Son's ailment pushes doctor's study

Impulse Oscillometry Spirometry aids those with respiratory problems

Posted: Monday, June 19, 2006

Unable to comfort his lung cancer-afflicted son, Dr. Michael Goldman developed the Impulse Oscillometry Spirometry procedure.

In doing so, Goldman, a renowned pulmonary scientist, brought cutting-edge research to Amarillo for lung and upper respiratory ailments.

No longer do patients have to huff and puff. They can breathe easily into the IOS with instant results.

The Procedure

"Basically, it's a loudspeaker that pushes a little burp of air into you and then it pulls it back," said Dr. Michael Goldman. "So, it's bupp, bupp, bupp, bupp, bupp. Five times a second."

"That information, the pressure that it causes at the mouth, the patient is just breathing normally. The instrument records the pressure in the mouth and the airflow. Then the computer analyzes that and tells us about airflow resistance in the lungs."

A doctor uses the test results to analyze and detect asthma, and other lung and upper respiratory diseases.

"What it (IOS) is measuring is two things," said Dr. Constantine Saadeh, a local physician. "The resistance of the airways, the ability of the lung to handle air that is coming out, and the inertia of the lungs."

The procedure's sensitivity proves invaluable in the diagnosis and treatment of asthma and upper respiratory illnesses.

"You know, asthmatics, between attacks, look normal. They're fine," Saadeh said.

The IOS detects abnormalities even if the patient doesn't complain, he said. It indicates if a patient will respond to treatment and if the drugs are working.

The IOS is an important tool for asthmatics, particularly children, some as young as 2.

The IOS helps with COPD, Chronic Obstructive Pulmonary Disease, showing improvement the doctor can measure, and it helps with other lung diseases.

Since the latter part of 2002, Saadeh used the spirometry, the old-fashioned breathing test requiring one to huff and puff, along with the IOS. After speaking with Goldman and joining the research, Saadeh understood the procedure better.

"We've been using it (IOS) almost exclusively to make diagnoses and treatment of patients with asthma and COPD," he said. "We're detecting more patients with lung problems than if we used just a traditional spirometry."

It's usefulness is beyond question.

"I think it should be the physician's dream to have an IOS in their office," Saadeh said. "Sometimes I think: 'How did we practice medicine without it?'"

Goldman, meanwhile, bought a house here, where he spends time on research and nears completion of a paper on vocal chord dysfunction.

His interest in the IOS procedure began when his son, David, lay in a UCLA hospital bed with cancer 14 years ago.

"I wanted to do something for all people with lung disease to make it easier to breathe and easier to test the lungs. So, that has been the motivation for me," Goldman said.

The scientist comes to Amarillo Pulmonary Research, Inc., which is affiliated with the Amarillo Center for Clinical Research and the Allergy A.R.T.S. Clinic in Amarillo.

"This equipment is so sensitive that we sometimes find patients who have a breathing problem who didn't even realize it but may have complained of other symptoms," Goldman said. "When breathing is relieved or improved, often other symptoms also improve."

Without the IOS, Saadeh said, it's difficult to accurately assess patients with asthma or other lung diseases. It's equally hard to follow up on patients without the IOS procedure.

Saadeh, familiar with conducting and interpreting the tests, offers the FDA-approved IOS for his patients.

"We're providing the technology of tomorrow today," he said.

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