Southeast Houston Pulmonology offers a wide variety of diagnostic and therapeutic services for patients with lung problems such as chronic obstructive lung disease, asbestosis, asthma, persistent cough and chest pain.

These tests provide essential information for the diagnosis and treatment of lung diseases. Pulmonologists divide the testing into several major categories: spirometry, lung volumes, and diffusion capacity.

Spirometry measures the quantity of air a person can exhale in a single breath. The patient exhales forcefully into a mouthpiece attached to a computer that measures the speed of exhalation. Patients with obstructive lung diseases such as emphysema, chronic bronchitis and asthma exhale at a much slower rate than normal. The next step is to repeat the spirometry after administering a medication called albuterol. Albuterol dilates the bronchial tubes and makes exhaling easier. This aids in making a diagnosis because the performance of asthma patients tends to improve after receiving albuterol.

The lung volumes test measures the size of the lungs, the quantity of air inhaled with each breath and the amount of residual air left after a full exhalation. The computer measures these by analyzing the volume of nitrogen during inhalation and exhalation.

The diffusion capacity test measures the ability of the lungs to extract oxygen from the air through a technique known as helium dilution. The lungs extract helium from air in much the same manner as they extract oxygen. The patient inhales a small quantity of helium and the computer measures the difference between the amount of helium inhaled and the amount exhaled. This estimates the lungs’ ability to extract oxygen from air.

Some diseases cause fluid to accumulate in the pleural space surrounding the lung. This accumulation, or effusion, of fluid restricts breathing and causes chest discomfort and shortness of breath. Thorocentesis describes the drainage of this fluid through a small tube allowing the lung to expand. Dr Hamer performs this procedure in our office by placing a small plastic tube in the lining around the lung under direct visualization with an ultrasound machine.

In some situations, including suspected lung cancer, hemoptysis (coughing blood), and sarcoidosis, pulmonologists need to look inside a patient’s trachea and bronchial tubes. This is a procedure Dr. Hamer performs with the help of an anesthesiologist at a nearby hospital. A bronchoscope is a fiber optic tube about the diameter of a thick pen that is inserted through the mouth or nose. It provides an excellent view of the trachea and bronchial tubes and the pulmonologist can identify cancers, impacted mucous or irritated mucosa. If necessary, Dr. Hamer can perform a biopsy to remove a small fragment of lung tissue to be examined by a pathologist. In some situations he may use a fine needle to sample enlarged lymph nodes in the center of the chest (Wang needle aspiration) as well.

There may be times when a spot on the lungs is inaccessible through a scope due to its location. In these cases we will arrange for a board-certified radiologist to use a needle to obtain a tissue sample under the direct guidance of a CT scanner. A pathologist will examine the tissue to determine if it is cancerous.

Our office and ultrasonographer are trained and certified to perform sonograms to search for deep vein thrombosis, or blood clots, in the legs. This provides a tremendous resource in protecting the lungs from pulmonary emboli. A pulmonary embolus is a blood clot that forms in the veins of the legs, dislodges and travels to the lungs, where it causes difficulty breathing and pain in the chest.

The most recent addition to our arsenal of diagnostic procedures is positron emission tomography. This new technique allows doctors to study nodules on the lungs and assess whether they are cancerous or benign. The scan works by measuring the utilization of energy in different areas of the lung. Cancerous tissue uses much more energy than normal lung tissue and appears positive on the scan.

The greater Houston area now has a large number of facilities offering PET scanners. If necessary, we will make arrangements for the procedure to be done at a nearby imaging center.

There are some conditions that cause severe neuromuscular impairment, such as muscular dystrophy, amyotrophic lateral sclerosis, and spinal cord injuries. Patients with these problems lack the muscle strength to breathe on their own and require the use of a home ventilator. Dr. Hamer and his staff can assist patients and their families in learning how to take care of a ventilator patient at home, react to emergencies, and monitor important parameters.

Many studies show that lung patients have improved quality of life when they participate in a pulmonary rehabilitation program. We offer this through several local facilities with sessions held three times a week for up to three months. During each session, therapists teach breathing techniques and exercises specific to each person’s needs. The duration and intensity of the exercises gradually increase over time, resulting in improved cardiovascular conditioning and muscle strength. After completing the program, patients should feel prepared to continue exercising properly and independently at home.

In some cases, patients with severe lung diseases such as emphysema, pulmonary fibrosis or chronic bronchitis will require treatment with oxygen. We can test and qualify patients for oxygen therapy to ensure that Medicare and other insurance companies will cover the cost of the treatment. In addition, we work with multiple durable medical equipment suppliers that offer a variety of oxygen delivery systems to meet each patient’s specific needs.

Some conditions, including spontaneous pneumothorax, emphysema and chest trauma, may cause a hole in the lung. This allows air to leak into the space between the lung and the chest wall. The increasing pressure inside the chest cavity from the accumulation of air causes the lung to collapse. A physician must insert a small tube between the ribs to evacuate the trapped air. Dr. Hamer performs this procedure at several local hospitals using intravenous sedation and local anesthesia. After the chest tube is in place, patients remain in the hospital for several days until the collapsed lung expands and the tube can be removed.