Pulmonary, critical care and sleep medicine physicians evaluate a broad spectrum of chest and sleep disorders. Most common lungs problems include asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, abnormal chest X-rays, lung mass/nodules, lung cancer. Common problems that are evaluated include shortness of breath, cough, chest pain, snoring, increased sleepiness and chronic fatigue. Sleep disorders that are often evaluated include obstructive sleep apnea [OSA], insomnia, hypersomnia, excessive daytime sleepiness, non-restorative sleep, and restless leg syndrome.
Our physicians also are on staff at the local hospitals which allow for continuity of care for our patients who are admitted to the inpatient floor and ICU (intensive care unit).
Our evaluation and management include but not limited to the following disorders:
- COPD (emphysema)
- Cystic fibrosis
- Pulmonary fibrosis
- Lung cancer
- Lung diseases caused by working conditions
- Lung infections (e.g. fungal infections)
- Pulmonary hypertension
- Sleep disorders
- Obstructive Sleep Apnea
- Shortness of Breath and difficulty with breathing
- Abnormal Chest Xray/Lung imaging
- Screening for lung cancer
Procedures that are conducted by our pulmonologist include sleep studies, pulmonary stress testing, bronchoscopy and pulmonary function testing.
Pulmonary Function Testing: This includes spirometry, lung volume by body plethysmograph, diffusion capacity and flow-volume curves.
Six minute walk test: Useful also for the diagnosis of shortness of breath and assessment of oxygen need.
Fully attended one or two night polysomnography [PSG] or sleep study: This is the test for obstructive sleep apnea. We have a fully functioning sleep lab with sleep study appointments readily available. Multiple sleep latency test [MSLT]. Diagnostic tool for narcolepsy.
A bronchoscope is a thin, flexible, lighted tube with a camera at one end. It is inserted through the nose (or mouth in some cases) so that pulmonologists can visually inspect the larynx (voice box), trachea (windpipe), and airways. Patients are usually sedated, but not "put to sleep" for a bronchoscopy procedure, which can be used to both diagnose and treat lung conditions.
As a diagnostic instrument, the bronchoscope allows pulmonologists to both visualize pathology (changes in the airway due to disease) and take samples that can be looked at under a microscope. Samples may be taken to confirm a diagnosis, such as cancer, or to help narrow down possible diagnoses. As a therapeutic instrument, the bronchoscope allows pulmonologists to deliver medications directly to the lungs, remove secretions that are causing blockages, cauterize bleeding blood vessels, and remove obvious anomalies.
Though bronchoscopy has been in use for decades, it has been continually refined and updated to improve its capabilities. At one point, bronchoscopy could only be used to investigate the large airways, leaving 90% of the lungs out of reach. The latest bronchoscopes employ radial probe endobronchial ultrasound (EBUS), navigation bronchoscopy, and virtual bronchoscopy to make it possible for pulmonologists to investigate 100% of lung tissue as well as some of the associated tissues that lie just beyond the lungs.
Pulmonary Function Testing
Pulmonary function tests (PFTs) are used to help diagnoses lung conditions like asthma, muscular dystrophy, and diseases caused by exposure to toxins. Pulmonary function tests are minimally invasive and require only that patients be able to cooperate and follow directions. The results of a PFT, which are interpreted by a pulmonologist, can provide information that can be used to both diagnose lung conditions and help manage them. PFTs can be performed on almost anyone.