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.
Pulmonary Function Testing
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.
Ultrasound Guided Thorocentesis
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.
Heart problems often cause difficulty breathing by impairing circulation and causing blood and fluid to accumulate in the lungs (pulmonary edema). Our office has a certified ultrasonographer who administers echocardiograms. Echocardiograms provide information about the size and strength of your heart, the condition of its valves, and the amount of pressure in the pulmonary artery between your heart and lungs.

Bronchoscopy, Endobronchial Biopsy, Transbronchial Biopsy and Wang Needle Aspiration

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.
CT Guided Needle Aspiration of Lung Masses
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.
Vascular Studies of the Lower Extremities
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.
Polysomnography (Sleep Studies) and CPAP (Continuous Positive Airway Pressure)

Many patients with respiratory problems have sleep apnea. This is a condition in which the upper airway becomes partially obstructed during sleep, causing breathing problems. Breathing can even stop completely for short periods of time. We arrange sleep studies at a nearby clinic where patients spend the night in a comfortable setting. During sleep, we monitor oxygen levels, chest wall movements, heart rate, eye movements, brain waves (EEG), and snoring patterns.

If we detect a pattern of excessive snoring and interrupted breathing, we will usually recommend a continuous positive airway pressure machine (CPAP). CPAP is a small plastic mask that fits over the nose and pushes air into the upper airway during each breath. This keeps the upper airway open and prevents recurrent episodes of apnea.
PET Scanning (Positron Emission Tomography)
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.
Home Ventilator Management
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.
Pulmonary Rehabilitation
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.
Oxygen therapy
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.
Chest Tube Insertion
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.
Endotracheal Intubation and Mechanical Ventilation

Endotracheal intubation is an emergency procedure used when a patient is in respiratory distress and unable to breathe properly on their own. A soft plastic tube is placed in the windpipe and connected to a mechanical ventilator. The ventilator helps the patient breathe until medications take effect and breathing becomes independent again.

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5010 Crenshaw Rd. Suite 100
Pasadena, Texas 77505
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Call: (832) 399-0399