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Dr. Ellie Golestanian, MD is a pulmonologist in Monroe, WI specializing in adult pulmonology, hospital medicine (hospitalist) and critical care (intensive care medicine). She graduated from University College London (UCL) Medical School. Dr. Ellie Golestanian, MD is affiliated with SSM Health and UW Health.
Bronchoscopy
Bronchoscopy is a procedure in which a thin tube with a camera, called a bronchoscope, is inserted in the mouth or nose and slowly advanced to the lungs. This allows doctors to see the respiratory tract, which includes the throat, larynx (voice box), trachea (windpipe), bronchi (airways), and lungs. Doctors may recommend those who have or show signs of lung problems - for example, lung cancer or difficulty breathing - to undergo a bronchoscopy.
In performing a diagnostic bronchoscopy, doctors may only wish to visualize the respiratory tract, or doctors may also collect samples of tissue or fluid. The samples can help diagnose patients' conditions or, if patients have cancer, they can be used for staging purposes. One method for sample collection is bronchoalveolar lavage. In a bronchoalveolar lavage, doctors inject saline (salt water) through the bronchoscope and then suction it out of the airways. The washout collected is tested for lung disorders. Doctors can also insert a biopsy tool to collect tissue or mucus samples. The following are biopsies that can be performed by bronchoscopy:
For visualization, bronchoscopy can be done alone, or it can be combined with ultrasound. Endobronchial ultrasound (EBUS) allows real-time imaging of the airway and is used for diagnosing and staging lung cancer, as well as for determining where the cancer has spread. EBUS can be performed with TBNA, a procedure known as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
Doctors can also use bronchoscopy as a treatment for lung problems. For example, if a foreign body is trapped in the airway, doctors can insert forceps through the bronchoscope to remove it. If the airway has become narrowed - which may occur if patients have an infection, cancer, or some other inflammatory issue - bronchoscopy can be used to place a device called a stent in the area of constriction. The stent will keep the airway open, allowing the patient to breathe properly.
During a bronchoscopy, patients will be given medication (sedative) to help them relax. If it is only a diagnostic bronchoscopy, patients will be kept awake, but if the bronchoscopy is for therapeutic purposes, patients will be put to sleep by general anesthesia. After the procedure, patients will need to stay in the hospital for a few hours. They will not be able to eat or drink for about 2 hours. Some patients may experience discomfort, such as a sore throat or pain while swallowing. Throat lozenges and gargling may help alleviate these symptoms, which should go away after a few days. Patients will need to have someone drive them home once their doctor determines that they are ready.
Pulmonary Stress Test
There are a number of different types of pulmonary stress tests, but they are all similar in that they measure how exercise affects the level of oxygen in the blood. A pulmonary stress test may be done to identify a specific level of impairment, or to see how well a treatment (such as inhalers or steroids) is working.
During the test, heart rate, blood pressure, oxygen level, and breathing may all be measured. Patients may be asked to wear a mask that measures how much oxygen they breathe in and how much carbon dioxide they breathe out. Then patients will be asked to exercise: It is the exercise that 'stresses' the body. Patients may be asked to walk around for a few minutes, to walk on a treadmill, or to pedal a stationary bicycle as far as they can.
A pulmonary stress test can see how well the heart, lungs, and muscles all work together when someone is moving around. It is used to identify heart disease, problems with lung function, to identify a need for supplemental oxygen, or simply as a measure to see how well a patient is able to tolerate exercise.
While physicians will give their patients specific instructions prior to the test, it is generally a good idea to wear comfortable clothes to exercise in and closed-toe shoes. Patients shouldn't do any heavy exercise right before the test. The test is painless and can be expected to take about an hour.
Dr. Ellie Golestanian, MD graduated from University College London (UCL) Medical School. She completed residency at Jefferson University Hospitals. She is certified by the Critical Care Medicine Pulmonary Disease and has a state license in Wisconsin.
Medical School: University College London (UCL) Medical School
Residency: Jefferson University Hospitals (1996)
Board Certification: Critical Care Medicine Pulmonary Disease
Licensed In: Wisconsin
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Dr. Ellie Golestanian is a specialist in hospital medicine (hospitalist), critical care (intensive care medicine), and adult pulmonology in Monroe, WI and Madison, WI. Dr. Golestanian's areas of expertise include the following: bronchoscopy and pulmonary stress test. Before performing her residency at Jefferson University Hospitals, Dr. Golestanian attended the University College London (UCL) Medical School. She is professionally affiliated with UW Health and SSM Health.
