A pulmonologist is a doctor who specializes in treating lung diseases. They are responsible for preventing, diagnosing, and treating respiratory conditions. The pulmonologist diagnoses and plans treatment based on patient interviews, physical examinations, and tests.
Pulmonologists perform specialized tests like pulmonary function tests and bronchoscopy to assess lung function. They also develop treatment plans involving medications, respiratory therapy, or procedures to improve breathing. Pulmonologists work closely with other healthcare providers to offer comprehensive care for patients with respiratory disorders.
Among the diseases
that a pulmonologist diagnoses and treats are, among others:
Respiratory symptoms may indicate minor infections or serious conditions necessitating prompt medical attention. If persistent symptoms such as cough, hoarseness, or sleep-disordered breathing manifest, it is advisable to initially seek consultation with a primary care physician (e.g., family doctor, internist, or pediatrician). The primary care physician will conduct preliminary assessments and, if required, make necessary referrals to a pulmonologist or otolaryngologist or initiate appropriate treatment.
Symptoms of pulmonary diseases may include:
Upon visiting a pulmonologist, no specific preparation is required. However, it is advisable to bring along current laboratory test results and any chest imaging tests, if available, as these may aid in diagnostic procedures.
A consultation with a pulmonologist commences with a comprehensive medical interview, encompassing inquiries about the following:
The lung disease specialist may also ask us about our lifestyle and living conditions, as various environmental factors often affect the functioning of the respiratory system.
Like visiting doctors of other specialties, e.g., an endocrinologist and pediatrician, we can expect a medical interview from a pulmonologist. The information provided is an important clue when diagnosing and ordering further tests. The specialist will also perform an auscultation test using a stethoscope.
For the visit to be as effective as possible and to allow you to answer your questions and start the proper treatment, in other words, to be able to help you as best they can, it is essential to prepare for it properly.
The cause of ineffective treatment of asthma or COPD is often the incorrect technique of using inhaled medications. Even the best and most expensive medication will not work if it does not reach the lungs. During the visit, they pay great attention to assessing the inhalation technique (at this point, the inhalers used by the patient are needed) and correct it if necessary. They use various training inhalers and measure the patient's inspiratory flow to select the best inhaler for the patient.
In the case of reporting for a visit with an abnormal result of an X-ray or computed tomography (CT) of the chest, a comparison with previous tests, even from many years ago, if they are available, is crucial. The doctor must have access to the examination image (usually on a CD) and not just the description. It often allows to avoid unnecessary examinations or suggests the need for urgent diagnostics.
When shortness of breath or cough is reported, a basic chest X-ray is always worth performing because the information contained therein may help make a diagnosis.
Similar to radiological tests, it is advisable to have results from different periods for comparative analysis.
Without such data, specialists recommend conducting at least a morphology with a smear, CRP, ESR, TSH, creatinine, and ionogram (sodium, potassium, and calcium) as it may yield critical insights.
Cardiology documentation (especially echocardiography), gastroscopy results, and, if available, hospital discharge papers.
Sometimes, patients' complaints are related to medications they are taking, so it is a good idea to check this by reviewing the list of medications.
Before your visit, think about what symptoms you have experienced or are experiencing recently. Write them down and describe them in detail.
If you have had previous tests, you should bring them. They can help your doctor make a diagnosis and choose the proper treatment.
The pulmonologist may perform a physical examination. Therefore, it is worth being prepared to remove your upper body clothes.
Before your visit, think about what you want to ask the pulmonologist. A list of questions can help you remember significant issues and facilitate communication with your doctor.
Try not to smoke traditional and electronic cigarettes before visiting a pulmonologist so as not to affect the results of lung function tests. It is also worth refraining from drinking caffeine and doing intense exercise.
Then the pulmonologist will conduct a physical examination and, if necessary, order additional tests (some of them can be performed immediately in the doctor's office). Physical examination by a pulmonologist includes:
Diagnostic tests that help diagnose respiratory diseases include:
Diagnostics of respiratory diseases include a detailed medical interview, physical examination, and numerous additional tests, including imaging, laboratory, and respiratory function tests.
After making a diagnosis, appropriate treatment is necessary. In the case of lung diseases, it most often includes pharmacotherapy and lifestyle changes. The drugs taken are intended not only to alleviate the symptoms of the disease but also to eliminate its causes. Depending on the diagnosed disease, these may include:
In a patient with chronic respiratory failure, the doctor may prescribe home oxygen therapy, which significantly improves the quality of life. Unfortunately, it is associated with the need to take certain precautions (including avoiding sources of fire) and strictly follow the doctor's recommendations.
If necessary, the pulmonologist may qualify the patient for hospital treatment, including decompression procedures (this is how pneumothorax is treated, among other things) and surgical procedures (allowing, among other things, the removal of foreign bodies or neoplastic changes from the respiratory tract). Additionally, sanatorium stays can be beneficial for lung diseases, and their pulmonologist or family doctor may refer patients.
Pulmonary rehabilitation constitutes a multifaceted, interdisciplinary endeavor that, in conjunction with an individualized care plan, ameliorates pathological conditions and enhances physical fitness, mental well-being, functional capacity, social standing, and overall quality of life in individuals afflicted by respiratory impairments.
Notably, pulmonary rehabilitation programs primarily cater to patients with chronic pulmonary conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, bronchial asthma, interstitial lung diseases (e.g., pneumoconiosis, fibrosis, sarcoidosis), and lung cancer.
Furthermore, the application of rehabilitation protocols extends to encompass post-thoracic and upper abdominal surgeries impacting respiratory function, including but not limited to lung cancer surgery, lung volume reduction, lung transplantation, and upper abdominal procedures. Moreover, pulmonary rehabilitation modalities are instrumental in managing and rehabilitating patients with respiratory comorbidities, including obesity, chest wall anomalies, and neuromuscular disorders.
The confluence of pulmonary and cardiac rehabilitation programs is imperative for patients with concurrent respiratory and circulatory system pathologies.
Key objectives of pulmonary rehabilitation, germane to the majority of participants in rehabilitation initiatives, encompass the attenuation of disease symptoms, enhancement of cardiorespiratory-dependent physical aptitude, augmentation of musculoskeletal vigor and resilience, promotion of overall mobility and adeptness in daily engagements, mitigation of adverse affective states, fortification of self-assurance, enhancement of self-worth and overall wellness, cultivation of a realistic self-assessment, fostering self-regulation of symptoms and disease progression, facilitation of adherence to prescribed treatments, advancement of a health-conscious lifestyle characterized by suitable physical activity and tobacco abstinence, and limitation of other risk factors for respiratory and circulatory ailments.
Further aims include preserving social and professional engagement, reducing medical consultations and hospitalizations, mitigating exacerbation frequency, decelerating disease advancement, and extending survival duration.
Detailed goals depend on the individual needs of the patient, resulting from the type and course of the disease (diseases), psychosocial situation, and personal preferences. These may include:
Table of Contents
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