What tests should/will Pulmonologist run to see if I have asthma?

[t_panic411]

Hi, I've posted a few threads in here recently.... Newly dx'd with reactive asthma but that was from Gp's who did not run tests so I am seeing a pulmonologist on july 10 to have tests ran to confirm diagnosis and get meds right.
I do believe it's asthma based in symptoms too, etc...
For those of you who have been to a pulmonologist....
What tests will they run on me? What tests should they run to know 100% if I do or do not have asthma? Also, if it's not asthma and is something else instead such as COPD, how can they tell the difference? Any info would be great since I'm going soon and would like to know which tests they should for sure run/what to expect....
ps.. Are any of these tests painful/risky? I have to take a cab alone to my visit which is no fun but ya gotta do whatcha gotta do I guess.

Thanks again!!!

[KWSN]

My asthma was diagnosed with spirometry. The test is very simple and quick. You basically take a deep breath and blow as forcefully as you can into the machine for as long as you can. The machine is basically measuring the amount of air you are moving with time. Then, you take a huff of albuterol (or other beta-2 agonist inhaler) wait 10-15 minutes for its effects to kick in and repeat the spirometry.

There are many parameters that can be determined from a spirometry plot, but if you show an improvement in peak flow and FEV (forced expiratory volume) of more than 10-15% that right there is fairly diagnostic for asthma. There are other tests (such as the "methacholine challenge") but I believe spirometry is now the standard. The nursing staff should give you some instructions about laying off the albuterol for at least several hours prior to the test. The key is your response to albuterol, so if you use it too close to the start of the test, the results will be invalid.

Knight Who Says Ni !

[t_panic411]

oh Joy..... I had miss my doc apt.

That kind of sucks but the last 4 days I have been feeling about 95% normal again (thank God) and have started backing off my steriod inhaler (for 2 days now). Hav not had to use my albuterol either.

Just a note;

Not sure if this would be of any importance to anyone......
Buuuutt.... I noticed my albuterol inhaler not kicking in as fast as it did when I 1st started taking it (probably cause i over used it out of fear of an attack)...
Anyway, I ended up getting a different inhaler called xoponex (spelling?). It's levalbuterol which is the exact same as albuterol but it does NOT have the extra (un-needed) stuff in it that makes you shake like crazy and your heart race, etc... I had taken this in a nebulizer for a week once but what a pain to lug that around every time you needed it.

This xoponex inhaler is great!!!

Anyway, the thing I have noticed which is weird cause I read they are the same thing is that when the albuterol seems to lose it's effectiveness with me, I switch to the levalbuterol (xoponex) for a while and it works great, then when it stops working as good, I switch back to the albuterol and it works as good as it did when I started for a while.
Anyone else have both inhalers and do this?
You notice a difference like this?

I think my asthma might be subsiding (thank God!). This was my 1st asthma attack and it was chemical induced (exposed to bleach fumes in enclosed area for too long) so maybe this will be a one time thing, maybe not. I STILL can't smoke a cigarette w/o having at least a mild asthma attack.
In a way, I'm glad cause I'm being forced to stop smoking like it or not and I could not do it any other way, it's just too addictive.

The good thing about missing my doc apt this time is that I had decided I wanted to go to an allergist instead since I was starting to feel clear/better.

Thanks for the info though!!!! If my asthma comes back - I'll be running to the pulmonologist!!

[Titchou]

I hate to tell you this but,as an adult, if you have asthma, it never goes away. It may get better but it will never be cured. Get to the pulmonologist, get tested and get on an appropriate regimen of a daily prevental (your steroid inhaler) and a rescue inhaler (albuterol, etc). Asthma can be fatal. Don't mess around.

[Solaray2]

Hi t_panic411,

Thanks for info on your experience w/xoponex.
I am going to give that a try (I could do w/out the side effects of Albuterol)

What tests will they run on me?

1. Spirometry Test (you blow through an air hose) which measures how quickly air can be expelled from the lungs before & after Bronchodilator.

Or

2. Extensive Lung function Tests (measures static lung functions, Diffusion Capacities, & Flow Rates) which includes:
************A. Plethysmography - You sit in an airtight box breathing in/out through an air hose with & without resistance to calculate air volumes in the lung.
************B. Gas dilution technique - you are connected to a spirometer w/ a volume of inert gas (ex Helium) and you breath it in through the air hose.
um) and you breath it in through the tube/hose

What tests should they run to know 100% if I do or do not have asthma?
I believe its the Spirometry Test.
In my case,
One Pulmonist did just the Spirometry Test for diagnosis.
While another Pulmonist was more complete and did the Spirometry test & the above Plethysmography Test for diagnosis.


Also, if it's not asthma and is something else instead such as COPD, how can they tell the difference?
Also with a Spirometry test. Bronchodilators (drugs that cause the airway to dilate) are usually added to confirm the diagnosis. If the test result does not show improvement with bronchodilators, then COPD is very likely.

My research came up with the following:
COPD & asthma are different but cause similar symptoms
1. COPD causes permanent damage to the airways. The obstruction is 'fixed'/ irreversible. Persistent lung disease with features of airway narrowing. Chronic obstructive pulmonary disease (COPD) describes a group of diseases that cause progressive damage to your lungs. These diseases include chronic bronchitis and emphysema.


2. In Asthma airway narrowing is intermittent and reverses quite easily with medication. With Chronic Asthma inflammation that is not properly treated properly you can get airway remodeling (I believe this means lung damage/scarring)

**People with COPD can have an Asthmatic component
**People with Asthma can have an COPD component.


What are the treatments ?
Anti Inflammatories, Bronchodilators, etc.

Are any of these tests painful/risky
No