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Pulmonary Procedures

Pulmonary Procedures

Asthma Education Program

The diagnosis of Asthma is on the rise in this country.  The number of people who have more severe and fatal attacks is also increasing.  This rise comes despite new and more effective medications.  Due to these concerns the National Heart Lung and Blood Institute (NHLB) began asthma research to find out why this was happening.  From this research has come a better understanding of asthma and its treatment.

THE IMPORTANCE OF ASTHMA EDUCATION

Educating the individual with asthma is considered to be one of the most important components of treatment.  With proper education, individuals could recognize symptoms earlier and respond to changes with a predetermined action plan.  NHLBI determined that making the patient an informed partner with the physician could significantly improve the management of this disease.

With the aid of an individualized Action Plan each patient is able to make decisions on treatment earlier in an episode, thus preventing a more severe episode from occurring.  The partnership between the asthma patient and his/her physician improves the communication, thereby building trust and improving compliance in their treatment regime.

THE ASTHMA EDUCATION PROGRAM

In response to these findings McLaren Greater Lansing developed an Asthma Education Program, using guidelines set by the National Heart Lung and Blood Institute (NHLBI).  The goal of the Asthma Education Program is to help those in the community with asthma control their disease.  Asthma patients who participate in the program are taught about many aspects of their disease.

  • What is Asthma?
  • Medications used to treat Asthma
    • Types of medication, actions, and side effects
    • Proper use of Metered Dose Inhalers
  • Triggers and how to control or eliminate them
  • Peak flow monitoring
  • How to respond to changes in peak flow

COMPONENTS OF THE ASTHMA EDUCATION PROGRAM

The program consists of two 1-hour sessions:

During the first 1-hour session, the patient is interviewed and individual needs are established.  Education is started covering the above areas.  If needed, a peak flow meter and/or a holding chamber are given with instructions on their use.  The patient is instructed on how to keep track of their peak flow readings and their symptoms.

Two weeks later, the patient returns and the results of their peak flow monitoring is analyzed.  From these results, an individualized action plan is developed.  The action plan tells the patient how to respond to changes in peak flow readings.  This information helps the patient to intervene earlier in an attack, thus potentially avoiding the need to visit the Emergency Room or physician.  Information covered in session one is also reviewed.

PHYSICIAN FOLLOW-UP

A letter summarizing the individual patient's needs that were covered during the classes is sent to the referring physician.  A copy of the Action Plan is also sent, thus improving communication and team work between patient and physician.

For all your inquiries concerning the Asthma Education Program and it's cost, please call (517) 975-6400 (scheduling office).  For inquiries concerning the Asthma Education Program, please call (517) 975-6400.

Asthma can be a crippling disease to many individuals as well as their families.  At McLaren Greater Lansing, we're making a difference by offering the asthma patient a program to help them control this disease and get life back on track.

McLaren Greater Lansing's Asthma Education Program
407 W. Greenlawn Avenue
Meerman Education Center
Lansing, MI 48910
(517) 975-6400
American Lung Association

 

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Bronchoscopy Procedure

Bronchoscopy:
A state-of-the-art diagnostic respiratory procedure

WHAT IS INVOLVED IN THE BRONCHOSCOPY PROCEDURE?

The bronchoscopy that has been recommended is a way of determining if there are any lung abnormalities. The physician will be using a lighted flexible instrument to look at all areas of the lungs. They will obtain specimens and biopsies for laboratory analysis to help diagnose any lung condition that may be present. This test takes approximately 5 hours. Please bring a driver to take you home after the procedure.

WHAT HAPPENS BEFORE THE PROCEDURE?

You are asked not to eat or drink anything after midnight the night before the bronchoscopy, or as otherwise instructed. If you are having the procedure as an outpatient, please register at the Outpatient Registration on the first floor of the main hospital (Greenlawn) at the time designated.

After registration, you will go to the Special Studies holding area on the third floor. A nurse will ask you to sign a form giving your consent for the procedure and any other steps found necessary during the bronchoscopy. Before your procedure, an IV may be started so that medication can be easily given during the bronchoscopy. You will be escorted to the bronchoscopy room one half hour prior to the procedure's start time. Members of your family will be asked to wait in a designated waiting area.

WHAT HAPPENS DURING THE PROCEDURE?

The bronchoscopy room has an x-ray machine, a heart monitor, an oxygen monitor and a blood pressure monitor. There, a specialist called respiratory therapist will explain the procedure and will assist the doctor with the bronchoscopy. You are encouraged to ask any questions that will help you understand what is about to happen. You will be asked to remove glasses, all jewelry, dentures or other dental appliances. Next, you will be given a breathing treatment that contains a local anesthetic called Xylocaine to numb the airways and make you more comfortable. When the doctor arrives, you will be given Versed in your I.V. to help you relax and sleep. The bronchoscope is guided through your nose and into your lungs by your doctor.

WHAT HAPPENS AFTER THE PROCEDURE?

Afterwards, the respiratory therapist will take you back to your room or to the Outpatient Recovery Area on the 3rd floor. Sometimes a chest x-ray is ordered after the bronchoscopy. You will be monitored until the anesthesia has worn off, which usually takes about two hours. You cannot eat or drink during this time. Your throat may hurt slightly after the procedure and it is not uncommon for a patient to cough up some blood. Increased shortness of breath or large amounts of fresh blood coughed up should be reported to your nurse. The results of the bronchoscopy will be shared with you by your doctor.

INTERVENTIONAL BRONCHOSCOPY

McLaren Greater Lansing, in conjunction with pulmonary physicians, now offers the newest techniques with bronchoscopy. The procedures are referred to as Cryotherapy, Argon Therapy and Electrocautery Therapy.

These specialized procedures are indicated for specific airway conditions. Your physician may discuss these options with you.

If you have any additional questions regarding this procedure, call the doctor who is performing this test, or call the Pulmonary Laboratory at (517) 975-7041.

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Cardiac Stress Testing

Standard Stress Test
Cardiolite Stress Test
Pharmacological Cardiolite Stress Test
Stress Echocardiogram

Standard Stress Test

What to expect:

During this test, the patient will walk on a treadmill while staff monitors the EKG, heart rate, and blood pressure. Once the desired heart rate is achieved (based on age) the treadmill will be slowed for a cool down and recovery period. When heart rate and blood pressure return to resting values, the test is complete.

Instructions

  • Do not eat, drink, or smoke 4 hours before your test. (If diabetic and taking insulin, notify your doctor for possible dose adjustments.)
  • Wear a short-sleeve button-down shirt and comfortable walking shoes or sneakers.
  • If you are taking medication for your heart, check with your doctor. He or she may ask you to stop taking these medicines a day or two before the test.

Total Time: 1 hour

Cardiolite Stress Test

What to expect:

When the patient arrives, a nuclear medicine technician will start an IV that injects a radioactive substance. This substance allows staff to take pictures of the patient's heart. After a waiting period, the patient will lie on a table and have pictures taken.

Once the images are captured, the stress portion of the test begins. The patient will walk on a treadmill while staff monitors the EKG, heart rate, and blood pressure until a target heart rate (based on age) is achieved. A second injection will then occur and the patient will be asked to exercise for one additional minute. Once the minute is complete the treadmill will be slowed for a cool down and recovery period.

When the patient's heart rate and blood pressure return to a resting value, another waiting period will take place. After, more pictures will be taken and the test is complete.

Instructions

  • Do not eat, drink, or smoke 4 hours before your test. (If diabetic and taking insulin, notify your doctor for possible dose adjustments.)
  • Wear a short-sleeve button-down shirt and comfortable walking shoes or sneakers.
  • If you are taking medication for your heart, check with your doctor. He or she may ask you to stop taking these medicines a day or two before the test.

Total Time: 3-4 hours

Pharmacological Cardiolite Stress Test

What to expect:

When the patient arrives, a nuclear medicine technician will start an IV that injects a radioactive substance. This substance allows staff to take pictures of the patient's heart. After a waiting period, the patient will lie on a table and have pictures taken.

Once the images are captured, the stress portion of the test begins. Medication will be used to excite the heart. The patient will lie on a table while staff monitors the EKG, heart rate, and blood pressure until a target heart rate (based on age) is achieved. A second injection will then occur and the patient will go through a cool down and recovery period.

When the patient's heart rate and blood pressure return to a resting value, another waiting period will take place. After, more pictures will be taken and the test is complete.

Instructions:

  • Do not eat, drink, or smoke 4 hours before your test. (If diabetic and taking insulin, notify your doctor for possible dose adjustments.)
  • No caffeine 24 hours prior to test.
  • Wear a short-sleeve button-down shirt and comfortable walking shoes or sneakers.
  • If you are taking medication for your heart, check with your doctor. He or she may ask you to stop taking these medicines a day or two before the test.

Total Time: 3-4 hours

Stress Echocardiogram

What to expect:

During this test a cardiopulmonary technician will monitor the patient's blood pressure, heart rate, and rhythm. During the first part of the test, an ultrasound of the heart (called an echocardiogram) will be performed. Next, the patient will walk on a treadmill until the heart is beating fast. When the heart is beating quickly enough the patient will lie down, and the technician will take another ultrasound to capture images of the heart immediately following exercise. Testing is completed at this point, but the patient may be asked to stay until the physician has reviewed the study.Instructions

Instructions:

  • Do not eat, drink, or smoke 4 hours before your test. (If diabetic and taking insulin, notify your doctor for possible dose adjustments.)
  • Wear comfortable walking shoes and be prepared to remove clothing from the waist up, to be replaced with a patient gown.
  • If you are taking medication for your heart, check with your doctor. He or she may ask you to stop taking these medicines a day or two before the test.

Total Time: 1+ hour(s)

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Electroencephalogram (EEG)

The EEG is a safe and painless test that evaluates the function of your brain. If you have experienced seizures, fainting, memory loss, headaches, dizziness, stroke or head injury, your doctor may request that you have an EEG. These studies evaluate brain wave and electrical function.  Physicians refer patients for evaluation of seizures, epilepsy, attention deficit disorders, headaches, dizziness, fainting, and memory disorders. All studies are performed by trained technologists and reviewed by the Center’s neuologists.  Results are sent to the referring physician.

In preparation of the test you will be asked to sleep less than five hours the night before the test. You should also wash and dry your hair prior to your test.

During the EEG, you will sit in a  comfortable reclining chair in a quiet room. The technologist will measure your head and scrub the areas where electrodes will be placed. The electrodes will be dipped in cool cream and placed on your scalp. The lights will be dimmed and you will be allowed to lie back in the chair. The technologist will monitor the activity of your brain as you rest with your eyes closed. During the test, a strobe light will flash for about two minutes and you will be asked to open and close your eyes. You may also be asked to breathe rapidly and deeply for a few minutes. Many people fall asleep during this relaxing procedure. 

The test lasts about one hour and you will be able to resume your normal daily activities after it is completed.

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Event & Holter Monitoring

Event Monitor

What to expect:

An event monitor is a monitor that is worn for 14-30 days, depending on the doctor's order. When the patient arrives, a cardiopulmonary technician will attach and activate the monitor. The process for using the monitor will be explained and the patient should feel comfortable with the monitor and its instructions before leaving. McLaren Greater Lansing contracts with a company that will contact the patient if he or she experiences an "event" while the monitor is activated. Prior to leaving, the patient will speak with a representative from the company. An envelope will be provided to send the monitor and accompanying items back to the company at the end of the monitoring period.

Instructions

  • Keep a log of activities while wearing the monitor and relay the events and notes to the cardiopulmonary staff.
  • Follow the instructions included with the event monitor.

Total Time: 30 minutes

Holter Monitor

What to expect:

A Holter monitor is a 24 or 48-hour heart monitor that records the patient's heart activity. When the patient arrives, a cardiopulmonary technician will attach and activate the monitor. The patient must keep a diary of normal activities and any symptoms experienced. They will be instructed to return at the same time 24 to 48 hours later to have the monitor removed.

Instructions

  • Keep a log of normal activities and any symptoms experienced in the 24 to 48-hour time span
  • Continue normal daily activities. However, NO swimming, showering or bathing as the monitor cannot get wet.

Total Time: 30 minutes

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Pulmonary Function Test (PFT)

Pulmonary Function Test (PFT)

What to expect:

For this test the patient will perform several different breathing exercises. To obtain accurate measurements, the cardiopulmonary technician will provide the patient with a mouthpiece and nose clips.

Instructions

  • Do not take any breathing medications 3-4 hours before your test.
  • Follow any special instructions the doctor may give you.

Total Time: 1 hour

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Pulse Volume Recording (PVR)

Pulse Volume Recording (PVR)

What to expect:

This is a non-invasive test to check circulation. A cardiopulmonary technician will place blood pressure cuffs on the patient's arms, thighs, calves, ankles, and possibly toes. Resting measurements will be obtained and then a short walk on a treadmill will follow. Once the walk is complete, post exercise measurements will be taken.

Instructions

  • Patients will be asked to remove pants, shoes, socks, and possibly shirt for this test.

Total Time: 1 hour

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