SERVICES
Respiratory Assessment
A respiratory assessment will generally focus on conditions or symptoms suggesting a cause within the lungs. A patient is usually referred and will therefore have had some initial tests or trials of treatment. Previous scans, blood tests and treatments are very important and may give an indication as to the nature of the patient's problems. It is important that this information is available for the consultation although this is not always possible. Test results are interpreted. They rarely provide a yes/no answer. It is common for two doctors to review the same results and arrive at different conclusions based on supplementary information/ observations or experience. A basic respiratory is mostly about history, distilling the patient's history. This is supplemented by a clinical examination which may lead on to further tests.
General Medical Assessment
This differs from the respiratory assessment in scope. A general medical problem is often one that does not fit neatly into an existing category. Breathlessness is a good example as the symptom can be caused by problems in the lung, brain, blood or heart.
Sleep Assessment
This is an initial assessment designed to look at sleep difficulties and their relation to daytime performance. The commonest problems are poor sleep hygiene and obstructive sleep apnoea. Additional considerations such as restless leg syndrome or REM sleep disorder may become apparent. Testing with overnight sleep studies are generally required to confirm the diagnosis and recommend treatment.
Lung Function Testing
This is one of the most important tests in respiratory diagnosis and management. It is performed in a hospital laboratory with a trained scientist. The test takes 20 to 40 minutes during which time the subject breathes in and out of a measurement device. The results indicate the size of different compartments of the lung and how they perform. Abnormalities can suggest different disease types as well as giving an indication of respiratory capacity. Both treatments and disease can change lung function and following these changes over time can give an indication how well a patient is doing.
Allergy Testing
Allergy testing is either carried out using skin prick testing in the pulmonary laboratory or by blood testing. It is very helpful to know if you are allergic to a specific compound as it may allow treatment choices such as desensitisation or inhaled therapy. The majority of tested compounds are aeroallergens such as pollen, dust mites and mould. Further information on house dust mite is available here and immunotherapy here.
Exercise Testing
This is a specific type of lung test where the subject exercises on a treadmill or static bike until exhaustion. Heart rate, breathing rate and oxygen consumption is measured every breath. Carbon dioxide production is also measured. This is a highly technical test that gives large amounts of information on exercise capacity and is very useful at looking at causes of breathlessness.
Bronchoscopy
This is a day case test done under sedation. A thin flexible tube is passed through the mouth into the lower airway of the lung to look for evidence of infection, inflammation or malignancy. Samples are generally taken at the time and sent to the laboratory for specific analysis which can take several days. An enhanced form of bronchoscopy termed EBUS is where the bronchoscope contains a tiny ultrasound probe allowing the inside of the chest cavity to be imaged. A thin needle can be placed in any enlarged lymph node or pass under ultrasound control and samples retrieved for further analysis. Further information on having a bronchoscopy is available here.