Fiberoptic bronchoscopy (bron-kos-ko-pi) is a visual exam of the breathing passages of the lungs (called “airways”). This test is done when it is important for your doctor to see inside the airways of your lungs, or to get samples of mucus or tissue from the lungs. Bronchoscopy involves placing a thin tube-like instrument called a bronchoscope (bron’ko-sko-p) through the nose or mouth and down into the airways of the lungs. The tube has a mini-camera at its tip, and is able to carry pictures back to a video screen or camera.
Endobronchial Ultrasound Bronchoscopy
Endobronchial ultrasound (EBUS) is a minimally invasive procedure used in the diagnosis of lung cancer, infections, and other lung disease. Our physicians are trained to use specialized bronchoscopic equipment that has additional ultrasound capabilities. This uses sound waves to visualize in real-time enlarged lymph nodes or other lesions near the main airways in lungs. These lesions can then be biopsied with a high degree of safety and success. EBUS is most commonly used to assess lymph nodes in the chest to evaluate for cancer metastasis. Prior to availability of this technique, a surgical procedure known as mediastinoscopy was needed to obtain such samples. The preparation for EBUS bronchoscopy and recovery is similar to that of traditional bronchoscopy. Often, EBUS is performed with the support of an anesthesiologist to provide sedation and support breathing during the procedure.
Navigational bronchoscopy is a relatively newer procedure that may be used to reach small lesions in the lung. This minimally invasive technique involves creation of a three-dimensional virtual “roadmap” of the lungs from the patient’s CT-Scan. This enables the physician to steer a bronchoscope with a specialized set of catheters through the lungs to reach the targeted lesion. Most often, navigational bronchoscopy is used to biopsy small peripheral lung lesions, that were previously difficult to biopsy. This can enable early diagnosis of lung cancer. This technique may also be used to place markers next to cancerous lesions to precisely deliver radiation therapy while reducing radiation exposure to surrounding healthy tissue. The preparation for navigational bronchoscopy and recovery is similar to that of traditional bronchoscopy. Often, navigational bronchoscopy is performed with the support of an anesthesiologist to provide sedation and support breathing during the procedure.
Thoracentesis (thor-a-sen-tee-sis) is a procedure that is done to remove a sample of fluid from around the lung. The lung is covered with a tissue called the pleura. The inside of the chest is also lined with pleura. The space between these two areas is called the pleural space. This space normally contains just a thin layer of fluid, however, some conditions such as pneumonia, cancer, or congestive heart failure may cause excessive fluid to develop (pleural effusion). To remove this fluid for evaluation (testing) or to reduce the amount of fluid, a procedure called a thoracentesis is done.
Pulmonary Function Tests
Pulmonary function tests (PFTs) are breathing tests to find out how well you move air in and out of your lungs and how well oxygen enters your body. The most common PFTs are spirometry (spy-RAH-me-tree), diffusion studies and body plethysmography (ple-thiz-ma-gra-fee). Sometimes only one test is done, other times all tests will be scheduled, often on the same day.
Pulmonary Function Tests in COPD
Pulmonary function tests (PFTs) are breathing tests to find out how well you move air in and out of your lungs and how well oxygen enters your body. The most common PFTs are spirometry, diffusion studies and body plethysmography (ple-thiz-ma-gra-fee). Sometimes only one test is done, other times all tests will be scheduled, often on the same day. To get the most accurate results from your breathing tests:
- Do not smoke for at least 4 hours before the test.
- Do not drink alcohol for at least 4 hours before the test.
- Do not exercise 30 minutes before the test.
- Do not wear tight clothing that makes it difficult to take a deep breath.
- Do not eat a large meal 2 hours before the test.
Lung Function Studies: Methacholine or Challenge Test
Challenge tests or challenge studies, are types of tests that measure if your lung function changes after you breathe in specific chemicals. In the US, the most common chemical used in this test is methacholine. The chemical histamine may also be used in the test. The reason for using either of these chemicals and the procedures are the same. A challenge study may be done to see if you have asthma or how well your asthma medicine is working.
It can be normal to have trouble sleeping from time to time, but if you are having trouble sleeping most nights, you may have a sleep problem. Sleep problems can affect your quality of life, and some can pose a serious threat to your health if left untreated. If you think you might have a sleep problem, discuss your symptoms with your healthcare provider. After reviewing your sleep history, your healthcare provider may refer you to a specialized sleep center/lab, where trained technicians will perform a sleep study. Sleep studies are tests that monitor your sleep, either overnight or during a series of naps during the day. These tests are painless and used to diagnose sleep problems such as insomnia, sleep apnea, or narcolepsy.