From 5 or 6 years old, children do a lung function test (spirometry) when they attend clinic. This is a test to see how well the air flows out of the lungs. One of the specialist physiologists at the clinic will carefully explain the test to you and your child at the time. The results of the test will be known to the doctor when you are seen in the clinic, and can help the doctor in making a diagnosis of your child’s problem, or how to alter treatment to give your child maximum benefit.

It is very likely your child will have already had chest X-Rays before being seen. Depending on where you live, these X-Rays may be able to be seen on the computer when you are seen in the clinic. Sometimes it can be helpful to repeat an X-Ray at the time of the clinic. This might even mean doing one when your child is well, to show what the lungs look like “at their best”. The doctor in the clinic will explain to you if an X-Ray is necessary, and why. The X-Ray can be discussed with you later in the clinic.

Sometimes more detail is needed than a chest xray can show. This is the case if there is concern your child may have a more complicated lung problem. In these cases, a CT scan (CAT scan) of the chest is requested. This can’t be done at the time of the clinic, but will be requested for a later date. The test requires that the child lies very still for approximately 3-5 minutes at a time, and can hold their breath for 20 seconds. If this is difficult for your child the doctors may suggest that the scan be done under a general anaesthetic. This is to make sure the picture from the scan is of the best quality to give as much information about your child’s chest as possible.

If your child regularly coughs up sputum (also called mucus or phlegm), the doctors may want to take a sample of this to see if any particular organisms are growing in it. For those children who cannot cough up phlegm there are other methods to get a sample including taking a swab from the nose, or from the back of the throat. These swabs are a little unpleasant for younger children, but take only seconds to perform. There are no long lasting ill effects from swabbing. The result from the swab takes approximately one week to come back to the doctors.

Sometimes, it may be recommended that a flexible bronchoscopy is performed. This is a test where a small ‘scope (camera on a guidable arm) is passed into your child’s airways to actually see what the lungs look like. This test allows the doctors to see if there are any poorly grown, or misshapen airways; any airways squashed (e.g. by glands); or if the airways look inflamed. It is usual to perform a “lavage” at the same time as the bronchoscopy. This is a test where an amount of saline (salt water) is washed into the lungs, and immediately sucked back out again. In doing this we can get better samples of mucus from which we can look for organisms, and sometimes also look for evidence of other, more complicated problems. The lavage doesn’t cause any serious or long term side effects. If a bronchoscopy (with or without lavage) is thought to help towards your child’s care, your doctor will discuss this with you. You can find more information using the “bronchoscopy” link, above.

Some children can have a problem of breathing that is more severe when they are asleep. In order to understand this better, it may be necessary to get your child to have a “Sleep Study”. This term covers a range of tests that are all done during sleep. The most basic test (overnight pulse oxymetry) is usually able to be done by your local community children’s nursing team, at home. The results may then need to be forwarded to us at Starship for comment. Other, more sophisticated, sleep tests can only be done in hospital, at present. This would require your child and an accompanying adult to be admitted for an overnight stay, when the test equipment would be set up, and a recording obtained. In most cases a single night’s stay is all that is needed. The results from these more detailed tests are not available on the day after the readings are taken, but are usually back by a couple of weeks after the test is done. Some children without complicated medical needs will have their sleep study performed at the New Zealand Respiratory and Sleep Institute. Even though this is not on the Starship Campus, these sleep studies are reported by the Starship sleep specialists in the same way as studies done at SCH are.