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Asthma Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient's names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Asthma Testing:

People with asthma are sensitive to different triggers in their environment. Triggers, or allergens, cause inflammation or swelling in your airways and make your asthma worse. An allergen is any substance that can bring on an allergic reaction.

Lung Function Test

What is a Lung Function Test?

A lung function test measures the capacity of the lungs to store and release air, to put oxygen in the blood and how quickly air comes in and out of your lungs. This test involves testing for gas exchange, inhalation tests, and spirometry rates.

Indications and Contraindication

The Lung Function Test is a series of tests performed to patients in order to evaluate the lungs, pulmonary reserve, detect abnormalities in the pulmonary and respiratory functions. It is also used to diagnose lung diseases such as:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Bronchitis
• Pulmonary fibrosis
• Emphysema
• Pneumonia

The lung function test should not be done to patients who have heart diseases, are under pain or are mentally incapacitated.

How do you prepare for a lung function test?

• Do not smoke 4-6 hours before the test.
• Wear comfortable clothes to make you breath easily and freely
• If you will be eating before the test, only have a light meal and avoid beverages with caffeine
• Follow your physician's instructions regarding the use of inhalers or bronchodilators

How does it feel? How long will it take?

The lung function test is a painless procedure that lasts for approximately 30 minutes depending on how many tests your physician has recommended. You will have to breathe through a mouthpiece with your nose restricted by clips so you might feel slightly uncomfortable during the test. You may also experience shortness of breath while doing the breathing tests. The lung function test takes approximately 30 minutes to finish.

Expected effects after the test:

There very little risks, complications and side effects after a lung function test. You might feel light-headed during and after the test. Patients who have respiratory problems may feel exhausted after the test.

Special instructions after the test:

If you experience exhaustion following the lung function test, you will need to recover and rest for a while before doing your normal activities. If possible, have a responsible adult drive you home as you might experience light-headedness after the test.

Interpretation of Results

Results for the lung function test vary with patient's age, sex, race, height and weight. Results are expressed in percentage values.

Normal Findings: Results are within the normal ranges, depending on age, sex, race, height and weight.

Lung function test includes and evaluates the following values:

Test	Value on obstructive diseases	Value on restrictive diseases
Forced Vital Capacity (FVC)	Less than expected value	Less than expected value
Forced expiratory volume in 1 second (FEV1)	Less than expected value	Less than expected value
Maximal midexpiratory flow (MMEF)	Less than expected value	Normal
Maximal volume ventilation (MVV)	Less than expected value	Less than expected value
Total Lung Capacity (TLC)	Higher than expected value	Lower than expected values
Expiratory Reserve Volume (ERV)	Higher than expected value	Lower than expected value
Residual volume (RV)	Higher than expected value	Lower or higher than expected value
Forced Expiratory flow (FEF)	Lower than expected value	Lower than expected value
Peak Expiratory Flow (PEF)	Lower than expected value	Lower than expected value

Abnormal Findings:

• Narrowing airways resulting to difficulty in expelling air out of the lungs (a condition called obstructive lung- caused by conditions such as asthma, chronic bronchitis, chest wall trauma, and emphysema)
• Inability to effectively expand the lungs and transfer oxygen to the blood (a condition called restrictive lung- caused by conditions such as pneumonia, inhalant pneumonitis and pulmonary fibrosis)

Notes:

In order for test results to be more accurate, you need to closely follow the instructions given to you while doing the test.

2. Antibody Test for IgE (RAST)

What is the Antibody Test for IgE (RAST)?

These tests are useful when skin testing is not possible or is inconclusive. A blood sample is taken and the level of an immunoglobulin associated with allergic reaction (allergen-specific IgE) is measured in a laboratory.

Indications and Contraindications:

An Antibody Test for IgE is done to diagnose food allergies, general allergies and asthma in patients.

How do you prepare for the Antibodies tests?

Fasting is not necessary before testing. There are no special preparations required prior to testing for Antibodies. Inform your physician if you are taking any kind of medications. It may be necessary for medications such as anti-depressants and anti-histamines to be discontinued about 3 days prior to the IgE antibodies test.

How does it feel? How long will it take?

This test requires a blood sample that is drawn from the veins on your arm. It is a painless procedure that usually lasts for a few minutes, about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein on your arm to draw blood. After the test, a small amount of throbbing might occur on the needle site

Expected effects after the test:

Normally, there are no major effects after the test. Commonly, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may occur.

Special instructions after the test:

After drawing the blood, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, do warm compresses few times a day. You may resume your daily activities after the test.

Interpretation of Results:

Normal Findings: Negative result of IgE indicate that you do not have an allergy to specific allergens

Abnormal Findings: High levels of IgE antibodies (positive results) indicate allergic reactions to certain allergens. IgE levels are also often higher on patients with asthma.

Notes:

• You may not need an allergy testing for mild allergic reactions.
• Allergy tests sometimes need to be repeated for accuracy, to prevent false-positive and false-negative results.

The Right Diagnosis and Treatment for Asthma

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical's  Personal Approach to Asthma

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer's, Diabetes, Parkinson's, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.