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Bronchoscopy is a procedure by which the doctor will pass a flexible scope through your nose and into your lungs. He can then take pictures and pieces of tissue if needed to send to the lab. The procedure takes about 10-15 minutes, with a total time in our office of approximately one hour. When you are awake you will be given home care instructions. Bring someone along to drive you. Click here for more information on this procedure.


Thoracentesis is the medical term used to describe a procedure that is used to drain a collection of fluid from the pleural space. The lungs are surrounded by two thin membranes within the rib cage. There is a small amount of surfactant between the membranes that allow them to slide over each other easily. There is normally no air, blood, or excess fluid between these two membranes.

When a significant amount of fluid collects between the pleural membranes, shortness of breath, cough, or chest pain may develop. The fluid collection is called a pleural effusion. Your physician will likely order a chest X-ray to determine the amount of fluid present, and based on the symptoms you have, physical exam, and radiological findings, may determine that you would benefit from having the fluid drained.

A thoracentesis may be done in the physicians office or in a hospital. The procedure is done with the patient sitting up. The physician will determine the best location to access the fluid collection. The skin is cleansed with antiseptic cleanser, and local anesthesia is provided. The physician uses a needle to access the space where the fluid collection is located, and the fluid is then drained into vacuum bottles.

The fluid may be sent to a lab for testing to help determine the cause of the fluid collection.


CT scans are frequently ordered and a diagnostic tool for a variety of lung problems. CT scans can be done in a hospital or an outpatient imaging center. There are various techniques used for CT scanning. Your physician will determine the type of scan that will provide the best chance for diagnosis in your specific situation.

Some CT scans are ordered with contrast dye. If you have had problems with IV dye in the past, you should notify the physician ordering the test. If you have high blood pressure, diabetes, or are over the age of 65, your doctor will also order a blood test to check your kidney function before IV dye is administered.

You should not have anything to eat or drink for 4 hours prior to your CT scan. Please arrive at the facility performing your scan 30 minutes before your scheduled test. If you will need a blood test done before your test, you need to arrive about an hour before your test.


A PET scan is usually ordered when a lung nodule, lung mass, or swelling of the lymph nodes in the chest has been identified with a CT scan and warrants further evaluation. A PET scan may also be ordered to determine the stage, or spread of a known cancer.

A PET scan identifies areas of high metabolism, which are characteristic of fast-growing cells. In some cases, a PET scan may identify inflammation. A PET scan that is considered negative is a good predictor that the area identified on the CT scan is likely benign. If a PET scan is considered positive, your physician will make recommendations for further follow-up or diagnostic studies.

There are 3 or 4 PET scanning centers in the Kansas City area. If a PET scan is ordered by your physician, our staff will contact the center your insurance prefers you use, and provide them with the information required for them to pre-certify the study with your insurance company. The PET center will contact you and set up your appointment for your scan and give you pre-procedure instructions. After your scan, the results will be sent to your doctor. You can set up an appointment after your PET scan to discuss the results with your doctor.

PFT (Pulmonary function test)

This is a basic lung function test. It will determine how big a breath you can take, how fast you can exhale air, and what your total lung capacity is. You will breathe through a mouthpiece and perform several breathing maneuvers. You may be given some breathing medicine. The test may take 20-30 minutes, and may be done on follow up visits to follow response to treatment.


This is a single breath test to check the severity of your shortness of breath, or to detect response to breathing medications. You will take a deep breath in, then blow through a mouthpiece as hard as you can, and as long as you can. This may be repeated 2-3 times. The test takes less than 5 minutes, but gives less information than a PFT.

MCT (methalcholine challenge test)

Also known as asthma challenge test.

This is a breathing test, similar to a PFT, but involves breathing some medicine to determine if you have asthma. You will probably breathe 5 successive strengths of medication, performing a short breathing test between doses. You will be given 2 puffs of Albuterol before the last breathing maneuver and at the end of the test. The test should take about one hour.

ABG (arterial blood gas)

This test is done at the hospital on an outpatient basis. A Respiratory Therapist draws a blood sample from an artery in your arm or wrist. Direct pressure is placed on the puncture site to stop any bleeding. The therapist will place the blood in an analyzer to determine oxygen, carbon dioxide levels. The results will get to your doctor. The test should take about 10-15 minutes in total.


This test measures oxygen saturation in your blood. It is painless. The therapist or nurse puts a clip on your finger that sends a light beam through your finger and gives us your oxygen level and heart rate. This is done at rest and while walking.


Your physician may prescribe oxygen for you if your body is not able to maintain an adequate oxygen level. The level of oxygen in your blood can be measured with a finger probe attached to an oxygen saturation monitor, done in the office. Your doctor may also want to order a blood test called an arterial blood gas. This test is generally done at a hospital lab. This test is more accurate while measuring other variables including carbon dioxide, carbon monoxide and pH levels.

Oxygen can be provided in various forms, in a concentrator, in a liquid form, or as compressed oxygen. Your doctor will determine which type of delivery will best meet your needs.

To obtain supplemental oxygen, one must meet specific medicare guidelines including a doctor’s prescription. Oxygen may be prescribed to help with short-term needs, such as recovery from surgery or pneumonia. As a long-term treatment for chronic illnesses, like emphysema, oxygen must be monitored periodically by your physician.

It is important to observe safety precautions while using oxygen. Oxygen causes fires to burn more readily. Do not smoke near oxygen. The medical equipment company that supplies your oxygen for you should instruct you in the safe handling of your equipment and your safety while using oxygen.

MSLT (Multiple Sleep Latency Test)

May be done to confirm excessive sleepiness. It is often used to check for narcolepsy. Testing is done during the day, generally after a sleep study has already been performed. It involves some of the same leads and monitoring equipment as a sleep study, and requires taking several naps. Your napping patterns will be analyzed, and your doctor can discuss with you the results.

MWT (Maintenance of Wakefulness Test)

Testing done during the day to evaluate the effectiveness of your sleep treatment. Not needed for all persons with sleep apnea or sleep disorders, but useful in some who’s jobs or personal lives require proof that your sleep problems are treated.