Patients with lung disease can have low levels of oxygen in their bodies and some need to use extra (supplemental) oxygen to keep their oxygen levels at a healthier level. Adults and children with lung diseases such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, cystic fibrosis (CF), or bronchopulmonary dysplasia (BPD) may require this therapy. Extra oxygen protects their bodies from the effects of low oxygen levels, helps them to function better, and allows them to stay more active.
Pulmonary Function Tests
Pulmonary function tests (PFTs) are breathing tests to analyze out how well your lungs are working. 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. Diffusion studies help us determine how well oxygen is brought into the body and how well carbon dioxide is removed.
- 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
Using Your New Inhaler With HFA Propellant
If you have a lung disease such as chronic obstructive pulmonary disease (COPD) or asthma, you are probably using an inhaler. There are several different types of inhalers, all of which deliver medicine into your lungs. However, if you have never been taught to use your inhaler correctly, then you may not be getting the full benefit of your inhaled medicine. At your next visit with your health care provider, bring your inhaler(s) and ask them to check that you are using them correctly.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease that makes it difficult to empty air out of the lungs. This difficulty in emptying air out of the lungs (airflow obstruction) can lead to shortness of breath or feeling tired because you are working harder to breathe. In general, COPD is a term that is used to include chronic bronchitis, emphysema, or a combination of both conditions. Asthma is also a disease where it is difficult to empty the air out of the lungs, but asthma is not included in the definition of COPD. It is not uncommon, however for a patient with COPD to also have some degree of asthma.
Signs and Symptoms of COPD
Chronic obstructive pulmonary disease (COPD) can cause shortness of breath, tiredness, production of mucus, and cough. Many people with COPD develop most, if not all, of these signs and symptoms.
Medicines Used to Treat COPD
The most common medications for treating chronic obstructive pulmonary disease (COPD) are bronchodilators and steroids. Both make breathing easier, but do this in different ways.
Surgery for Chronic Obstructive Pulmonary Disease
If you have COPD, you may benefit from lung surgery. Only a small number of people however, have the type of COPD that will benefit from surgery. The major types of surgery for COPD are bullectomy, lung volume reduction (LVRS) and lung transplantation. If you have COPD and require surgery for other reasons, you should speak with your health care provider before having any operation.
Alpha-1 Antitrypsin Deficiency
Alpha-1 antitrypsin deficiency is an inherited form of emphysema (em-fuh-ZEE-muh). People with the condition, also known as AAT deficiency, do not have enough of a protein called alpha-1 antitrypsin (AAT) in their blood. This protein is made in the liver, and it protects the lungs so they can work normally. Without enough AAT, the lungs can become damaged by emphysema. AAT deficiency can also cause liver damage.
What is Lung Cancer?
Lung cancer is an abnormal, uncontrolled growth of cells within the lung. Lung cancer is the leading cause of cancer deaths in the United States and will cause more deaths this year than cancer of the breast, prostate, colon, liver, or kidney and melanoma combined.
LUNG CANCER SCREENING
If you smoke cigarettes, or quite smoking less than 15 years ago, and are between the ages of 55 to 80, you may be a candidate for lung cancer screening. Lung cancer screening in a specific group of patients has been shown to decrease mortality (death). If you have questions about lung cancer screening or think you may be a candidate, please ask your doctor for more information.
Staging of Lung Cancer
Once your lung cancer is diagnosed, staging tells you and your health care provider about the size of your cancer (tumor) and how far it has spread. The stage of your cancer is based on your symptoms, results from tests like a CT (“CAT”) scan or PET scan, and biopsies. A biopsy involves removing a piece of tissue (usually from your lung or lymph node), and looking at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV for non-small cell lung cancer and “limited” or “extensive” for small cell lung cancer. The higher the number (or when the word “extensive” is used) means the bigger the tumor and/or the more the cancer has spread.)
Sarcoidosis (sar-coy-DOE-sis) is a disease in which inflammation produces tiny lumps of cells in organs throughout the body. The lumps, called granulomas, most often appear in the lungs, but they also can occur in the lymph nodes, eyes, skin or other areas of the body. If these tiny lumps grow in an organ, they can affect how well the organ works. When sarcoidosis affects the lungs (pulmonary sarcoidosis), the disease can reduce the lung capacity, cause abnormal stiffness of the lungs, and cause breathing problems.
Lymphangioleiomyomatosis (lim-FAN-jee-oh-ly-oh-myoh-ma-TOE-sis), commonly known as LAM, is a rare lung disease that affects women almost exclusively, usually during their childbearing years. People with LAM have an unusual type of muscle cell that grows in the tissues of the lungs. Although these cells are not considered cancerous, they grow uncontrollably throughout the lungs. These muscle cells can block the lymph vessels, blood vessels, and airways, preventing the lungs from providing oxygen to the rest of the body.
Acute Respiratory Distress Syndrome (ARDS)
Acute Respiratory Distress Syndrome (ARDS) is a life threatening problem in which the lungs are severely injured. Inflammation (swelling) occurs throughout the lungs. In the lung tissue tiny blood vessels leak fluid and the air sacs (alveoli) collapse or fill with fluid. This fluid buildup keeps the lungs from working well. Persons with this problem will have trouble getting enough oxygen in and removing carbon dioxide from the body, and become short of breath. Persons with ARDS must be given extra oxygen and will usually need the help of a mechanical ventilator (respirator) to breathe. With medical care, many people with ARDS survive and recover. However, up to 40% of people with ARDS die from the syndrome, even with intensive treatment.
What is Vocal Cord Dysfunction (VCD)?
Vocal Cord Dysfunction means that your vocal cords do not act normally. With VCD, instead of your vocal cords opening when you breathe in and out, your vocal cords tend to close. When your vocal cords close, it makes it harder to get air into or out of your lungs. People with vocal cord dysfunction may have symptoms of cough, shortness of breath, or wheezing. Sometimes vocal cord dysfunction can be mistaken for asthma.
Occupational Lung Diseases
Occupational lung diseases are caused or made worse by your work environment. They occur from inhaling dusts, chemicals, bacteria, or mold at work. It is important to know about these lung diseases because they can be prevented or kept from getting worse.
The major groups of occupational lung diseases are:
- work-related asthma
- lung disease from dusts and metals
- allergic problems
- reactions from irritants
- lung or other cancers
Obstructive Sleep Apnea in Adults
Obstructive sleep apnea (OSA) is a common problem that affects a person’s breathing during sleep. A person with OSA has times during sleep in which air cannot flow normally into the lungs. The block in airflow (obstruction) is usually caused by the collapse of the soft tissues in the back of the throat (upper airway) and tongue during sleep.
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 or 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. Depending on the situations, some sleep studies can be done at night.
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. Bronchoscopy is sometime done with an ultrasound probe (EBUS or endobronchial ultrasound) to better visualize and biopsies structures such as lymph nodes. Navigational bronchoscopy uses state of the art technology to more precisely localize and biopsy small lung lesions.
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.
A chest tube is a tube that is placed between the ribs into the pleural space (see “thoracentesis”) to drain fluid or air. Sometimes chest tubes are left in place when there is a continuous problem that requires on going drainage. With some systems, patients are able to drain fluid at home using collection bottles to help alleviate shortness of breath.