Breathing New Life Into Pulmonary Care At St. Clair Hospital

As you may have read here, St. Clair Hospital is dedicated to providing quality lung care to Pittsburgh and western Pennsylvania alike. Our pulmonary care options are particularly important due to the number of lung health issues that impact local residents. From lung cancer, to chronic obstructive pulmonary disease, to asthma, there are many potential sources of poor lung health.

By its very nature, poor lung health is a challenge that needs to be overcome as quickly as possible, as noted by St. Clair Hospital’s own Andrew Perez IV, M.D. “Why do people get short of breath? There are so many possibilities,” he says, referring the diagnostic challenges that come with his profession. In addition to multiple physical causes of short breath, it’s possible for anxiety or mental health issues to become a false diagnosis for patients who need specialized care.

“I teach medical students and residents that they should never write off shortness of breath as anxiety – in fact, that should be the last thing to consider,” says Dr. Perez. “Shortness of breath creates anxiety for most people. Breathing comfortably impacts quality of life.”

Fortunately, at St. Clair Hospital staff members such as Dr. Perez have the ability to use new minimally invasive diagnostic technologies that can help them get to the root of a patient’s problems quickly and efficiently. As a result of these technologies, our staff can work more quickly than ever toward restoring the quality of life of our patients – all at a much faster, less invasive pace than what was once possible.

About The Technology Changing Pulmonary Care

Newer diagnostic tools in pulmonary healthcare make a big difference at hospitals such as St. Clair. Comparatively, in the past, surgery (under general anesthesia) was necessary to obtain the lung biopsies that could help doctors discover what was happening inside of a patient’s chest. Now, however, newer procedures are done on an outpatient basis, with light sedation. Patients now can recover and head home more quickly, no surgery required – and their doctors can get a clear picture of their lungs without a single incision.

This new process is thanks to modernized, minimally invasive diagnostic technologies, known collectively as interventional pulmonology technologies. Under this label include procedures such as:

• Endobronchial Ultrasound (EBUS). EBUS is a sophisticated procedure that combines bronchoscopy with ultrasound (diagnostic sound waves). Here’s how it works: a special bronchoscope with a light, an ultrasound probe and a tiny needle at its tip is placed through a patient’s mouth and carefully slid into the trachea and large airways. “It’s an ultrasound from within,” explains St. Clair Hospital’s Patrick G. Reilly, M.D. of Pittsburgh Chest Physicians. “It enables us to locate something on the other side of the trachea or bronchial wall. We can locate lesions in the lung and can actually see through the probe. We obtain tissue and fluid samples for biopsy and have cytology studies done, to diagnose cancer, infection and other things like lymphoma and sarcoidosis. It’s very helpful for patients with known cancer, for determining the stage of the cancer.”
• Navigational Bronchoscopy. This procedure utilizes special software to identify targets in the lung and then guide a probe right to them. “First, we do a CT scan, and enter that information into a computer,” Dr. Reilly says. “With a special probe through the bronchoscope, we gather more information that goes to another computer. The two computers are linked and together they create a three-dimensional reconstruction of the lung. It uses GPS-like technology to give us a map of the lungs and navigates the end of the probe right to the lesion, while we watch it on screen. We can get very far out in the lung and get a biopsy. Without it, the patient would have to have surgery.”
• Transbronchial Biopsy. This final procedure is done with fluoroscopy – also known as real-time X-ray technologies. This, says Dr. Reilly, is most useful for looking at more diffuse, interstitial lung diseases. For example, this biopsy would be better for finding sarcoidosis than a specific lesion. “With the bronchoscope, we are able to go as far out as possible with biopsy forceps and take a number of biopsies that are very sensitive for certain diseases.”

Any one of these three procedures enable the pulmonologists at St. Clair to make a diagnosis with greater accuracy and speed. They expedite the earlier diagnosis of diseases such as lung cancer and thus improve survival. For St. Clair’s patients, these procedures also mean there is no need for diagnostic surgery  – and no anesthesia, no incision, no post-operative pain, and no overnight admission to the Hospital.

Rehabilitation: Restoring Quality Of Life

New technology is a critical part of modern care at St. Clair Hospital. However, these procedures are just the beginning in a patient’s journey. Ultimately, the simple exercises associated with pulmonary rehabilitation are key elements in restoring quality of life to patients with lung disease, according to Stephen G. Basheda, D.O., Chief, Pulmonary Diseases, at St. Clair Hospital.

“Pulmonary rehab is one of our best assets at St. Clair and is vitally important in the treatment of [illnesses such as chronic obstructive pulmonary disease],” Dr. Basheda notes. “People with lung disease become deconditioned, which worsens their shortness of breath and depletes their energy. They become progressively more sedentary, which leads to further deconditioning. Pulmonary rehab breaks that cycle. When you build strong leg muscles through exercise, you can actually reduce shortness of breath and improve quality of life.”

To help its patients recover more quickly, St. Clair Hospital operates a Pulmonary Rehabilitation Program. “At St. Clair, we are aggressive about getting patients into the program early,” Dr. Basheda says. “It’s a fantastic program and gets excellent results. Patients who join the program have fewer exacerbations of their disease and fewer re-admissions.”

In fact, rehabilitation options are just as important to St. Clair’s patients as all of its diagnosing capabilities. According to Dr. Basheda, people who have lung disease often are reluctant to go out and they can become isolated. But, “when they go to pulmonary rehab, they enjoy seeing the others, they feel better and want to keep going. It has great value for patients.”

Additionally, according to Dr. Basheda, “[Patients] benefit equally from exercising and education, and there is a significant social element: they make friends, have peer support and thus are more likely to commit to continued exercising. Studies have shown that people are less likely to exercise on their own, but when they join an organized group, they make the commitment.”

It’s these benefits that prove how even the fanciest of technologies need to be paired with the most effective of treatment options – however basic they may seem.

Diagnostic and care options alike have made an incredible difference in the life of St. Clair Hospital’s pulmonary health patients. You can read some of the profiles and testimonials of recovering patients in our next blog post, or by downloading our Summer 2016 edition of HouseCall Magazine.