What to expect at the Lung Wellness Clinic
A Respiratory Assessment
All respiratory clients attending The Lung Wellness Clinic need a respiratory assessment to help determine how well the respiratory system is functioning.
What to expect:
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- A thorough medical history (first visit 30 – 45 minutes)
- Lung function assessment (30 – 45 minutes)
- Exercise challenge testing
- Detailed information on findings
- Education and counselling
- Plan for the way forward
Performance of Lung Function Testing
Spirometry
A spirometer measures the amount of air you can breathe out in one second and the total volume of air you can exhale in one forced breath.
These measurements will be compared with a normal result for someone of your age, height and sex, which will help show if your lungs aren’t working properly.
Preparing for the test
You will be told about anything you need to do to prepare for the test when you make your appointment.
If you use bronchodilator medication (medicines, usually inhaled, that help relax and widen your airways), you may need to stop using it beforehand.
You should also avoid smoking for 1 hour before the test and avoid strenuous exercise for a few hours beforehand.
It’s best to wear loose, comfortable clothing on the day of the test.
What happens during a spirometry test
A soft clip will be placed on your nose to stop air escaping from it.
The tester will explain what you need to do. When you’re ready for the test, you’ll be asked to:
- inhale fully, so your lungs are completely filled with air
- close your lips tightly around the mouthpiece
- exhale as quickly and forcefully as you can, making sure you empty your lungs fully
This will normally need to be repeated at least 3 times to ensure a reliable result.
In most cases, the test may need to be repeated around 15 minutes after taking some inhaled bronchodilator medication.
This can show if you have a lung condition that responds to these medications.
Overall, your appointment should last around 60 minutes. You’ll be able to go home soon after the tests have finished and can return to your normal activities.
Your results
You will get your results immediately and the result will be fully discussed with you. The results will then also be sent to the doctor who referred you for the test, who will discuss them with you and treat you further.
The measurements will also show whether any problem with your lungs is “obstructive”, “restrictive”, or a combination of the two:
- obstructive airways disease – where your ability to breathe out quickly is affected by narrowing of the airways, but the amount of air you can hold in your lungs is normal (such as in asthma or COPD)
- restrictive lung disease – where the amount of air you can breathe in is reduced because your lungs are unable to fully expand (such as in pulmonary fibrosis).
Are there any risks or side effects?
Spirometry is a straightforward test and is generally considered very safe. Some people may feel dizzy, faint, shaky, sick or tired for a short period afterwards.
Most people can have a spirometry test safely. But the test increases the pressure inside your head, chest, stomach and eyes as you breathe out, so it may need to be delayed or avoided if you have a condition that could be made worse by this.
For example, spirometry may not be safe if you have, or have recently had, unstable angina, a heart attack, uncontrolled high blood pressure, or an operation to your head, chest, stomach or eyes.
Exercise Challenge Testing
The exercise challenge test determines whether your child has exercise-induced airway narrowing. You may have also heard your child’s healthcare provider talk about exercise-induced asthma (EIA) or exercise- induced bronchoconstriction. Seeing if the airways become narrow while exercising can help in diagnosing and managing asthma.
What is the exercise challenge test?
During the exercise challenge test, your child will exercise with a free run outdoors under controlled circumstances for between 6 – 10 minutes. The exercise intensity will be increased based on your child’s fitness level and response to the aerobic capacity.
Before exercising and at many timed intervals after exercising your child will be asked to blow forcefully into a spirometer, a tool that measures lung capacity.
How do I prepare my child for the exercise challenge test?
Your child should wear loose-fitting, comfortable clothing and athletic shoes right for exercising. Make sure your child does not do heavy exercise at least four hours before the test or eat a heavy meal for about 2 hours before the test. Before starting the exercise challenge, your child must be able to perform pulmonary function tests by blowing forcefully into a spirometer. If they can’t adequately perform pulmonary function tests, we will most likely cancel the challenge. Your child should not take medicines that can change their airways’ responsiveness to exercise.
Exercise challenge test Medicines
This chart below shows when your child should stop taking these medicines before the exercise challenge test.
| Type of Medication | Withdrawal Time | Drug Names |
|---|---|---|
|
Short-acting inhaled bronchodilators |
6 hours before |
Ventolin, Venteeze, Asthavent, Bricanyl |
|
Long acting inhaled bronchodilators or combination therapy |
24 hours before |
Foxair, Symbicort, Vannair |
|
Antihistamines |
24 hours before |
Avamys, Flowmist |
If you have any questions about your child’s medicines and whether they need to stop taking them before the test, call your child’s healthcare provider.
What happens during the exercise challenge test?
Before beginning to exercise your child will blow forcefully into a spirometer, a tool that measures lung capacity, to determine baseline lung function.
Your child will then run outdoors on a flat surface for 6 – 10 minutes.
Once exercise is complete your child will immediately blow into the spirometer and then again at 2, 5, 10, 15, 20 and 30 minutes after exercising.
If your child’s lung function decreases to a certain level at any point during spirometry testing, we will administer salbutamol. We will then wait 10 minutes and have your child blow into the spirometer again.
If your child’s lung function has not reached a certain level of pre-exercise spirometry when 30 minutes have passed, they will receive salbutamol. After 10 minutes, your child will blow into the spirometer to re-measure their lung function to ensure it has returned to the certain pre-exercise level. Your child’s healthcare provider will be told if your child’s lung function does not return to the certain pre-exercise level.
The total test will take about 60 minutes to complete.
We will then interpret the results and discuss the results with you.
What are the potential side effects of the exercise challenge test?
While rare, your child could experience the following complications during or after the exercise test:
- Falling
- Heartbeat irregularities
- Wheezing
- Shortness of breath
If there are any problems emergency treatment will be provided if needed.
What if I have questions about the exercise challenge test?
If you have any questions about preparing your child for the exercise challenge test or about the procedure, contact us via linds@icon.co.za
The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.
Making Self Management Planning and Action Plans Together
What is a self-management plan?
A self-management plan is an agreed set of guidelines between you and your healthcare provider on “what to do when”. It basically gives you some ‘signs’ to work from so that you can identify when your illness is getting better or worse; the plan tells you exactly what to do depending on the change. The action you take may, for example, be to increase your medication, visit your GP or call an ambulance.
Overall aim is:
- To keep you free of symptoms during the day and night
- To be able to carry out all normal activities including exercise
- No work or school missed because of your asthma
- To keep your lungs working at their best all the time
- To keep you as well as possible on the least amount of medication
- Fewer unscheduled physician visits for respiratory disease
- To ensure you need fewer/no emergency visits or admissions to hospital
- Improved independence through use of your action plan
- Communication of your respiratory assessment, progress and action plan with your physician and other healthcare professionals
- Peer support
- Fewer and shorter hospital stays
- Prompt response to your phone calls and inquiries (within 24 hours)
- Individualised treatment plans, implementation strategies and follow-up
- Access to educational material
How It Works
To schedule a clinic appointment, or for enquiries contact us on +27 83 659 5299