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Bronchoscopy is a procedure that lets doctors look at your lungs and air passages. It's usually performed by a doctor who specializes in lung disorders (a pulmonologist). During bronchoscopy, a thin tube (bronchoscope) is passed through your nose or mouth, down your throat and into your lungs.
Bronchoscopy is most commonly performed using a flexible bronchoscope. However, in certain situations, such as if there's a lot of bleeding in your lungs or a large object is stuck in your airway, a rigid bronchoscope may be needed.
Common reasons for needing bronchoscopy are persistent cough, infection and something unusual seen on a chest X-ray or other test.
Bronchoscopy can also be used to obtain samples of mucus or tissue, or to remove foreign bodies or other blockages from the airways or lungs.
Bronchial Thermoplasty is a safe and effective outpatient procedure that provides a long-lasting reduction in severe asthma attacks for adults with severe asthma who are not well controlled with maintenance medications, such as Advair™, Symbicort™, and Dulera™ and one or more of the following:
Bronchial Thermoplasty reduces the amount of excess smooth muscle tissue in the airways. Thus in response to an asthma trigger, there is less constriction or narrowing of the airways, so breathing is easier, and there is less likelihood of a severe asthma attack. This is different from asthma medicines that work by opening up the airways by reducing swelling or causing the muscle in the airway wall to relax; although these medicines don't always work well in people who have severe asthma.
Bronchial Thermoplasty is typically performed under moderate sedation in three separate sessions scheduled three weeks apart. Each session lasts about an hour and focuses on a different part of the lung to ensure all of the reachable airways are treated. No incision is required to perform this procedure. The catheter is introduced into your airways through a bronchoscope that is inserted through your mouth or nose. The physician performing the procedure will carefully treat along the length of the airways in the part of the lung planned to be treated in each of the sessions. After the procedure, you will be carefully monitored for 2 to 4 hours and discharged on the same day. The treating physician will provide you with more details on what to expect during and after the procedure.
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Our physicians will order sleep studies based on the patient's symptoms and risk factors. Common symptoms include daytime sleepiness, snoring, fatigue, headaches, and lack of concentration.
Although anyone can develop sleep apnea, there are some identified risk factors, such as being overweight. According to the National Heart, Lung and Blood Institute, about 50 percent of people with OSA are overweight or obese. Men also tend to have sleep apnea more often than women. Having large tonsils or adenoids is also considered a risk factor.
Depending on your insurance, your insurance may approve you for in-lab sleep studies such as a PSG (polysomnography) and then a CPAP Titration Study, or they may approve a home sleep study.
PSG - Polysomnography
An in-center polysomnography (PSG) test takes place in a sleep center. These sleep centers offer all the comforts and amenities of home, including a private, comfortable room where you can relax and have a typical night’s sleep.
PSG records your brain waves, heart rate and breathing as you sleep. It also charts your eye movements, limb movements and oxygen in your blood. PSG can diagnose or rule out sleep disorders such as obstructive and central sleep apnea, restless leg syndrome (RLS) and more in adults and children.
A CPAP titration is a test that is used to determine your optimal positive airways pressure (PAP) settings. Proper PAP settings can eliminate most or all apnea events. It is performed when a patient has been previously diagnosed with sleep apnea through a PSG sleep study or HST, and have been placed on PAP the entire night.
Home Sleep Study
HST is a type of diagnostic polysomnography which is self-administered by the patient in his/her home, making it a convenient option for many adult patients whose schedules prevent them from taking an overnight in-center sleep test, or are homebound due to illness. HST cannot be performed on children and cannot diagnose other sleep disorders such as restless leg syndrome, periodic limb movement disorder or narcolepsy. These patients should be tested in a sleep center.
After a sleep study (PSG, CPAP Titration, or Home Sleep Study) has been performed on a patient, the 8 – 24 hours of data needs to be processed in order for it to be clinically useful. This usually means that the sleep study data will be reviewed by a sleep technologist (RPSGT or RST) and a sleep physician. After sleep study scoring is completed by the sleep tech, it will be sent to a sleep physician who will re-review this data and scored tech report and issue an interpretation of the sleep study, and often recommendations. The sleep physician’s report will then be sent back to the referring clinician who will present the findings to the patient. Treatment options are often discussed by the sleep physician.
Treatment options may include a continuous pressure airway pressure device (CPAP), bilevel positive airway pressure device (BIPAP), or an auto-titrating pressure airway device (APAP).