psychiatrist that from his medical background he could agree with a statement that had been told to me and I wanted some form of yes or no to its validity. The statement was that if you let GAD/Panic continue with little to no treatment, it can affect your health, It can continually dump Stress hormones in your system until you are overstimulated. This of course will take the body time to rid this and if a situation suddenly arises, it can cause a rise in the hormone levels again.
More to the Overstimulated excess hormones, If you have this as a issue, can simple liittle triggers suddenly kick back in the hormone stress dump to the body if you are not fully stable and healing? I have recurring issues with Shortness of Breath (SOB), that I expect some but wonder how much is caused by the GAD.
When I was a young child, under 10, if I did something bad and had to face dad, I would have certain feelings that put me on edge, made me ill and more. The same feelings occur when I have advanced thought of whats to come when I get to work or if I have to climb a simple set of stairs. To keep details short and sweet, I have looked over the 6 PFTS I have taken since 2001. Percentages to expected and actual degree of measurement vary by age, this I understand. but I have compared not only the percentage of expected but actual volume capacities and Dlco and VA and Fev and so on and notice that those are still in close range. We both noticed that the FEV 25/75 has fluctuated over the years was high, went down went up went down back up. Currently its higher than it was 2+ years ago when I went about my daily life as if nothing mattered. I would expect the test to be opposite if this was the reason to my issue. Can a test have good passable results yet still be an issue to breathing?
Ok to wrap this up. can I have such an overabundance of sensitivity from the extended period of time with hormone dump as Ill call it that little thoughts or sensations can trigger a new explosion of repeat Shortness of Breath.
Oh I should mention that I can go about my merry way working like raking the yard and yes Ill be a bit out of breath because im out of shape or my back hurts because of the movement but if I am going at it, no problems. Now if i do the same thing but my phone rings, I panic because I will run out of air talking on the phone. This began a year ago as I started to really stress out. Heck I can go on a good bike ride and as long as I dont try to talk I dont run into problems but if I do talk and I think of it I become SOB Not sure if it happens if i dont think of it.

Enough for now, I may have to dump funds in to continue if I come up with more questions.


Expert:  Dr. Jacob George Pulinilkunnathil replied 2 Days.

Admin Message -
Hello,
Your consult has been closed.Your consult is now older than 1 month. If you have further queries, I request you to initiate a new consult. You could consult the same Doctor as well, please mention the same in the new consult with the same doctor.
Hope this communication was fruitful. Wish you good health.
Thank you
In-house Physician
DoctorSpring.com


Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Experience: 
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
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