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Pulmonary Services

COPD Evaluations & Treatments

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. 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.

Asthma Evaluations & Treatments

Breathing is something most of us take for granted. But asthma can make breathing hard, even scary.Fortunately, with lifestyle changes and treatment, most people with asthma can lead full, active lives. Asthma is a disease of the bronchi. These small tubes must be open for air to pass. But in asthma, the muscles around the bronchi tighten, narrowing the passages. Also, the tissue that lines the tubes becomes inflamed (or swollen), and bronchial glands produce too much mucus. This clogs the small airways and makes breathing hard. The problems wax and wane, so symptoms come and go.

Lung Nodule/Mass Evaluations

A lung nodule is defined as a “spot” on the lung that could be up to about 1 and ½ inches in diameter. If an abnormality is seen on an x-ray of the lungs that is larger than 3 cm, it is considered a “lung mass” instead of a nodule, and is more likely to be cancerous.

Mediastinal Mass Evaluations

The mediastinum extends from the thoracic inlet to the diaphragm, and contains many vital structures. ​Vital structures include the heart and great vessels, and the esophagus. The evaluation and general management of mediastinal masses will be taken care of by our specialists. They will discuss with you the specific causes of an anterior mediastinal mass and run tests to see inside the airways of your lungs or get samples of mucus or tissue from the lungs to help determine the cause.

The mediastinum includes those structures bounded by the thoracic inlet, diaphragm, sternum, vertebral bodies, and pleura. It is typically described as having three compartments: anterior, middle, and posterior. Alternatively, the middle compartment has been called the visceral compartment. The remaining posterior compartment is often called the paravertebral sulcus. The cardio pericardial structures, the trachea, and the esophagus are part of the visceral compartment and opposite of the paraspinal space/posterior mediastinum. The diagnosis of a mediastinal mass can be based upon the location within the mediastinal compartments themselves.

Short of Breath Evaluations & Treatments

Shortness of breath should always be taken seriously. Even though things like running or congestion may cause shortness of breath, you should take note on how often it occurs and what you were doing. ​​Other things can cause shortness of breath like asthma or panic attacks; the treatment will vary on what symptoms and causes you might have.

Fiberoptic Bronchoscopy

Fiberoptic Bronchoscopy 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 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.

Endobronchial Ultrasound

​​Endobronchial ultrasound (EBUS) is a technique that uses ultrasound technology incorporated in a special bronchoscope or along with bronchoscope to visualize airway wall and structures adjacent to it. ​​​The clinical application and diagnostic benefit of EBUS have been established in many studies. EBUS has been incorporated into routine practice in many centers because of its high diagnostic value and low risk. ​It may replace more invasive methods for staging lung cancer or for evaluating mediastinal lymphadenopathy and lesions in the future.

​EBUS and guided sampling are gaining popularity rapidly. There are four primary reasons your doctor may recommend an endobronchial ultrasound: To look for the presence of tumors or enlarged lymph nodes. To diagnose tumors within the lung To diagnose lymph nodes in the mediastinum (the area between the lungs) or hilum (the region near the top of the lungs). To diagnose tumors in the mediastinum In addition to diagnosing and staging lung cancer, and endobronchial ultrasound may also be used to detect infections or help to diagnose other lung conditions such as sarcoidosis. ​This process can help get a diagnosis in one process, rather than two. This method requires no surgery like other methods and allows you to see an ultrasound image to see the lymph nodes with no guesswork involved.


Thoracentesis is a procedure to remove fluid from the space between the lungs and the chest wall called the pleural space. ​​The process is done with a needle inserted through the chest wall. Ultrasound pictures are often used to guide the placement of the needle.

Pulmonary Function Studies

These are known as your SPIRO readings, which are very important, especially after a transplant. ​​It monitors your breathing levels daily so that we can catch changes in your breathing.

Nebulizer Treatment

Some medicines need to be given through a nebulizer treatment. Nebulizer treatments are also called breathing treatments, aerosol treatments or med nebs. ​​​A nebulizer changes medication from liquid form to a mist making it easier to inhale. Nebulizers are predominantly effective in delivering asthma medications to infants and small children and to anyone who has difficulty using an asthma inhaler or trouble taking regular medicines.

Oxygen Therapy

Oxygen therapy is a treatment that supplies your body with the proper amount of oxygen to your brain. Normally, your lungs absorb oxygen from the air. However, some illnesses and condition, like damaged lungs can prevent you from getting enough oxygen. Oxygen therapy may help you function better and be more active. The oxygen can be administered by a nasal tube or face mask.

Smoking Cessation Assistance

​​​Discover everything you need to know about how to quit smoking. ​​​​​We know that each person is different and we plan to help you find a way to stop smoking in a safe and healthy way. We can educate you on the risks of smoking and provide you with solutions to overcome your nicotine addiction.

Pulmonary Rehabilitation

Pulmonary rehabilitation is a process to help improve the health of people who have chronic breathing problems. ​​​​​​The program might include breathing strategies, exercise training, nutritional counseling, support, and more. Our specialist suggests you have exercise rehab approximately three times a week to keep up your strength and energy.

Sleep Services

If you are suffering from a sleep disorder or disruption, we have some ideas to help you. We commonly treat:

  • Narcolepsy
  • Sleep apnea
  • Teeth grinding
  • Insomnia
  • Low oxygen
  • Restless Leg Syndrome
  • Snoring
  • Sleep walking
  • Sleep starts
  • Sleep terrors
  • Sleep disordered breathing evaluations & treatments
  • Excessive daytime sleepiness evaluations and treatments
  • Insomnia evaluations and treatment
  • Polysomnography
  • CPAP therapy
  • Oral Appliance therapy

Sleep disordered breathing evaluations & treatments

Can snoring be harmful? Snoring is a very common problem in the United States. It is estimated that 44 percent of males and 28% of females snore habitually. Snoring is an indication of increased upper airway resistance. Habitual snoring could herald the presence of sleep disordered breathing, otherwise known as, obstructive sleep apnea or OSA. Individuals who snore are seven times more likely to develop OSA than non-snorers. OSA can cause daytime sleepiness and difficulty concentrating or staying on task. OSA is also associated with elevated blood pressure, mild pulmonary hypertension, coronary artery disease, cerebrovascular disease, arrhythmias and ischemic stroke. In fact, individuals with untreated severe OSA have a three to six fold increased risk of dying sooner from any cause than individuals who do not have OSA.

Excessive daytime sleepiness evaluations & treatments

Excessive daytime sleepiness can occur for a variety of reasons. By far the most common reason for excessive daytime sleepiness is not getting enough sleep at night. ​​​Additionally, sleep disordered breathing (obstructive and central sleep apnea), nocturnal seizures, cardiac arrhythmias, and circadian rhythm disorders can occur unknowingly during sleep which can disrupt sleep and cause excessive daytime sleepiness. Excessive daytime sleepiness can cause cognitive impairment and memory problems. Additionally, people who have excessive daytime sleepiness are 5-7 times more likely to be involved in an automobile accident than those who do not suffer from excessive daytime sleepiness.

Insomnia evaluations & treatment

Can’t sleep at night? Insomnia affects many, and decreases the full potential of our lives, leaving us deprived of the essential sleep that we need to maintain our day. ​Don’t let another night slip by before talking to our specialists about evaluations and treatment options. ​We’re here for you and care about the well-being of your life. Sleep is a priority in our lives. We’ll treat it like one.


Polysomnography is commonly called a PSG or sleep study. A sleep study is commonly used to determine if snoring is caused by obstructive sleep apnea, also known as OSA. The sleep study can also detect if someone is having seizures in their sleep, abnormal heart rhythms, sleep walking or talking, acting out their dreams or not getting enough oxygen while they sleep.

CPAP therapy

CPAP therapy stands for continuous positive airway pressure. ​CPAP therapy is commonly used to treat obstructive sleep apnea, otherwise known as OSA. As the name implies, this therapy utilizes airway pressure, ie a column of air, to help keep your airway open so that you can maintain breathing at night and prevent your airway from closing due to OSA.

Oral Appliance Therapy

Oral appliances (OA) is an alternative therapy in the treatment of obstructive sleep apnea, also known as OSA. Additionally, some oral appliances can be used to treat snoring.

Sleep tests:

  • Multiple Sleep Latency Testing (MSLT)
  • Maintenance of Wakefullness Testing (MWT)

In Office Procedures

Here are a few of the most common in-office procedures we offer:

  • Screening spirometry
  • Complete pulmonary function testing
  • Exercise induced asthma testing
  • Pulse oximetry
  • Sleep disorder evaluations
  • Nebulizer treatment
  • Oxygen therapy
  • COPD evaluation
  • Chronic cough and shortness of breath evaluation
  • Polysomnography