Asthma

[Guest]

I applied as a firefighter last spring. I was accepted into the Fire Academy, but in the health inspection I was told that I may have an asthma so I could not become a firefighter. This seemed strange, for I have never felt ANY symptoms or heard wheezing from my lungs. Spirometry results were FEV1 4.10 l/84%, FVC 5.72l/102%, VC 5.98 l/106%, FEV% 80%, MEF50 3.44 l/s/52%, MEF25 1.17l/s/40%. In bronchodilation test MMEF improved +33%.
Later I was tested also without bronchodilation test, results were VC 106%, FVC 104%, FEV1 90%, FEV/VC 85%, FEV1/FVC 87%, PEF 87%, MEF50 61%, MEF25 49%, MMEF 61%.
I was also made other tests: spiroergometry, PEF measuring for two weeks with bronchodilator, bronchial provocation test w/histamine, exhaled NO measurement. All were normal.
Ok, sorry about the statistics. My questions are: do I have an asthma? Results seem to be awfully close to the normal, especially in the last test, which was unfortunately made without bronchodilation. Could the lessened values be because of bad technique? Should I ask for an opinion of another doctor? They said I MAY have an asthma do they have a test which could rule if I really have it or not? Should I give up becoming a firefighter?

[Guest]

The values you mention that are low the MEF50 and MEF25 are effort dependent and can be quite variable. If you had a normal bronchial provocation test and have no symptoms or wheezing, I would not call this asthma. If you did have any of the symptoms such as shortness of breath with exertion, cough, etc or had wheezing on a physical examination, it would be more compelling for asthma. A second opinion from a pulmonologist(board certified) is a good idea and that person can help you make the decision on being a firefighter.
[quote] I applied as a firefighter last spring. I was accepted into the Fire Academy, but in the health inspection I was told that I may have an asthma, so I could not become a firefighter... [/quote]

[Guest]

Thank you for your answer. I'd like to ask few more questions about this, though. Could the reason of disqualification be the improved MMEF value in the bronchodilation test (it improved +33%)? Has it improved significantly, so it could be considered as a reversible obstruction?
The doctor also ordered me Flixotide 250 micrograms(flutikasone or something like that) by inhaling for three months. First month twice a day, then once a day for 2 months. Should I take them? I've never had any symptoms you mentioned in your reply or actually any symptoms that could point to an asthma (even after bronchial provocation), so it seems a bit strange to take these medications which may have strong side effects without a clear reason.
Also, is there a test which could really rule out decisively if I have an asthma or not, so I wouldn't have to wonder? Thanks in advance.

V
[quote] The values you mention that are low the MEF50 and MEF25 are effort dependent and can be quite variable. If you had a normal bronchial provocation test and have no symptoms or wheezing, I would not call this asthma... [/quote]

[Guest]

It may be that the improvement with bronchodilators is what lead your doctor to refer to this as asthma. The bronchial provocation test is generally the test we use to make a definitive diagnosis. As for you taking the medication, I cannot answer that as I am not your physician. You should discuss those things with your own physician.
[quote] Thank you for your answer. I'd like to ask few more questions about this, though... [/quote]