By Eulalee Thompson 
Patient Donna Brown breathes into the mouthpiece attached to the spirometer, the medical instrument that assists health professionals to diagnose lung disease. Right: Patient Donna Brown being shown the correct way to use her asthma inhaler medication. - Ian Allen/Staff Photographer
Shortness of breath or a persistent cough could indicate lung disease.
To be certain, ask your physician for a pulmonary function test.
PERSISTENT COMPLAINTS of shortness of breath, a cough that won't go away or chest pains could mean that it is time for your physician to recommend a pulmonary function test.
This non-invasive diagnostic test will produce values on a curve that will assist the medical expert to determine, in a scientific way, the presence of a lung disorder.
Dr. Paul Scott, pulmonologist at the University Hospital of the West Indies' (UHWI's) Pulmonary Unit said that the results of the spirometer, the instrument used to carry out the diagnostic test, will indicate values which are normal; abnormal indicating obstruction or abnormal indicating restriction.
The values indicate how well the lungs are taking in air, the volume of air which the lungs are able to hold and how well the lungs are exhaling air. The values which would most interest Dr. Scott are the forced vital capacity (FVC) indicating the maximum volume attained by the lungs and the forced expiratory volume (FEV1) the volume attained by the lungs after one second. He said that the ratio of these two values helps him to categorise the condition into either restricitive or obstructive lung disease.
The two most common types of obstructive lung diseases, seen in the Pulmonary Unit, are asthma and emphysema, where Dr. Scott said that there is a decrease in the exhaled air flow caused by a narrowing or obstruction of the airways.
"Studies are indicating that there is an increase in lung diseases here. Asthma is the most common lung condition with a 20 per cent prevalence in the population. We consider this prevalence to be very high but similar to trends in other Caribbean countries such as Barbados and Trinidad," he said.
The reasons for the high prevalence are unclear but Dr. Scott made reference to links between asthma flare-ups and environmental conditions such as dust and pollen in the air. He was also concerned about higher asthma death rates in rural areas when compared to urban areas.
"The problem with asthma is that it is underdiagnosed and there is still a stigma attached to the condition. For example, patients would prefer to hear other terms, such as bronchitis, they don't like to be told that they have asthma," Dr. Scott said.
The other common lung disease which Dr. Scott diagnoses often in the Unit, is pulmonary embolism or clots in the lungs. He said that this condition is diagnosed more often in patients who have been immobilised; who have been sitting on an aircraft for a long time; who have suffered a heart failure or the 'flu or those who have recently undergone surgery.
Although spirometry is useful in diagnosing a wide range of lung disease, Dr. Scott says that sometimes other evaluations are necessary such as a bronchoscopy - the placing of a tube with a light attached through the mouth or nostril to investigate the lungs. During the bronchoscopy, samples can also be taken for a lung biopsy.
