discoordinated swallowing (dysphagia) with aspiration
apnea (breathing pauses) of prematurity and infancy
obstructive sleep apnea
chronic lung disease of premature infants
congenital lung abnormalities
immune deficiency diseases
gastroesophageal reflux disease
respiratory complications of neuromuscular weakness diseases
tracheostomy care
CPAP/BIBAP and home mechanical ventilation
Office and Hospital Consultations, Initial Visits and Follow-up Care Visits
Patients' problems are assessed by a thorough history and physical exam by the physician. Diagnostic testing is tailored to the specific issues for each patient. An action plan is developed to restore the patient to good health, normal activity and normal family lifestyle. Patients are provided with a notebook containing information about the practice, education handouts, special instructions, pulmonary function testing results and the daily action plan. Patient/family education about their illness is reviewed at every visit. Emphasis is placed on communication between the patient, family and physician/office staff and primary care physician.
Non-invasive diagnostic services performed in the office include
flow-volume loop spirometry before and after rescue inhaled bronchodilator
quiet breathing flow-volume loops in infants (requires some patient cooperation)
nasal cytology (examination of nasal secretions under a microscope looking for nasal allergy and infection)
rapid strep testing
RSV and influenza A and B testing of nasal secretions
nasal secretions culture
allergy skin testing for seasonal, year round and selected food allergens/pollens
We interpret non–invasive diagnostic services performed outside of the office including
flow-volume loop spirometry
lung volumes and diffusing capacity
pulmonary exercise stress testing
airway provocation with methacholine challenge
multichannel sleep studies
Invasive diagnostic services include
flexible laryngoscopy (directly looking at the voice box and vocal cords)
flexible bronchoscopy with lavage and ciliary biopsy if indicated (looking down the wind pipe and major branches of the large breathing tubes done under general anesthesia)
24 hour pH probe study (looking for gastroesophageal reflux disease)
immune deficiency disease screening and response to pneumococcal vaccine
Intravenous (IV) infusion services are available for patients with
immune deficiency diseases who need IV gammaglobulin
cystic fibrosis who need home IV antibiotics
persistent sinus infections who have failed treatment with oral antibiotics and need IV antibiotics
Synagis and Xolair Injections
Synagis injections for infants with extreme immaturity and infants with congenital heart disease and congestive heart failure who meet the criteria established by the American Academy of Pediatrics.
Xolair injections for patients with severe persistent asthma who meet the criteria established by the FDA.
