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Alex Chapman - Respiratory Physician

Private Service, Respiratory

Description

Dr Alex Chapman is the Clinical Director for Medicine at North Shore and Waitakere hospitals. He is an experienced General and Respiratory Physician, qualifying in 1997 in the UK and moving to New Zealand in 2010 following a 4 year period as a Respiratory Consultant in the NHS. He has Southern Cross Affiliation but welcomes referrals from all sources.

Alex has wide interests, including difficult asthma, smoking related disorders, respiratory infection, cancer, interstitial and occupational lung disease and sports physiology. He has always retained his general acute medical expertise throughout a busy career within hospital medicine.  

Where a diagnosis is unclear Alex is experienced at utilising advanced diagnostic techniques such as thoracic ultrasound, bronchoscopy, endobronchial ultrasound guided biopsies and cardiopulmonary exercise testing. He is a skilled interventionalist and ran the teaching programme for chest drain insertion at the hospital for 10 years. This was a unique programme for NZ, training a generation of doctors and improving safety within the hospitals. 

Alex enjoys seeing professional and amateur athletes who have sports related medical respiratory and chest symptoms and was the team doctor for New Zealand's top professional road cycling team Bolton Equities Black Spoke Pro Cycling Academy. 

Alex currently runs his private consultations from 181 Shakespeare Road,  Milford and is supported by an efficient administrative team and a top level pharmacist.  

"Of paramount importance is my interest in people. A patient orientated approach has always guided my management decisions."

What is Respiratory Medicine?
Respiratory medicine is the branch of medicine that treats people with diseases affecting the lungs and breathing.
The role of our lungs is to deliver oxygen into our bloodstream and remove carbon dioxide.  When you breathe in, air passes through the throat into the windpipe (trachea). The base of the windpipe divides into the right and left tubes (bronchi) which divide again and again each time getting smaller and smaller until the smallest airways called the alveoli are reached. The alveoli act like balloons i.e. when you breathe in they inflate and when you breathe out they relax.
Oxygen moves across the walls of the alveoli and enters the bloodstream and is carried to the rest of the body after passing through the heart. Carbon dioxide is passed from the blood into the alveoli and is breathed out of the lungs.
 
Common symptoms or signs of lung disease include: shortness of breath, wheezing, long-term cough, coughing up blood, and having chest pains.
 
Respiratory physicians are doctors who specialise in treating conditions of the lungs.

Consultants

Referral Expectations

We advise GP recommended referrals but self referrals are possible if patients are self funding.

If you have any change in your condition before you come to your appointment, please see your GP immediately.

Fees and Charges Description

Southern Cross Affiliate

 

Alex is a Southern Cross Affiliated Provider for consultations under the Respiratory & sleep medicine (Lung function tests & sleep studies) category.

Procedures / Treatments

Asthma

Asthma symptoms include coughing, wheezing, a tight feeling in the chest and trouble breathing. Asthma occurs when the main breathing tubes of your lungs are over-sensitive and react to things that don’t affect other people. As a result of this they become swollen and narrow. If your asthma is not getting better with standard treatment (preventer and reliever inhalers) or if you are having more asthma attacks than you or your doctor are comfortable with, you may be referred to a specialist. In most cases you’ll be asked to give a complete medical history and will also be examined by the doctor. Sometimes other conditions can appear like asthma or complicate asthma, so you may be asked to have some tests to help in the diagnosis. Tests looking for severity and complicating features of asthma include: chest X-ray, spirometry and CT chest. For more details see below. You may, however, not need any of these tests. Treatment This includes taking medicines as well as changing some lifestyle factors. A peak flow meter can be used to keep a watch on your asthma and help with plans to prevent attacks. Stopping smoking is very important as is learning to recognise what brings an asthma attack on. Asthma is treated with inhaled medicines. There are two types: 1. a preventer medicine is taken every day. It soothes the irritated breathing tubes and prevents worsening of asthma, “asthma attacks”. 2. a reliever treats the asthma attacks. It relaxes the tightened muscles around the breathing tubes. For more information on asthma see www.asthmanz.co.nz

Asthma symptoms include coughing, wheezing, a tight feeling in the chest and trouble breathing. Asthma occurs when the main breathing tubes of your lungs are over-sensitive and react to things that don’t affect other people.   As a result of this they become swollen and narrow.
If your asthma is not getting better with standard treatment (preventer and reliever inhalers) or if you are having more asthma attacks than you or your doctor are comfortable with, you may be referred to a specialist.
In most cases you’ll be asked to give a complete medical history and will also be examined by the doctor. Sometimes other conditions can appear like asthma or complicate asthma, so you may be asked to have some tests to help in the diagnosis. 
 
Tests looking for severity and complicating features of asthma include:
chest X-ray, spirometry and CT chest.  For more details see below.
You may, however, not need any of these tests.
 
Treatment
This includes taking medicines as well as changing some lifestyle factors.  A peak flow meter can be used to keep a watch on your asthma and help with plans to prevent attacks.  Stopping smoking is very important as is learning to recognise what brings an asthma attack on.
Asthma is treated with inhaled medicines.  There are two types:
1. a preventer medicine is taken every day.  It soothes the irritated breathing tubes and prevents worsening of asthma, “asthma attacks”.
2. a reliever treats the asthma attacks. It relaxes the tightened muscles around the breathing tubes. 
For more information on asthma see www.asthmanz.co.nz
 
Chronic Obstructive Pulmonary Disease (COPD)

This term is used to describe lung disease where the breathing tubes become blocked and the surrounding tissue and air sacs inside the lungs become damaged. COPD includes conditions such as emphysema, chronic bronchitis and chronic asthma. COPD is a long term and sometimes fatal disease that can be managed and slowed down. Smoking is the main cause of emphysema and chronic bronchitis. Chronic bronchitis is an inflammation of the main breathing tubes (bronchi) in the lungs, which results in the production of excess mucous (phlegm) and a reduction in the amount of airflow in and out of the lungs. In the early stages of chronic bronchitis, a cough usually occurs in the morning. As the disease progresses, coughing persists throughout the day. There is often associated shortness of breath and an increased rate of chest infections. Emphysema is the gradual destruction of the air sacs (alveoli) in the lungs. The alveoli are unable to completely relax. As they become larger they are not as good at transporting oxygen to the blood. Emphysema cannot be cured, but can be managed through medication and lifestyle changes. Investigations You may have some of the following tests before or after your clinic appointment: chest X-ray, spirometry, lung function tests, CT chest. The specialist will decide if you need any of these tests, depending on your symptoms and examination findings. Treatment There are ways to manage COPD. The first and most important is to stop smoking if this applies to you. There are exercises and dietary changes that can help maintain and improve fitness. Medications include inhalers, although they are not used for everyone. If you have COPD it is a good idea to have the flu vaccination every year.

This term is used to describe lung disease where the breathing tubes become blocked and the surrounding tissue and air sacs inside the lungs become damaged. COPD includes conditions such as emphysema, chronic bronchitis and chronic asthma.  COPD is a long term and sometimes fatal disease that can be managed and slowed down. Smoking is the main cause of emphysema and chronic bronchitis.

 

Chronic bronchitis is an inflammation of the main breathing tubes (bronchi) in the lungs, which results in the production of excess mucous (phlegm) and a reduction in the amount of airflow in and out of the lungs. In the early stages of chronic bronchitis, a cough usually occurs in the morning. As the disease progresses, coughing persists throughout the day.  There is often associated shortness of breath and an increased rate of chest infections.

 

Emphysema is the gradual destruction of the air sacs (alveoli) in the lungs. The alveoli are unable to completely relax.  As they become larger they are not as good at transporting oxygen to the blood.  Emphysema cannot be cured, but can be managed through medication and lifestyle changes.

 

Investigations
You may have some of the following tests before or after your clinic appointment:

 

chest X-ray, spirometry, lung function tests, CT chest.  The specialist will decide if you need any of these tests, depending on your symptoms and examination findings.

 

Treatment
There are ways to manage COPD.  The first and most important is to stop smoking if this applies to you.  There are exercises and dietary changes that can help maintain and improve fitness.  Medications include inhalers, although they are not used for everyone. If you have COPD it is a good idea to have the flu vaccination every year.
Lung Cancer

This is when abnormal malignant cells divide and grow in an uncontrolled fashion in the lung tissue. The effect of this is to destroy normal lung tissue and block off the breathing tubes. There are several types of lung cancer. The most common cause is cigarette smoke; however exposure to asbestos, marijuana smoke and a number of other chemicals can also increase your risk of developing cancer. Common signs and symptoms · a cough that gets worse with time · coughing up blood · chest pain · loss of appetite and weight · tiredness · repeated doses of, or not improving, bronchitis or pneumonia. Diagnosis To diagnose lung cancer your doctor will look at your medical and smoking history. You will also have a physical examination. This is usually followed by a number of tests. The aim of the tests is to confirm the diagnosis and find out what type of cancer it is which usually involves obtaining some cells to look at under the microscope. Test you are likely to have include: · chest X-ray. This is the first test that may raise the question of a lung cancer. It is usually followed by other tests to confirm the diagnosis · CT scans with or without fine needle aspirate (see below) · bronchoscopy (see below). Treatment Once lung cancer is diagnosed, a process known as staging determines the extent of the disease. Knowing the type and stage of cancer means the doctor can plan your treatment. Different treatment options include: · surgery. The type of surgery depends on the size and type of cancer · radiotherapy is a form of high energy radiation (X-ray) that kills cancer cells · chemotherapy is the use of drugs aimed at killing cancer cells. The aim of treatment is to keep the person as well as possible even if the cancer cannot be cured. If you have a lung cancer there will be ongoing follow up with specialists and nurses throughout treatment and afterwards. For more information about lung cancer see www.cancernz.org.nz

This is when abnormal malignant cells divide and grow in an uncontrolled fashion in the lung tissue. The effect of this is to destroy normal lung tissue and block off the breathing tubes. There are several types of lung cancer.  The most common cause is cigarette smoke; however exposure to asbestos, marijuana smoke and a number of other chemicals can also increase your risk of developing cancer.
 
Common signs and symptoms
·        a cough that gets worse with time
·        coughing up blood
·        chest pain
·        loss of appetite and weight
·        tiredness
·        repeated doses of, or not improving, bronchitis or pneumonia.
 
Diagnosis
To diagnose lung cancer your doctor will look at your medical and smoking history. You will also have a physical examination. This is usually followed by a number of tests.  The aim of the tests is to confirm the diagnosis and find out what type of cancer it is which usually involves obtaining some cells to look at under the microscope. Test you are likely to have include:
·        chest X-ray. This is the first test that may raise the question of a lung cancer.  It is usually followed by other tests to confirm the diagnosis
·        CT scans with or without fine needle aspirate (see below)
·        bronchoscopy  (see below).
 
Treatment
Once lung cancer is diagnosed, a process known as staging determines the extent of the disease. Knowing the type and stage of cancer means the doctor can plan your treatment.
Different treatment options include:
·        surgery.  The type of surgery depends on the size and type of cancer
·        radiotherapy is a form of high energy radiation (X-ray) that kills cancer cells
·        chemotherapy is the use of drugs aimed at killing cancer cells.
The aim of treatment is to keep the person as well as possible even if the cancer cannot be cured.
If you have a lung cancer there will be ongoing follow up with specialists and nurses throughout treatment and afterwards.
For more information about lung cancer see www.cancernz.org.nz
Lung Function Tests

You may be advised to take lung function tests to find out how much air moves in and out as you breathe. The two most common tools used to measure lung function are spirometers and peak flow meters. Lung function tests are usually done before and after taking a medication known as a bronchodilator (asthma reliever medication) to open your airways.

You may be advised to take lung function tests to find out how much air moves in and out as you breathe.
The two most common tools used to measure lung function are spirometers and peak flow meters. 
Lung function tests are usually done before and after taking a medication known as a bronchodilator (asthma reliever medication) to open your airways.
Spirometers

Spirometry is a test which measures the speed at which your lungs can be filled and emptied of air. It can be used to diagnose problems of breathing and monitor the usefulness of treatment. In order to do spirometry, you take a deep breath in and blow out as hard as you can into a hollow tube attached to a spirometer machine for 6 seconds. You will be asked to do the test 3 times. The whole process takes 10 – 15 minutes depending on whether or not you are given some inhaled medicine and asked to do it again to monitor if there is an improvement.

Spirometry is a test which measures the speed at which your lungs can be filled and emptied of air.  It can be used to diagnose problems of breathing and monitor the usefulness of treatment.
In order to do spirometry, you take a deep breath in and blow out as hard as you can into a hollow tube attached to a spirometer machine for 6 seconds.  You will be asked to do the test 3 times. The whole process takes 10 – 15 minutes depending on whether or not you are given some inhaled medicine and asked to do it again to monitor if there is an improvement.
Peak Flow Meter

This is a small hand-held tube that can measure what is happening in your breathing tubes. You can have one at home and measure your peak flow by blowing into it as hard and fast as possible. You will be shown how to measure it and compare it with what you can blow when you are well as part of your asthma management plan if you think you are having an asthma attack.

This is a small hand-held tube that can measure what is happening in your breathing tubes.  You can have one at home and measure your peak flow by blowing into it as hard and fast as possible.  You will be shown how to measure it and compare it with what you can blow when you are well as part of your asthma management plan if you think you are having an asthma attack.
Blood Gas Tests

This is similar to a blood test but instead of a needle going into a vein it is inserted briefly into a small artery in your wrist. A small amount of blood is taken and sent to the laboratory for information about the oxygenation of your blood and other gases. Blood gas measurements may also be used if you have known respiratory, metabolic or kidney disease, especially if you have severe difficulty breathing. Many conditions can cause a blood gas imbalance and while the blood gas tests do not identify the exact cause of the imbalance they will point to either a respiratory or metabolic problem.

This is similar to a blood test but instead of a needle going into a vein it is inserted briefly into a small artery in your wrist.  A small amount of blood is taken and sent to the laboratory for information about the oxygenation of your blood and other gases.
Blood gas measurements may also be used if you have known respiratory, metabolic or kidney disease, especially if you have severe difficulty breathing. Many conditions can cause a blood gas imbalance and while the blood gas tests do not identify the exact cause of the imbalance they will point to either a respiratory or metabolic problem.
Chest X-ray

A chest X-ray is normally undertaken to check the chest wall, lungs and heart. A chest X-ray is often the first test used to determine the reason for shortness of breath, persistent cough, chest pain or injury. Although you may think of an X-ray as a picture of bones, a trained observer can also see air spaces, like the lungs (which look black) and fluid (which looks white). Women should always advise their doctor if they are or think they may be pregnant before an X-ray is undertaken. When having a chest X-ray you are exposed to a very small amount of radiation. What to expect? You will have all metal objects removed from your body. You will be asked to remain still in a specific position and hold your breath on command. There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room.

A chest X-ray is normally undertaken to check the chest wall, lungs and heart. A chest X-ray is often the first test used to determine the reason for shortness of breath, persistent cough, chest pain or injury. Although you may think of an X-ray as a picture of bones, a trained observer can also see air spaces, like the lungs (which look black) and fluid (which looks white).
Women should always advise their doctor if they are or think they may be pregnant before an X-ray is undertaken. When having a chest X-ray you are exposed to a very small amount of radiation.
 
What to expect?
You will have all metal objects removed from your body.  You will be asked to remain still in a specific position and hold your breath on command.  There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room.
Computer Tomography (CT) Scan

With CT you can see much more detail than with a normal X-ray. Using an X-ray beam, which is sent through the body from different angles, creates a CT image and by using a complicated mathematical process a computer is able to produce an image. This allows cross-sectional images of the body without cutting it open. The CT is used to view all body structures but especially soft tissue such as body organs (heart, lungs, liver etc.). What to expect? You will have all metal objects removed from your body. You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening. You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner. You will be asked to remain still and hold your breath on command. There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner. Some procedures will require Contrast medium. Contrast medium is a substance that makes the image of the CT clearer. Contrast medium can be given by mouth, or by injection into the bloodstream. The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.

With CT you can see much more detail than with a normal X-ray. Using an X-ray beam, which is sent through the body from different angles, creates a CT image and by using a complicated mathematical process a computer is able to produce an image.  This allows cross-sectional images of the body without cutting it open.  The CT is used to view all body structures but especially soft tissue such as body organs (heart, lungs, liver etc.).
 
What to expect?
You will have all metal objects removed from your body.  You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening.
You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner.  You will be asked to remain still and hold your breath on command.  There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner.
Some procedures will require Contrast medium.  Contrast medium is a substance that makes the image of the CT clearer. Contrast medium can be given by mouth, or by injection into the bloodstream.
The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.
 
Fine Needle Aspirate

Depending on what is seen on the CT scan an additional test can be done where a fine needle is inserted into your chest into the cancer and some cells sucked up into the needle. This is done while taking pictures with the CT scanner to guide the doctor as to where to place the needle. Local anesthetic is put into your skin and muscles so that the test is not overly painful. A specialist doctor does this.

Depending on what is seen on the CT scan an additional test can be done where a fine needle is inserted into your chest into the cancer and some cells sucked up into the needle.  This is done while taking pictures with the CT scanner to guide the doctor as to where to place the needle.  Local anesthetic is put into your skin and muscles so that the test is not overly painful.  A specialist doctor does this.
Bronchoscopy

During this test a thin fibreoptic tube is inserted into your breathing tubes, through the nose, to view the tubes and take a biopsy (remove cells or tissue) to see if there are cancer cells present. It is usually undertaken under local anesthetic. You may be given medicine to make you sleepy and relaxed. A specialist doctor does this procedure in an operating theatre environment.

During this test a thin fibreoptic tube is inserted into your breathing tubes, through the nose, to view the tubes and take a biopsy (remove cells or tissue) to see if there are cancer cells present. It is usually undertaken under local anesthetic. You may be given medicine to make you sleepy and relaxed.  A specialist doctor does this procedure in an operating theatre environment.

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Contact Details

Alternative email: tess.respiratorymedicine@gmail.com

181 Shakespeare Road
Milford
Auckland 0620

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181 Shakespeare Road
Milford
Auckland 0620

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181 Shakespeare Road
Milford
Auckland 0620

This page was last updated at 11:33AM on June 12, 2024. This information is reviewed and edited by Alex Chapman - Respiratory Physician.