Respiratory disease refers to chest conditions such as asthma, allergy, bronchitis, COPD, lung cancer, lung fibrosis as well as conditions such as allergy and sleep and breathing problems. Respiratory doctors often deal with symptoms such as breathlessness, cough, chest infections, and allergies. Many people who snore or stop breathing at night are also seen by respiratory doctors.
Respiratory medicine has a broad range of conditions and many types of tests are used to understand and diagnose these conditions such as breathing tests, x-rays and CT scans and camera tests in the lungs. These and other tests are available at the Beacon Hospital. To talk to a coordinator/schedule an appointment, please call Beacon Hospital scheduling department at 01 293 8652.
The cost for a consultation and CT of lung is €500. This is currently not directly covered by any health insurers either at Beacon Hospital or indeed at any other private Irish hospital.
Who are we?
We are a team of Consultants specialising in respiratory disease with training and expertise in the diagnosis and management of respiratory conditions. We have access to all necessary tests and procedures at Beacon Hospital and have backup from other supporting services such as chest surgeons and other physicians. The Consultants in Respiratory and Internal Medicine in practice here are:
Pulmonary Function Tests (PFTs)
PFTs may be used to confirm the diagnosis and track the progression of respiratory disease, as well as enabling clinicians to assess an individual’s response to a given therapy. They are frequently requested by anaesthetists as part of pre-operative assessment of individuals undergoing surgery. PFTs may also be used in healthy individuals who undergo routine health-check and for those undergoing pre-employment screening.
During your initial visit to the Respiratory Lab, a qualified technician will ask you to perform a series of Pulmonary Function Tests (PFTs). Spirometry, Gas Diffusion and Lung Volumes are the quickest and most common basic tests. You may be asked to perform one or all of these tests during your visit.
1) Basic PFTs
Spirometry testing is quick, non-invasive and painless. If you regularly experience breathlessness, have difficulty breathing, or otherwise suspect you have a lung disease, spirometry should be performed. The patient will be asked to quietly breathe in and out through a mouthpiece. The technician will then instruct the patient to rapidly fill the lungs with air and immediately blast this air out as quickly as possible back into the mouthpiece and continue the blast out until the lungs are completely empty. They will rapidly fill the lungs again to complete the test.
ii. Gas Diffusion (DLCO)
Diffusing capacity is used to measure the ability of the lungs to transfer gas from inspired air to the red blood cells in the pulmonary capillaries.
DLCO is particularly used to evaluate various fibrosing diseases such pulmonary fibrosis or asbestos exposure but is also used to evaluate emphysema, CF, cardiovascular diseases and the effects of chemotherapy agents or other drugs.
The patient will inhale maximally and hold this air in their lungs for 10 seconds, after which they will gently exhale the air back into the mouthpiece. The expired air is analyzed by the computer.
iii Lung Volumes by Body Plethsmography
Inspired and expired lung volumes are useful for detecting, characterising and quantifying the severity of lung disease. It is primarily useful for diagnosing and monitoring restrictive lung diseases such as sarcoidosis, asbestos exposure or pulmonary fibrosis. The patient will gently “‘pant”’ into a mouthpiece against a closed shutter for a few seconds.
Depending on your query or symptoms, more involved testing can be performed. Including the above, we also offer the following services:
2) Sleep Studies
Sleep studies are tests that watch what happens to your body during sleep. The studies are done to find out what is causing your sleep problems. The most common respiratory sleep disorder would be sleep apnoea. If you suffer from the following symptoms, you may have sleep apnoea that can be diagnosed from a sleep study: (ref: www.isat.ie)
- Loud, frequent and irregular snoring
- Your spouse/partner indicates that you periodically stop breathing or appear to be choking during your sleep, or gasp for breath
- Excessive daytime sleepiness and/or falling asleep when you don’t intend to. This could be almost anytime you are sitting down, such as during a lecture, while watching TV, while sitting at a desk, and even while driving a vehicle. Even if you don’t literally fall asleep, excessive fatigue/tiredness could be a positive indicator.
- Body movements often accompany the awakenings at the end of each apnoea episode, and this, together with the loud snoring, will disrupt the spouse/partner”’s sleep and often cause her/him to move to a separate bed or room.
- Forgetfulness (short term memory), difficulty in concentrating, focusing and completing repetitive tasks. Bouts of irritability and depression are common. If working, a disimprovement in performance over a period of time.
3) Bronchial Challenge Testing
Mannitol and/or Exercise challenge testing are used to determine degrees of airway responsiveness (e.g. Airway narrowing), either triggered by an aerosol solution (e.g. asthma) or by exercise (exercise induced bronchospasm).
i. Mannitol challenge testing involves inhaling various concentrations of a powder that is known to tighten the airways in responsive patients. Generally, it is used to exclude a diagnosis of asthma or to test the relative risk of its future development.
ii. Exercise challenge testing involves exercising for 4-6 minutes at your target heart rate. You will then perform a basic breathing test every few minutes to assess the response of your airways from the exercise.
4) Six Minute Walk Test (6MWT)
The distance walked by the patient in 6 minutes wearing an oxygen monitor on there finger, is used to assess sub maximal level of response of pulmonary system.
5) Allergy Skin Prick Test
An allergy is abnormal immune responses to commonly occurring substances (that are not harmful in themselves). These include foods, inhalants (pollen, dusts, and animal dander), insect bites and drugs. Skin tests have been proven to be of benefit in the diagnosis of allergy and have been proven to be more sensitive than a blood test (RAST). It also has another advantage of providing results almost immediately. Regular antihistamines should be discontinued prior to the test.
The technician applies the allergens to the skin on your forearm or back, and then a gentle scratch is applied by lancet over each allergen (See Figure). Readings are taken after 15 mins. Sample allergens available include: Egg, Peanut, Dust Mite, Grass Pollen, Tree Pollens, cat, dog, aspergillus funnigatus, cladosporium etc.
6) Maximum Inspiratory & Expiratory Pressure (MIP & MEP)
The maximum inspiratory pressure is the highest atmospheric pressure developed during inspiration against an occluded airway (MIP). The maximum expiratory pressure is the highest pressure developed during expiration against an occluded airway (MEP). These are a useful measure of the power of the inspiratory and expiratory muscles. Often used in conjunction with other test in the diagnosis of neuromuscular disease.