Chest X-Ray
A chest X-ray gives a black and white picture of your lungs, ribs, heart, and diaphragm muscles.
How do I prepare for the test?
For a chest X-ray, usually you will be asked to remove your shirt (and bra), and to wear a gown. You will also be asked to remove any necklaces. You must tell the radiologic technologist if you are or might be pregnant.
What happens when the test is performed?
Most of the time, chest X-rays are done with the patient standing. A technologist will help position
you against the film (which looks like a large board) so that the clearest picture may be obtained. Usually a front view and a side view are taken. You will be asked to take in a deep breath just before each picture is taken. The technologist will leave the room or stand behind a screen while your X-ray picture is taken.
How long is it before the result of the test is known?
Typically, your physician will obtain the results in two or three days.
If there is anything we can do to make you more comfortable while in the Radiology Department, please do not hesitate to ask.
Ultrasound – Abdomen (gallbladder, liver, pancreas, spleen)
Ultrasound is a painless way to view the structures inside your abdomen using sound waves and a type of sonar detection system that generates black and white pictures.
Ultrasound of the abdomen is useful for finding gallstones and looking for fluid around the abdominal organs. With ultrasound, it is difficult to get a clear picture of organs that are filled with air (such as the stomach or intestines).
How do I prepare for the test?
You will be asked not to eat on the day of the test. Food in your stomach causes your intestines to fill with extra air while you are digesting your food. This makes it more difficult for us to see the structures we are trying to see.
If you have diabetes and take insulin, discuss with your physician what you should do before the test. Your physician will instruct you on how you should manage your diabetes on the day of your test.
What happens when the test is performed?
You will lie on your back during the test. A sonographer will first apply a clear jelly on your lower abdomen. This helps the ultrasound sensor slide more easily over your abdomen when the sensor is placed against your skin. The sensor looks like a microphone.
When the sensor is in place, a picture will appear on a video screen, and the sonographer will move the sensor back and forth over your abdomen to see the internal organs from different views.
If you feel any soreness or pain where the sensor it pushing against your body you should tell the sonographer. In some cases, this discomfort might indicate a possible problem.
Must I do anything special after the test is over
The jelly will be wiped off. You will have no side effects from this test.
How long before the result of the test is know?
Typically your physician will obtain the results in two – three days.
If there is anything we can do to make you more comfortable while in the Ultrasound Department, please do not hesitate to ask.
Barium Swallow or Upper GI Series
A barium swallow or Upper GI series is an X-ray test used to examine the upper digestive tract (the esophagus, stomach, and small intestines). Since these internal organs are normally not visible on X-rays, you will be asked to swallow a liquid (barium) that shows up on X-rays. The barium will temporarily coat the inside lining of the esophagus, stomach, and intestine, allowing the outline of these organs to be visible on the X-ray pictures.
How do I prepare for the test?
You will be given instructions to stop eating and drinking on the night before your test. This is important because food in your stomach or intestine could prevent the physician from seeing a clear outline of these organs. Usually it is not a problem for you to take your regular medications, but you should check this with your physician. Make sure that your physician and the radiologic technologist know if you are or could be pregnant.
If you have diabetes and take insulin, discuss with your physician what you should do on the day of your test.
What happens when the test is performed?
You will be asked to change into a hospital gown. Prior to the start of the test, you will be asked to drink a thick white liquid (barium) that some people describe as “chalky”. You might also be given some tablets to swallow. These tablets fizz, causing air bubbles to be released in your stomach. This might make you feel like burping, but you should try not to. We will get better pictures if you can keep yourself from burping.
The technologist may ask you to stand or lie in different positions during the test. This helps to spread around the liquid you have swallowed. Most often, the actual X-ray pictures are taken while you lie on your back on a table. The X-ray machine or the table will be moved a few times so we can get pictures of all the internal structures. You will be asked to hold your breath for each picture because the motion associated with breathing can blur the image.
Must I do anything special after the test is over?
After the test, you can eat normally and perform normal activities. You should drink more water than usual to help clear out the barium and to prevent constipation, which can be a side effect of the test. Your stool may appear light in color for a couple of days
How long before the result of the test is known?
Typically your physician will obtain the results in two – three days.
If there is anything we can do to make you more comfortable while in the Radiology Department, please do not hesitate to ask.
Pulmonary Function Tests (PFTs)
Three tests are usually performed to help measure how well your lungs are able to inhale and exhale air. The tests also show how efficiently oxygen is being transferred from your lungs into your blood stream.
Specifically, what tests are usually performed?
Spirometry measures how well you exhale the air in your lungs. This test can help determine if you have any lung diseases such as asthma or chronic obstructive pulmonary disease (COPD).
A lung volume measurement will help detect a restrictive lung disease. A person with a restrictive lung disease cannot inhale a normal volume of air. Sometimes this is a result of inflammation or scarring of the lung tissue. It can also be a result of abnormalities of the muscles or bones in the chest area.
A diffusion capacity test (also know as a DLCO) will give an estimation of how effective your lungs are in transferring oxygen from the air you breath into your bloodstream.
How do I prepare for these tests?
It is recommended that you do not eat a heavy meal prior to the test. If you smoke, you should not smoke for six hours prior to the test. If your physician has requested that inhaler medications be used for this test, you will be given specific instructions when you schedule this test.
What happens when these tests are performed?
You will meet a respiratory therapist who will be performing the tests. He or she will review with you what to expect during the testing. The tests are not painful and you will be able to remain in your own clothing. If at any time you are having difficulty, it is important to let your therapist know.
Spirometry—You will be asked to breathe into a mouthpiece that is attached to a circular device, which is called a spirometer. The spirometer will record the amount of air that you are breathing in and out. To help us get an accurate reading, a nose clip may be used. This will not hurt but may be a little uncomfortable. You may be asked to breathe normally or to take a deep breath and to blow the air out of your lungs as if you were blowing up a balloon.
Lung Volume Measurement—There are several different ways that this test can be performed. The staff at the location where you choose to have this test done will provide you with specific instructions. This test measures the volume of air your lungs can hold.
Diffusion capacity—You will be asked to take a breath (usually one) of carbon monoxide. This test is safe; it will not hurt or poison you. When you exhale, we will measure the amount of carbon monoxide. By comparing the amount of carbon monoxide inhaled with the amount exhaled, we can determine how quickly oxygen travels from your lungs to your blood.
How will these tests feel?
The tests will not hurt, but you might experience some lightheadedness or shortness of breath. It is important that you tell your therapist how you are feeling during the test.
During the testing, it is very important that you follow all instructions very carefully. A poor seal around the mouthpiece of the spirometer or not following the directions of the therapist could provide inaccurate results. To ensure the best care possible, we must provide an accurate measurement of your lung function to your physician.
Must I do anything special after these tests are performed?
After the tests, you may eat normally and perform your normal activities.
How long before the results of the tests are known?
Typically your physician will obtain the results in 2 – 3 days
If there is anything we can do to make you more comfortable while in the Cardio-pulmonary Department, please do not hesitate to ask.
Electrocardiogram (EKG)
An electrocardiogram (EKG) is a recording of the heart’s electrical activity. In addition to recording your heart rate and heart rhythm, this test can detect a decreased flow of blood to heart muscle and an enlarged heart.
How do I prepare for the test?
This test can be performed at any time of day and does not require fasting. However, if you are having this test before scheduled blood work, please check with your physician to see if you can eat and drink before your EKG, because your blood work might require that you fast. We suggest that you wear loose-fitting clothing so you are more comfortable.
What happens when the test is performed?
You will be taken to an examination room and asked to remove your clothing from the waist up. Once your clothing has been removed, you will be asked to lie on a table. We will do everything we can to protect your privacy and provide you with a cover for your chest. However, we may not be able to provide a cover until we have prepared you for the EKG.
The technician will place quarter-sized sticky gel covered pads, called electrodes, to your chest. These will be applied from the middle of your chest towards your left arm. They will also place a gel pad on each leg and each arm.
After the pads have been applied, the technician will clip the EKG leads to the tab on the electrode—you will not feel this. Once the technician is satisfied that everything is placed where it should be, you will be asked to lie very still.
This test will take about one or two minutes and does not hurt.
If your physician has ordered an exercise stress test you may be required to walk on a treadmill or ride a stationary bike while your EKG is performed. If an exercise stress test has been ordered, you will receive specific instructions from the technician when you schedule your appointment.
What happens when the test is finished?
Once the EKG is completed, the machine will provide a tracing (picture) of your heart rhythm and electrical activity.
The technician will examine the tracing to make sure that all areas of the heart were examined. If the technician is satisfied with the tracing, the gel pads (electrodes) will be removed and you may get dressed. If not, the EKG may be repeated.
Must I do anything special after the test is over?
Once the technician is satisfied that an accurate tracing has been obtained, you will get dressed and be free to leave.
How long before the result of the test is known?
Your physician may have made arrangements with a cardiologist (heart specialist) to interpret your EKG. Your physician should have an interpretation of your EKG in two or three days. If anything significantly abnormal is detected, your physician will be notified immediately.
If there is anything we can do to make you more comfortable while in the Cardio-pulmonary Department, please do not hesitate to ask.
Echocardiogram (Echo)
This is a painless test that uses sound waves to get a picture of your heart. The sound waves bounce off your heart and heart valves, producing an image. This test does not use radiation. It relies upon sound waves that are conducted through a clear gel that is applied to the chest. From this image, the physician can detect any damage to your heart or heart disease. This test will also show how well the walls of your heart are contracting (pushing the blood throughout your body).
Why is this test performed?
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The Echocardiogram can tell your physician many things. It is a common test that is performed to detect:
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Cardiomyopathy—heart muscle that is thick, weak, stiff, or too big.
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Congestive heart failure—a problem with the heart valves, circulation to the heart muscle, or the chambers of the heart.
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Coronary artery disease—the vessels providing blood to the heart muscle are obstructed due to possible hardening of the arteries. Hardening of the arteries is called atherosclerosis.
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Cardiac ischemia—inadequate oxygen supply to the heart muscle. This is usually a result of atherosclerosis.
How do I prepare for the test?
If your physician has ordered a routine echocardiogram, there is nothing special you need to do before the test. This test can be performed at any time of the day and does not require fasting. However, if you are having this test before scheduled blood work, please check with your physician to see if you can eat and drink before your Echo, because your blood work may require that you fast. We suggest that you wear loose-fitting clothing so you are more comfortable.
What happens when the test is performed?
You will be taken to an examination room and asked to remove your clothing from the waist up. Once your clothing has been removed you will be asked to lie on a table. We will do everything we can to protect your privacy and provide you with a cover for your chest. However, we may not be able to provide a cover until we have prepared you for the Echocardiogram.
The technician will apply some conductive gel on your chest. This is a clear gel that helps to produce a picture of your heart and valves.
The technician will gently rub a hand-held device, called a transducer, on your chest.
The transducer is able to send and receive sound waves. The sound waves received by the transducer are then converted into a picture of your heart and heart valves.
Once the technician is able to obtain a good picture of your heart, the lights in the room will be turned down. This helps the technician obtain the best picture quality.
The pictures are then saved electronically, in paper form, or on videotape.
This test will take approximately 30 – 45 minutes.
Must I do anything special after the test is over?
Once the technician is satisfied that an accurate picture has been obtained, you will get dressed and be free to leave.
How long before the result of the test is known?
Your physician may have made arrangements with a cardiologist (heart specialist) to interpret your echocardiogram. Your physician should have an interpretation of your echo in two or three days. If anything significantly abnormal is detected, your physician will be notified immediately.
If there is anything we can do to make you more comfortable while in the Cardio-pulmonary Department, please do not hesitate to ask.
Upper Endoscopy
An endoscopy allows the physician to examine part of the upper digestive system. The physician will examine the esophagus to see if you have polyps (abnormal tissue growth), ulcer disease (irritated tissue lining the esophagus) or any signs of bleeding.
How do I prepare for the test?
You will be given instructions to stop eating and drinking on the night before your test. This is important because you will be given a mild sedative during the test.
Usually it is not a problem for you to take your regular medications, but you should check this with your physician. Make sure that your physician and the radiologic technologist know if you are or could be pregnant.
If you have diabetes and take insulin, discuss with your physician what you should do on the day of your test.
What happens when the test is performed?
This test can be performed in the hospital or a Same-day Surgery Center.
It is very important that you bring someone with you who can drive you home after the test is performed.
Once you are registered and you meet the nurse, you will be asked a series of questions. Some of the questions you will be asked are:
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Have you had anything to eat or drink since midnight last night?
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Are you allergic to any medications, latex (balloon material) or food?
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What medications do you regularly take?
If you regularly take medications, it might be helpful to write down the name of the medication, the strength of the medication, and how often you take it. Please be sure to include any over-the-counter medications, supplements, or herbal supplements that you take.
You will be asked to change into a gown and to remove any jewelry, dentures or body piercings. You should give your valuables to the person who accompanied you to the hospital.
An intravenous catheter (IV) may be inserted to administer medications during the test.
You will be given a mild short-acting sedative, which will make you groggy. You will not be “put to sleep” (general anesthesia) for this test. An anesthetic will be sprayed in your throat, which will help you not to cough or gag during the procedure.
Once the anesthetic has taken effect, a small tube is passed down your throat. Since you have been sedated and your throat has been anesthetized, this should not bother you.
The small tube is called a scope. The scope contains a very small camera that will allow the physician to look at your esophagus and stomach.
Once the area has been examined, the scope will be removed. Since you have been sedated, you should feel little or no discomfort.
Must I do anything special after the test is performed
After your test is performed, you will be in a recovery area for approximately one hour.
While in the recovery area, a nurse will check your heart rate, blood pressure, breathing, oxygen level, and gag reflex.
After the short-acting sedative has worn off and your physician has given you discharge instructions, you will be free to leave with the person who will be driving you home.
Your discharge instructions will provide specific instructions on when you can eat and drink.
How long before the result of the test is known?
Typically, you will get the results from your physician in three to five days.
If there is anything we can do to make you more comfortable while in the Endoscopy Department, please do not hesitate to ask.
Polysomnogram (Sleep Study)
Before we discuss what a sleep study is, it would be better to describe a normal sleep pattern. When you sleep, there are two different stages that are normally experienced. One stage is called NREM (Non-Rapid Eye Movement) and the other stage is REM (Rapid Eye Movement). The duration of the different stages of sleep will vary among individuals based upon age and health.
REM sleep is associated with dreaming and muscle paralysis except for the eye muscles and your diaphragm. This sleep stage is sometimes referred to as “Dream Sleep”. When you are in a REM stage of sleep, your breathing may become irregular, your heart rate will increase, and your eyes move rapidly. During this time, your brain requires extra oxygen. The dreams that you have during REM sleep are often very active and very vivid.
NREM sleep has several stages: light sleep, true sleep and deep sleep. The NREM sleep is said to contribute to psychological rest and might even boost the immune system.
Light sleep usually lasts for five to 10 minutes. This is the time between waking and sleeping.
True sleep is deeper than light sleep. In this stage, the eye movements usually disappear, your muscles relax, and there is very little body movement. Usually, fragmented thoughts and images will pass through your mind.
During deep sleep (sometimes called delta sleep), your heart rate and the number of times you breathe in a minute will slow down. As your sleep becomes deeper, it is more difficult to be awakened.
When people have difficulty sleeping, they may experience depression, irritability, sexual dysfunction, early morning headaches, learning and memory difficulties and heavy snoring. Sometimes it is a spouse or friend who will notice these changes. It is important that you see your physician and explain the symptoms that you have. You might have sleep apnea. Sleep apnea should be diagnosed and treated as soon as possible because it may be associated with irregular heart beat, high blood pressure, heart attack, and stroke. Apnea means there is no airflow (breathing) for periods 10 seconds or longer.
Who gets sleep apnea?
Sleep apnea occurs in men and women of all ages. It is estimated that 18 million Americans have sleep apnea. People who snore loudly, are overweight, have high blood pressure, or have a problem with their upper airway might be at increased risk for sleep apnea.
What is sleep apnea?
It is a breathing disorder characterized by brief interruptions (10 seconds or longer) in breathing while you are sleeping. There are two types of sleep apnea:
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Central— the brain does not send the signals to the breathing muscles to take a breath. This type is not very common.
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Obstructive—air does not flow in and out of your nose or mouth even though you are trying to take a breath. This type is more common.
What causes sleep apnea?
Sometimes the throat muscles and tongue relax so much that they partially block the opening to your airway.
Sometimes the muscles at the back of your tongue and the small fleshy tissue that hangs at the back of your throat (it looks like a punching bag) relax and sag into the airway opening.
Some obese people may have a small airway as a result of the amount of tissue in the airway passage. Since the airway may be narrow, air cannot flow into or out of the nose and mouth.
All of these result in heavy snoring, periods of no breathing, and frequent arousals (wake up periods) from sleep.
If I have sleep apnea, how will it be treated?
There are currently three treatment options available for individuals with sleep apnea. Your physician would select a treatment plan based upon your individual needs and your medical history. The three options are:
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Behavioral therapy—For individuals with mild cases of sleep apnea, behavioral therapy may be all that is required. Individuals would need to avoid using sleeping pills, alcohol, and tobacco, which affect the airway by making it more prone to collapse during sleep. Overweight individuals will have improvement with weight loss.
CPAP (Continuous Positive Airway Pressure) is the most common, effective treatment therapy for individuals with sleep apnea. The individual wears a mask over the nose or over the nose and mouth during sleep. The mask is connected to a small machine located next to your bed that provides air under pressure. The machine continuously delivers the air under pressure, helping to increase the amount of air you breathe without increasing the work of breathing. The amount of air pressure is adjusted to each individual based upon the severity of the sleep apnea. As you breathe, the air, which is under pressure, passes through the nose to help keep the throat from collapsing (relaxing and making the airway smaller).
If I have sleep apnea, how is it diagnosed?
Your physician may order a sleep study (Polysomnogram). This test will record several body functions while you are sleeping. Some of the functions measured are electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory rate and effort (how hard your muscles work to breathe), and oxygen levels in your blood. This test will help your physician diagnosis sleep apnea and determine how severe it is.
This test is performed in a sleep study center.
What is a sleep study (Polysomnogram)?
This test monitors your brain waves (EEG), electrical activity of your muscles, breathing rate and pattern, blood pressure, oxygen levels in your blood, and heart rate and rhythm while you are sleeping. There is a trained healthcare provider present to observe you during this test.
How do I prepare for the test?
The Sleep Study Center will provide you with specific instructions for the test. You should not take any sleeping medication, drink alcohol or drink any beverages with caffeine in them before this test.
What happens when this test is performed?
This test is usually performed in a Sleep Study Center. This test is usually done in the daytime; however, your physician may order the test to be done at night so your normal sleep pattern can be monitored. You will be asked to lie on a bed in the test center. Electrodes (sticky gel coated pads) will be placed on the scalp, near the outer edge of the eyelids, and on your chin. You might also have electrodes placed on your chest just like when you had your EKG.
Just like during the EKG, small leads will be attached to the pads so recordings of your brain waves, heart rate and rhythm, and muscle activity can be monitored and recorded. This will not hurt, but may be a little uncomfortable.
A recording will be made while you are awake, while you are falling asleep, and when you are in REM sleep. Sometimes a video camera is used to record the different positions of your body while you are sleeping.
Must I do anything special after the test is performed?
Once the technician is satisfied that the study has captured how your body reacts before sleep and during sleep, you will get dressed and be free to leave.
How long before the result of the test is known?
Your physician should have an interpretation of your Sleep Study in about seven to 10 days. If anything significantly abnormal is detected, your physician will be notified immediately.
If there is anything we can do to make you more comfortable while in the Sleep Study Center, please do not hesitate to ask.