What is a PFT (Pulmonary Function Test)?

What is a PFT (Pulmonary Function Test)?

A pulmonary function test (PFT) measures how well a pair of lungs work. These simple, low-risk tests can assist in diagnosis and treatment of lung disorders.

A physician may order a PFT to gain insight into a lung-related problem. They are common when diagnosing and monitoring chronic lung conditions, allergies, restrictive airway problems and respiratory infections. The test can also be used for patients with diseases like sarcoidosis and scleroderma.

Types of Pulmonary Function Tests

Spirometry

The most basic type of lung function test is spirometry, most often used to diagnose diseases like COPD and asthma. It measures rate of air flow and the volume of air the lungs can hold.

This test requires that a person breathes into a tube connected to a computer. Some breaths will be normal, but the test also requires breathing at maximal effort.

Lung Volume Test

A lung volume test is another way to measure how much air lungs can hold. It is more precise than spirometry because in addition to measuring the amount of air in the lungs, it also it measures the air remaining at the end of a normal breath.

This test is very similar to spirometry, but the person will perform the test in a small room with clear walls.

Lung Diffusion Capacity

A lung diffusion capacity test only requires normal breathing, so the risk of lightheadedness is very low. During the test, a person breathes in and out of a tube. The test itself only takes a few minutes, but the doctor may also require a blood sample to measure hemoglobin levels.

Arterial Blood Gas Test

Your lungs are responsible for taking oxygen from the air you breathe and transporting it throughout the body. If your healthcare professional is concerned about the levels of oxygen and carbon dioxide in your blood, they may recommend an arterial blood gas test. For this test, blood is taken from an artery in the wrist, then analyzed.

Fractional Exhaled Nitric Oxide Test (FeNO)

Nitric oxide is a marker for inflammation in the lungs. Fractional exhaled nitric oxide tests measure the amount of nitric oxide exhaled. A person simply exhales into a tube that is connected to a portable device.

Risks of PFTs

Pulmonary function testing has very little risk. Aside from tests that are accompanied by blood work, they are completely non-invasive. The most common issues include dizziness during the test, coughing, shortness of breath, or an asthma attack triggered by deep breathing.

If you have specific questions about any of these PFTs, don’t hesitate to ask your provider.

How Does Winter Affect Asthma?

How Does Winter Affect Asthma?

For those living with asthma, it’s not uncommon for symptoms to worsen in the winter.

The cold, dry winter air serves as an irritant for lung diseases like asthma, COPD and bronchitis. People spend more time indoors during the cool winter months, leaving them more exposed to asthma triggers such as mold, pet dander and dust mites.

Signs of lung irritation include:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest tightness

The first step for an asthmatic is identifying what situations trigger these adverse symptoms. From there, you can formulate a plan to protect your lungs all season long.

Reducing Risk

To avoid serious medical emergencies, take daily steps to manage their asthma in the winter.

Carry a Scarf. If a sudden change in temperature triggers asthma symptoms, consider using a scarf to cover your nose and mouth on colder days. When exiting a warm building and stepping into the cooler winter air, the scarf will act as a barrier, providing additional warmth and moisture for air that enters the lungs.

Use an Inhaler as Prescribed. For patients who use an inhaler to manage symptoms, it is important to stay on schedule. Continue to use a control inhaler (as prescribed) and carry a rescue inhaler at all times. If an asthmatic finds that they are using a rescue inhaler excessively, they should consult with their doctor.

Get a Flu Shot. When asthma patients contract the flu, it can make breathing even more difficult (COPD patients are also more likely to experience complications with the flu). Immunization is the best way to avoid contracting the virus. To minimize the risk of catching a common cold, wash your hands regularly and avoid contact with anyone who is ill.

Consider Air Quality. People who spend more time indoors during the cold winter months are exposed to more indoor air pollutants. An indoor air purifier can help remove some irritants from the air at home.

Support System. In case of emergency, those with severe asthma should keep friends and family informed of their whereabouts.

By learning their asthma triggers and preparing accordingly, you have the best chance of staying safe and healthy throughout the winter months.

PCCMA Invites Public to Learn About Common Sleep Problems at Community Event Feb. 9

80 million adults have sleep apnea; only 1 in 5 are diagnosed
Experts to lead discussion on sleep apnea, treatment options

PCCMA Invites Public to Learn About Common Sleep Problems at Community Event Feb. 9

Pulmonary & Critical Care Medicine Associates is holding a community event focusing on sleep apnea, a common condition that affects a person’s breathing during sleep. The event, free and open to the public, will be held Saturday, Feb. 9, from 10 to 11 a.m. at the PCCMA Sleep Center at 50 N. 12th St. in Lemoyne.

More than 18 million adults in the United States have sleep apnea, but only about 20 percent have been diagnosed. A person with sleep apnea has times during sleep during which air cannot flow normally into the lungs. These pauses in airflow can occur off and on during sleep, and cause a person to wake up from a sound sleep. If sleep apnea is not treated, serious health problems may develop including type 2 diabetes, high blood pressure, heart disease and depression.

Attendees will learn about sleep apnea symptoms, diagnosis and treatment options. Patients previously diagnosed with sleep apnea are also encouraged to attend to ask questions about treatment options and hear from other patients.

PCCMA Sleep Center Manager Salvatore Santelli, RPSGT, CSE and Respiratory Therapist Trevor Burns, BS, RRT will lead the discussion.

Space is limited. To register, contact Trevor at (717) 629–7168.

Why Sleep Apnea Might Increase Cognitive Decline

Why Sleep Apnea Might Increase Cognitive Decline

Numerous studies conducted over the past decade suggest that obstructive sleep apnea (OSA) can have negative effects on the brain’s structure and function.

Restorative sleep is necessary for brain health. Sleep apnea deprives the brain of a full, healthy sleep cycle leading to symptoms like shortened attention span, irritability, fatigue and trouble with short-term memory. People suffering from sleep apnea also have trouble converting short-term memories into long-term memories.

Sleep apnea can affect the brain in more serious ways than just temporary symptoms. It can change the shape of the brain by significantly reducing both gray matter and white matter concentration in certain areas of the brain.

Researchers from New York University conducted a study of 2,500 people with Alzheimer’s disease. On average, they found that patients with breathing disorders were diagnosed with mild cognitive impairment 10 years earlier than those without.

Symptoms of cognitive impairment are much more prominent in older adults, but sleep apnea also affects children’s developing brains.

Restoring the Damage

There is hope for patients living with sleep apnea. Continuous positive airway pressure (CPAP) therapy has been shown to reverse the damage caused by severe OSA. Improvements in the brain’s gray matter were seen after three months of therapy, but reversal of damage to white matter was only seen after 12 months of treatment.

Effective treatment can improve cognition, alertness, mood and overall quality of life. Therefore, the “Stop the Snore” campaign was developed through a collaboration of organizations like the American Academy of Sleep Medicine, Sleep Research Society and CDC.

The campaign encourages people to consult a doctor if they are experiencing warning signs for sleep apnea. This includes snoring, gasping and irregular breathing while asleep.

Obstructive sleep apnea is a common condition that affects over 18 million Americans, but many who suffer from the disease don’t know the far-reaching health implications that can result. If you or a loved one are experiencing symptoms of sleep apnea, it’s recommended that you consult a medical professional.

Diabetes Drug Found to Treat Lung Disorder

Diabetes Drug Found to Treat Lung Disorder

Metformin is a drug commonly used to treat non-insulin-dependent diabetes. It targets cell metabolism to lower blood glucose levels. That same drug is now showing promise for treating pulmonary fibrosis.

Pulmonary Fibrosis

Pulmonary fibrosis causes scar tissue to grow inside the lungs. This causes low oxygen levels and causes difficulty breathing.

The disease can be caused by environmental factors such as pollution, an infection or certain medications. Most cases of pulmonary fibrosis are idiopathic, meaning doctors cannot determine the cause.

Although therapies can help patients breathe easier and manage their symptoms, there is currently no cure for pulmonary fibrosis.

Metformin Showing Promise

Metformin is thought to treat pulmonary fibrosis by inhibiting the formation of certain components that lead to the development of pulmonary fibrosis. For example, one protein called NOX4 is generally higher in the lungs of patients with pulmonary fibrosis. Research showed that reducing these levels with metformin would lessen the inflammatory response that leads to symptoms.

Metformin is already proven to be safe and effective by the Federal Drug Administration, speeding up the process to get it to pulmonary fibrosis patients who could benefit from it. Future clinical trials will be simplified and have a decreased risk for unexpected adverse reactions.

In July 2018, researchers made a new discovery in the use of metformin for pulmonary fibrosis. A study at the University of Alabama showed that established pulmonary fibrosis could be reversed with metformin treatment. Using lung cells from mice, their study supports the concept that the drug could be a useful therapeutic strategy for those living with pulmonary fibrosis.

While there are currently no studies supporting clinically relevant outcomes in humans with pulmonary fibrosis, this is still an important step. Effective treatment options are lacking for people living with pulmonary fibrosis. More research is needed, but metformin is showing promise for the future of pulmonary fibrosis treatment.

Lung Cancer: Early Detection is Key to Treatment

Lung Cancer: Early Detection is Key to Treatment

Lung cancer is the leading cause of cancer death. This is because most lung cancers are in advanced stages when first detected. During Lung Cancer Awareness Month, we’re focusing on the importance of early detection.

Symptoms often don’t appear until the disease is widespread, leading to a lack of early diagnoses. Even early-stage symptoms are often mistaken for other problems. Some symptoms include:

  • Prolonged cough that worsens over time
  • Chest discomfort
  • Wheezing and trouble breathing
  • Coughing up bloody mucus

If lung cancer is found at an earlier stage, it may be easier to treat. Sometimes cancerous cells are found during tests for other diseases, such as pneumonia, other lung conditions or heart disease. Though accidental, this kind of early detection could improve a patient’s outcome.

Lung Cancer Screening

Screening for lung cancer is an attempt to detect the disease before symptoms present themselves. If your doctor suggests that you undergo lung cancer screening, remember that it doesn’t mean they think you have lung cancer.

It is simply a recommendation, usually given to those at higher risk for lung cancer, such as a history of smoking or being exposed to other environmental toxins. It’s important to remember there are risks and benefits associated with being tested.

There are three tests commonly used to screen for lung cancer:

  • Low-dose spiral CT (LDCT) scans use low-dose radiation and an x-ray machine to detect abnormal cells. Studies show that screening with the LDCT scan does reduce the risk of heavy smokers dying from lung cancer.
  • Chest x-rays of your lungs may reveal an abnormal mass or nodule.
  • Sputum cytology checks for signs of lung cancer like cancer cells in your mucus.

New blood tests known as “liquid biopsies” are on the horizon as a new early-detection tool and have seen positive results. These tests are still in the research phase and not yet ready for widespread distribution.

Despite the benefits of early detection, lung cancer screening may not be beneficial for everyone. In some cases, finding the cancer early has minimal affects on the cancer’s outcome. There is also a chance that the test could produce either false-negative or false-positive results.

Talk to Your Healthcare Provider

To decide if lung cancer screening is right for you, have an honest conversation with your healthcare provider. For patients with a higher risk for lung cancer, yearly screening that leads to early detection could be well worth any risks associated with lung cancer screening.

If something abnormal is found during the routine screening, it means doctors can act quickly to formulate a treatment plan. This gives patients the best chance of recovery.

Does Vaping Cause Cancer?

Does Vaping Cause Cancer?

Electronic cigarettes, also known as e-cigs or vaping products, have recently grown in popularity. The devices are widely considered an alternative to smoking cigarettes and other tobacco products.

Conventional cigarettes deliver more than 4,000 chemicals and carcinogens to the lungs, making them a known cause of lung cancer. Though designed as a replacement for cigarettes, can vaping also cause cancer? This is a highly debated topic in the medical community today.

How Vaping Works

Electronic cigarette products work by heating liquid into a vapor. That vapor is then inhaled through a mouthpiece. They are usually battery operated or rechargeable.

The devices don’t contain tobacco. Instead, nicotine and other substances are found inside the liquid juice. There are also liquids that contain no nicotine.

Chemicals and Other Substances

Although electronic cigarettes contain fewer chemicals than conventional cigarettes, they do contain several potentially harmful chemicals. Nicotine is often one, but the FDA also found levels of other cancer-causing chemicals including diacetyl, a chemical that has been linked to popcorn lung. These chemicals are introduced to the lungs when the vapor is inhaled.

In one study, researchers tested the saliva and urine of participants to determine the level of toxins in their body. They were divided into three groups:

  • Those who do not smoke
  • Those who only smoke electronic cigarettes
  • Those who smoke both electronic cigarettes and conventional cigarettes

The study found some toxin levels were three times higher in the “dual use” group than the “electronic cigarette only” group. However, some chemicals were also three times higher in the “electronic cigarette only” group than the “non-smoking” group.

Many electronic cigarette toxins were equally prevalent in nicotine-free vaping products. Furthermore, many were carcinogenic (cancer-causing).

Previous studies have suggested that vaping devices with higher voltages may pose a higher risk because they produce more toxins.

Helping Smokers Quit?

Vaping is a common habit of people who are trying to quit smoking conventional cigarettes. There are some success stories, but there is no official FDA approval supporting the claim that electronic cigarettes are a safe or effective method to help smokers quit.

The American Cancer Society supports any smoker who considers quitting, but advises them to choose FDA-approved aids that are proven to be successful.

In fact, vaping is becoming more popular among younger generations, possibly because of the fruity flavors and belief that it’s a safer alternative than smoking cigarettes. More teens are vaping than smoking conventional cigarettes, according to data from the National Institutes of Health.

Future Research

It’s clear among the medical community that more research must be done on the health effects of vaping. Based on available evidence, vaping is less harmful than smoking cigarettes. However, there is not enough evidence to determine long-term health effects of vaping, including its likelihood to cause cancer.

The best way to protect against cancer is to avoid cigarette products altogether.

Diabetics at a Higher Risk for Lung Disease

Diabetics at a Higher Risk for Lung Disease

Diabetic patients are always told that their disease could affect their feet, heart and kidneys, but they should also be cognizant of how diabetes could put them at greater risk for certain lung conditions.

Patients with a diabetes diagnosis are at increased risk for developing lung diseases like asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, restrictive lung disease (RLD) and pneumonia. This risk may be due to declining lung function in patients with diabetes.

Diabetes and Lung Disease

Diabetes is a disease that affects a patient’s blood glucose. This causes additional complications throughout the body, including a compromised immune system that doesn’t effectively fight infection. Because the immune system can’t easily fight off disease, bacteria, viruses and fungi can spread to the lungs and cause serious complications.

Additionally, studies have shown that those with diabetes have a reduced lung capacity. This could be caused by either high blood sugar levels that stiffen lung tissue or excess fat tissue in the chest cavity constricting the lungs.

One study found that adult patents with both Type I and Type II diabetes are 22 percent more likely to have COPD, 54 percent more likely to have pulmonary fibrosis and eight percent more likely to have asthma. In comparison to the general population, diabetics are also nearly twice as likely to be hospitalized for pneumonia.

Smoking

Smoking is detrimental to anyone’s lung health, but it is especially harmful for diabetic patients. When a person has diabetes, smoking could lead to serious conditions like heart disease, poor blood flow, kidney disease, nerve damage or blindness.

For patients with diabetes, it is important to inform your doctor of any noticeable changes in lung function. Early diagnosis is the best way to maintain healthy lung function throughout your lifetime. Proper management of diabetes could also be beneficial for minimizing the risk of developing related lung diseases.

Circadian Rhythm: Is your ‘Body Clock’ on Schedule?

Circadian Rhythm: Is your ‘Body Clock’ on Schedule?

A circadian rhythm is your body’s daily cycle. It keeps your physical, mental and behavioral changes working like clockwork. Most living things have circadian rhythms, including plants and microorganisms.

Circadian rhythm is affected by natural factors produced by the body, but environmental factors like daylight can also have an effect.

Sleep cycles, eating habits, digestion, body temperature and hormone release are all influenced by circadian rhythm. Irregular rhythms have been linked to various health complications, including:

  • Sleep disorders
  • Depression
  • Bipolar disorder
  • Seasonal affective disorder
  • Obesity

Circadian Rhythms and Sleep

Your body’s clock controls the production of melanin, a natural hormone that makes you tired. When there is less light (at night), it is generally a signal for your body to produce more melanin. The circadian rhythm also controls when you wake up.

Resetting Your Internal Clock

Ninety percent of people in the U.S. use technological devices within an hour before bedtime. The popularity of using mobile devices, television and computers at night has led researchers to study how the light from those devices may affect circadian rhythm.

The blue light emitted by electronic devices delays the production of melanin, making it difficult to fall asleep. To minimize this effect, turn off electronic devices a couple hours before bed or whatever is realistic for you. A good substitute is reading an old-fashioned book.

Traveling between time zones can also wreak havoc on your body’s natural circadian rhythm. When your body’s existing rhythm conflicts with the normal time of your new destination, you might experience jetlag. It sometimes takes a couple days for your biological clock to reset.

People with rotating work schedules also find it difficult to maintain a regular circadian rhythm.

The best way to keep your circadian rhythm on track is by maintaining a regular schedule. If you go to sleep and wake up at roughly the same time each day, your body will adjust to give you more energy throughout the day. It may also help to go for a walk each morning to expose your body to sunlight.

If you have problems with your sleep/wake schedule or feel that your circadian rhythm is otherwise off balance, schedule an appointment with your doctor to eliminate any underlying conditions and determine a plan to help regulate your circadian rhythm.

COPD Complications in Flu Season

COPD Complications in Flu Season

Because influenza primarily affects the respiratory tract, it is especially dangerous for individuals with COPD and other preexisting respiratory conditions. The rate of unfavorable outcomes for patients with respiratory diseases – like COPD – is significantly higher than for the general population who contract the flu.

Flu season is quickly approaching, which means patients with COPD should take extra precautions to protect themselves. If you do get the flu, there are special considerations to improve your chances of a full recovery.

Fighting the Flu Before Infection

There are steps you should take to minimize your chance of contracting the flu. These steps are important for everyone, but especially the elderly and people with chronic diseases such as COPD.

  1. Avoid contact with the virus. The flu is a highly contagious disease that can spread when you’re in contact with someone carrying the flu virus. If possible, avoid encountering sick people during flu season. If you yourself are sick with the flu, minimize contact with anyone who has COPD or other respiratory problems.
  2. Hygiene. During flu season, be especially conscious of your hygiene. Wash your hands regularly with soap and warm water. This is especially important when you’ve been in a highly populated area where germs are more likely to spread from person to person.
  3. Flu shots. A yearly flu vaccine is arguably the best way to protect yourself during flu season. The Centers for Disease Control recommends that everyone over the age of 6 months get vaccinated by the end of October each year. You’re especially encouraged to receive a flu shot if you’re over the age of 65, or if you have asthma or COPD.

If You Contract the Flu

If you’re exhibiting flu symptoms, call your doctor immediately. Symptoms include fever, shivering, headache, sore throat and cough.

You may be prescribed antiviral medications within 24 hours of your symptoms starting. These medicines can shorten the duration of your illness and make your symptoms milder, preventing serious complications.

New influenza strains are constantly emerging, indicating that the flu will remain a serious problem for the foreseeable future. Being proactive and vigilant can help prevent complications from the flu in patients with COPD.

The flu could trigger exacerbations for patients with COPD, worsening symptoms beyond the expected day-to-day variation. Inhaled bronchodilators, systemic corticosteroids and antibiotics may be prescribed to manage secondary complications.

For more information about flu prevention and complications for patients with COPD, ask your primary care physician or contact Pulmonary & Critical Care Medical Associates at (717) 234-2561 weekdays from 8 a.m. to 4:30 p.m.

Lemoyne: 50 N. 12th Street, Lemoyne, PA 17043
Carlisle: 220 Wilson Street, Suite 104, Carlisle, PA 17013
York: 1750 5th Ave, Suite 300, York, PA 17403

Phone: (717) 234-2561

For medical emergencies, call 911.

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