FULL CONSULTATIONS AND FOLLOW-UPS
During your initial visit, you will be asked to complete a comprehensive health questionnaire. You will meet privately with a provider to review your past medical history, answers on your health questionnaire, and the reason for your visit. You will be able to speak directly to the health care provider and be examined. If necessary, prescription medicines, X-rays, laboratory testing, non-pharmacologic recommendations, and referrals to other specialists will be provided. If needed, follow-up visits will be arranged prior to leaving the office. Once test results are available, you will be able to visit with the provider and review the results.
SPIROMETRY TESTS
Spirometry is a common office test used to assess how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale. It is used to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing. Spirometry may also be used periodically to monitor your lung condition and check whether a treatment for a chronic lung condition is helping you breathe better.
PULMONARY FUNCTION TESTS
Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.
You may have a PFT if your healthcare provider needs help to diagnose you with a health problem such as:
- Allergies
- Respiratory infections
- Trouble breathing from injury to the chest or a recent surgery
- Chronic lung conditions, such as asthma, bronchiectasis, emphysema, or chronic bronchitis
- Asbestosis, a lung disease caused by inhaling asbestos fibers
- Restrictive airway problems from scoliosis, tumors, or inflammation or scarring of the lungs
- Sarcoidosis, a disease that causes lumps of inflammatory cells around organs, such as the liver, lungs, and spleen
- Scleroderma, a disease that causes thickening and hardening of connective tissue
PFTs may be used to check lung function before surgery or other procedures in patients who have lung or heart problems, who are smokers, or who have other health conditions. Another use of PFTs is to assess treatment for asthma, emphysema, and other chronic lung problems. Your healthcare provider may also have other reasons to advise PFTs.
POLYSOMNOGRAPHY - UNATTENDED SLEEP STUDIES
An attended sleep study, also called a Home Sleep Study, is a sleep study tool that is used for the diagnosis of obstructive sleep apnea. Most HST devices are portable – about the size of a telephone handset.
They usually measure the following biologic parameters:
- Nasal and Oral Airflow – by thin wire that is taped by the nose and mouth – some sensors look like an oxygen cannula.
- Respiratory Effort – by elastic belt bands that are placed across the chest and abdomen.
- Oximeter Finger Probe – a small clip-like device that attaches to the finger tip and emits a red light that assists in the evaluation of oxygen levels in the blood while sleeping.
A patient is usually ordered a HST by his or her doctor who suspects that the individual has obstructive sleep apnea. The patient usually applies the above mentioned sensors to the body before sleep time and sleeps with the equipment for 1 – 3 nights. The equipment is returned to the diagnostic service company where the data is downloaded and processed for interpretation by a sleep physician.
Once the data is interpreted by a sleep physician, a diagnostic interpretation report is sent back to the ordering physician who discusses the results of the home sleep testing.
6 MINUTE WALK TESTS
The 6 minute walk test measures the distance someone can walk quickly on a flat, hard surface in 6 minutes. The test reflects the person’s ability to perform daily physical activities. Because COPD affects everyone differently, lung function and exercise tolerance testing help doctors and patients work together to develop the best treatment plan.
The 6-minute walk test was developed as a valid alternative to standard treadmill-based exercise testing for people who are elderly or who cannot perform treadmill-based exercise testing. You may have another 6-minute walk test after a certain amount of time has passed to test how much you have improved, as well.
FLEXIBLE FIBEROPTIC LARYNOSCOPY
In flexible laryngoscopy, a thin, flexible viewing tube (called a laryngoscope) is passed through the nose and guided to the vocal cords, or larynx. Fiberoptic cables permit a physician to directly inspect the nose, throat, and larynx for abnormalities.
The purpose of the laryngoscopy is:
- To detect laryngeal abnormalities, such as inflammation, lesions, or narrowed passages (strictures)
- To help diagnose the cause of a persistent or bloody cough, hoarseness, or throat pain
- To determine the cause for difficulty swallowing or a feeling of a lump in the throat
ALLERGY SKIN TESTING - FOODS & ENVIRONMENTALS
The Prick Testing method for allergy skin testing is when the skin is pricked with a sharp device that introduces the suspected substance, allergen, or drug into the skin.
If you do not react to any of the prick tests and there is reason to believe you may be allergic to certain foods or environmental allergens, the physician may order Intradermal Testing which is another method of skin testing which involves injecting of a small amount of the suspected allergen under the surface of the skin. Intradermal testing typically cannot be done the same day as prick testing.
The entire testing process will take about 60 minutes, depending on the reaction. We test a variety of important allergens that are found in our region including trees, grasses, weeds, molds, dust mites, and animal dander, as well as many foods and drugs that the patient is suspected to be allergic to.
After administering the suspected substance, allergen, or drug, we wait approximately 20 minutes to review the results. A positive reaction occurs when the skin becomes red, raised, and itchy. The skin reaction will gradually dissipate within 30-60 minutes. Some people will experience local swelling beginning 4-8 hours after testing. This is not serious and typically no treatment is required. It should disappear in the next few days. Less than 1% of patients may develop systemic reactions to skin testing, which may consist of any or all of the following symptoms: itchy eyes, nose, or throat, nasal congestion, runny nose, tightness in the throat or chest, wheezing, lightheadedness, nausea or vomiting, hives, or anaphylactic shock. This is very rare, but in the event of such reactions, the staff is fully prepared and emergency equipment is readily available.
Our food allergy prick tests cover a panel for up to 80 allergens, including specific fruits, vegetables, seafood, and seasonings.
Our environmental allergy prick tests cover a panel for up to 62 allergens, including molds, tree pollen, weeds, pets, and other common foods.
IMMUNOTHERAPY
Immunotherapy involves a series of injections (shots) given regularly for several years. The first shots you receive will contain very tiny amounts of the antigen or antigens to which you are allergic.
Most immunotherapy injections are given in the adipose (fatty) tissue in the back of the upper arm. Another common injection site is in the subcutaneous fat of the abdomen.
You will receive 4 vials of immunotherapy, starting with Yellow which has a concentration of 1:10,000, then Green which has a concentration of 1:1,000, then Blue which has a concentration of 1:100, and finally Red which has a concentration of 1:10.
The first several shots of each vial must be given in the office in case of anaphylactic shock, which is an extreme, sometimes life-threatening allergic reaction to an antigen to which the body has become hypersensitive.