Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

The festival of Diwali is greeted with great pomp and splendour and along with the regular festivities, the pollution levels in the air also rise due to the ritual of bursting fire crackers. In an analysis, the rise of harmful pollutants such as sulphur dioxide and nitrogen dioxide seemed to reveal a disturbing outcome.

The rise in pollution during Diwali affects you in the following ways:

The PM (particulate matter which is smaller than 2.5mm) enters your lungs and bloodstream and has several health impacts including chronic respiratory symptoms such as painful breathing and shortness of breath which might cause premature death.
High sulphur dioxide levels in the air during Diwali also lead to inflammation of air passages and causes complications in respiration.
A compound called  strontium  found in the atmosphere multiplies by 120 times during the festival and causes bone damage and blood clotting ailments.
Firecrackers contain heavy metals which are toxic to the human body and the amount of magnesium in the air goes up by 22x, which poses a significant threat to all forms of life.
The noise pollution also rises during the festival and in extreme cases, can permanently damage one s hearing.
However, there are a few measures you can undertake to steer clear of the excessive pollutants present in the air:

Limit the amount of time you spend outdoors even while exercising. This is because the air remains contaminated, days after all the festivities get over and the pollutants take a very long time to dissipate.
Even on the road, drive with the windows of your car rolled up to avoid intake of adulterated air and use a face mask if you are a two-wheeler rider.
Plant a lot of green plants inside your house as they purify the air you are breathing and ensure a supply of fresh oxygen.
Install an air purifier in the room to make sure you breathe in fresh, uncontaminated oxygen when you sleep. The air purifier will also help in lessening your respiratory complications.
Also, in case you notice any respiratory or breathing problem, it is advisable that you consult a pulmonologist, to rule out serious health issues. 

Diwali - How the Rise in Pollution Level Affects Your Health?

Asthma is a condition that can flare up anytime; be it at your child's soccer practice or during the middle of the night. Whenever the condition sets in, it leads to your child struggling for breath. For a parent to witness this situation can be hard; but you should know the techniques to keep the situation under control.

Here are a few tips on how to manage the situation:

1. Find out the triggers in your home: Asthma is triggered due to substances that your child may be allergic to. Examples are cigarette smoke, fur of pets and dust. If possible, keep your child away from the known triggers so that the condition does not flare up again.

2. Keep records of the following: It is good to have an action plan ready for your child when the bouts of asthma strike. When you visit the doctor to discuss about your child's condition then make sure that you have these records at hand.

The triggers that caused the bout of asthma
How many times did your child have wheezing episodes?
The number of times your child has been admitted for the same reason
The medications that your child is currently taking, dosage and/or whether they have been changed
How often does he/she need medications if he/she has acute symptoms?
3. Knowledge of the test your child may require: Asthma control test is a type of test that allows parents and children to grade asthma symptoms without a doctor. A pulmonary function test is used to detect the capacity of the lungs and flow of air.

4. See how your child responds to the treatments: You should consider changing the treatments for your child if he/she has recurrent symptoms of asthma attack and require frequent visits to the Emergency Room even after taking medications for an extended duration.

5. Long term treatment plans require patience: Any asthma treatment plan requires patience as they might not immediately cure symptoms.

How to Manage if Your Child Is Suffering From Asthma

The term asthma and bronchial asthma are often used interchangeably. Bronchial asthma refers to the chronic inflamation of the airways either due to some internal or environmental allergen. This leads to the narrowing of airways, which makes breathing difficult and blocks air from entering the lungs. Children are most affected by this condition as the immune system is still in the process of maturity and often grows out of it as they age. However, if not treated, this can lead to many complications like respiratory failure and can prove to be fatal. Asthma cases often spike in winter months and in the flowering season. It can also be triggered by second hand or passive smoke, stress, sudden unaccustomed physical exercise, food additives, dust, house mites, perfumes, certain drugs and many other allergens. A family history of asthma, allergic rhinitis, atopic dermatitis and other allergic conditions can also increase a child s risk of suffering from this condition.

Some of the most noticeable symptoms of bronchial asthma include:

1. Wheezing 
2. Shortness of breath 
3. Excessive coughing that worsens at night 
4. Tightness of the chest 
5. Lowered energy levels 
6. Rapid breathing 
7. Tiredness 
8. Indrawing of chest and lower neck

These symptoms often worsen after exercising. Lung function test and Chest X-ray are often used to confirm a diagnosis of bronchial asthma. Once diagnosis is being confirmed, it should be categorized as per severity. Your doctor may prescribe medication in the form of pills and inhalants as per the category of disease. It is important to note that these cannot cure asthma, but can help manage it. Inhalers deliver low doses of steroids directly to the lungs to reduce inflammation and other inhaled medication like Beta 2 agonist will open the airway by relaxing the muscles of airway. Children suffering from asthma must be taught how to use the inhalers and should always have it with them. In the case of school going children, their teachers should also be informed about the condition. Parents should also know how to keep it, use it and clean the device in a proper and hygienic way.

In very small kids those inhalational medication can be given by face mask and spacer, but as the age grows or in case of elder children above 6 years of age, they can directly take the medication from spacer. Those children who are already on inhalers, but still face asthma attack , for them nebuliser is the better choice to manage the emergency. It will make the liquid medicine into mist and enters into the air passage easily and work promptly.

In addition, certain lifestyle changes can also help reduce the frequency of asthmatic attacks. Avoid going outdoors on windy days or days when air pollutant level is high. Reduce the child s exposure to allergens like pet hair, dander and dust by dusting and vacuuming on a weekly basis. Avoid the use of humidifiers inside your house as moist air can promote the infestation of dust mites. Try to keep the child in a room with adequate air and sunlight. Take plenty of green leafy vegetables and fruits, which contain lots of vitamins and minerals. If possible get your child to wear cover his or her nose and mouth while in outdoors.

Childhood Asthma - 8 Signs To Look For!

Asthma is a respiratory disease that takes place with a variety of symptoms including breathlessness, wheezing and coughing. It usually occurs when the airways get obstructed, which in turn leads to inflammation of the tubes. So how can you recognise the signs and symptoms of asthma? here is a list of ways!

Risk identification: it has been observed by doctors and medical science that there is no specific reason for the onset of this ailment. It can be caused due to genetic as well as environmental factors. So, in order to recognise the symptoms, you will first of all have to take stock of both these factors. Find out if you have any blood relatives who have suffered from this ailment and try to find out how it started and at what age, so that you can watch out for the same warning signs. Also, if you are more prone than others when it comes to allergic conditions like rhinitis and atopic dermatitis, then you are at risk. Other risk factors also include living in a high pollution zone, as well as being overweight, smoking, working within close range of exhaust fumes and other chemicals, and other such factors.

Symptom identification: to be able to identify whether or not you are at risk, you must identify the potential symptoms including persistent shortness of breath, which may strike regularly. Also, another symptom is not being able to sleep comfortably due to excessive coughing and breath shortness as well as shallow breathing and wheezing. You may also experience some amount of chest tightening or constriction. These symptoms will usually get worse if you happen to be suffering from the flu or a cold. 

Respiratory health: if you are suspecting the onset of this disease, it would be a good idea to watch your respiratory health by observing the rise and fall of your breath when you are doing energy consuming and strenuous activities like exercising or other such tasks. Sports induced asthma is an actual condition that can get worse when your lungs are faced with cold and dry air. Also, if you are facing exhaust fumes and chemicals as a part of your job, then you are at risk of occupational asthma, in which case you should watch your respiratory health very closely. These symptoms can also get worse when you are around animals and pets due to the allergens that may trigger wheezing and coughing. A lung function test can be conducted by the pulmonologist in case you are suffering from any of these symptoms and conditions on a persistence and prolonged basis. 

Knowing and reporting your symptoms to the doctor is important for getting timely treatment.

How to Recognise Asthma?

Asthma is a distressing condition during which people find it difficult to breathe as the bronchi or tubes carrying air to lungs swell up. This happens when mucus inside bronchi comes into contact with an allergen like a pollutant or dirt causing symptoms like wheezing, coughing, more mucus production and difficulty breathing. There is no cure for asthma. As of now, it can only be managed. But managing asthma becomes really difficult during low air quality days, especially during winters when it s cold and dry.

The most common air pollutants are gases like sulphur dioxide, nitrogen dioxide, vehicle smoke, and suspended particles. Each one of them can trigger an asthma attack by itself because of its deleterious effect on the lungs. The smaller the particulate matter is, the more dangerous it becomes as these particles get lodged in the air sacs inside lungs, causing not just asthma from worsening but also fatal diseases like lung cancer.

So, most asthma patients suffer from frequent attacks due to air pollution. How can these attacks be prevented? Here are some tips:

According to research, asthma can be managed by making modifications in everyday life. On high air pollution days due to ozone, for example, asthmatics tend to experience more lung inflammation. If you are an asthmatic, you should reduce time spent outdoors, especially doing strenuous activity in the mornings and evenings. Keeping medications on hand and using those at the very start of an asthma attack also helps. There should always be a plan in place to lessen the chance of an asthma attack on poor air quality days starting from a rescue inhaler to preventive medication if your doctor feels you need it.
Stay hydrated and breathe through the nose. Dehydration is dangerous for asthmatics especially when air quality is bad. In this case, lungs can become badly affected because they need right temperature and levels of water to work properly. It s crucial to breathe through the nose only and not the mouth as the air breathed in from the mouth can be very cold and dry and can cause even more inflammation of the lungs.
Know your asthma triggers and change lifestyle. Avoiding your triggers is key to managing asthma. If traffic fumes are a trigger, it s best to change the route you take to work to manage your asthma. If you don t know your triggers look back at your last asthma attack and remember what you were doing. Did you pet your dog? Write a diary and discuss with your doctor on how to avoid your triggers. Use a face mask when outdoors to limit exposure to allergens. 
Track your asthma to recognise early signs of asthma. If you know that it s getting worse, you should have a fool-proof plan in place.

Air Pollution - Tips to Prevent Asthma From Worsening!

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