One of the most fun things I got to do on this rotation was take my own pulmonary function tests (PFTs). PFTs are a battery of breathing tests commonly ordered to characterize asthma, chronic obstructive pulmonary disease, and other lung abnormalities. At its most complex form, the set-up is the one shown above. There is a "body box" which can be completely sealed so the machine can precisely measure changes in volume and pressure.
You put your mouth on the device shown above which can deliver various combinations of gases and measure pressures, flow, and volume of breathing. We went through basic spirometry as it is taught in medical school; I breathed normally, then inhaled to my maximum and exhaled as quickly and completely as I could. I then did a handful of other maneuvers from inhaling and exhaling as hard as I could against a closed valve (calculating maximum inspiratory and expiratory pressures) to breathing in large volumes as rapidly as I could (to test for diaphragm weakness). I also breathed in a whole bunch of different gases: carbon monoxide to calculate diffusing capacity, methane, and 100% oxygen as two separate methods of calculating total lung capacity. The data generated included graphs like this:
Overall, it was a great way to spend the afternoon. It was highly educational, both in reviewing basic lung physiology, formulas, and relationships, but also in interpreting data. Seeing my own graphs and numbers was far more fascinating and relevant than reading a textbook chapter. But moreover, I found it really important to learn what a patient experiences when we ask him to do pulmonary function tests. It wasn't as easy as I thought it would be, and I'm a healthy person. I can't imagine how hard it must be for someone with lung problems. I think it's educational, fun, and important for providers to undergo some of the tests their patients have to take, and this was a great experience for me to do so.All three images are shown under GNU Free Documentation license, from Wikipedia.
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4 comments:
(This comment has nothing to do with this specific post). I'd just like to thank you for putting in so much of your valuable time into this blog, it's really been valuable to me in ways which I wouldn't have understood prior to reading this. Your posts are incredibly insightful and they have really reiterated my desire to go into medicine. I've thought of becoming a doctor for years and after volunteering at UCSF this summer I really got to see what its all about. The only thing that I really missed out on was everything that you've described in your blog, the surgeries, life threatening situations, philosophical and ethical conundrums that residents such as yourself face. I hope to be in your position in a couple of years.
Thanks
-High School Student
thank you for your kind words and best of luck in the future!
Craig
Hi Craig: Wanted to let you know about a new device for pulmonary rehabilitation. It is called the Respift S. You can find more information on it at www.respifit.net. Provides the patient biofeedback and the ability to do strength and endurance training. There have been a lot of studies about inspiratory muscle training as well if you need them.
Thanks, Dave
very cool, I'll look into it!
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