Our practice specializes in the care of children from birth to young adulthood with respiratory (lung) problems including but not limited to:

• asthma including exercise induced shortness of breath
• cystic fibrosis
• recurrent infections (pneumonia, bronchitis, bronchiolitis, RSV, sinusitis)
• croup
• chronic cough
• chest congestion
• discoordinated swallowing (dysphagia) with aspiration
• apnea (breathing pauses) of prematurity and infancy
• obstructive sleep apnea
• chronic lung disease of premature infants
• congenital lung abnormalities
• immune deficiency diseases
• gastroesophageal reflux disease
• respiratory complications of neuromuscular weakness diseases
• tracheostomy care
• CPAP/BIBAP and home mechanical ventilation

Office and Hospital Consultations, Initial Visits and Follow-up Care Visits

Patients' problems are assessed by a thorough history and physical exam by the physician. Diagnostic testing is tailored to the specific issues for each patient. An action plan is developed to restore the patient to good health, normal activity and normal family lifestyle. Patients are provided with a notebook containing information about the practice, education handouts, special instructions, pulmonary function testing results and the daily action plan. Patient/family education about their illness is reviewed at every visit. Emphasis is placed on communication between the patient, family and physician/office staff and primary care physician.

Non-invasive diagnostic services performed in the office include

• flow-volume loop spirometry before and after rescue inhaled bronchodilator
• quiet breathing flow-volume loops in infants (requires some patient cooperation)
• nasal cytology (examination of nasal secretions under a microscope looking for nasal allergy and infection)
• rapid strep testing
• RSV and influenza A and B testing of nasal secretions
• nasal secretions culture
• allergy skin testing for seasonal, year round and selected food allergens/pollens

We interpret non–invasive diagnostic services performed outside of the office including

• flow-volume loop spirometry
• lung volumes and diffusing capacity
• pulmonary exercise stress testing
• airway provocation with methacholine challenge
• multichannel sleep studies

Invasive diagnostic services include

• flexible laryngoscopy (directly looking at the voice box and vocal cords)
• flexible bronchoscopy with lavage and ciliary biopsy if indicated (looking down the wind pipe and major branches of the large breathing tubes done under general anesthesia)
• 24 hour pH probe study (looking for gastroesophageal reflux disease)
• immune deficiency disease screening and response to pneumococcal vaccine

Intravenous (IV) and subcutaneous (SC) infusion services are available for patients with

• immune deficiency diseases who need IV gammaglobulin
• cystic fibrosis who need home IV antibiotics
• persistent sinus infections who have failed treatment with oral antibiotics and need IV antibiotics
• subcutaneous gamma globulin along with the IVIG

Synagis, Xolair, Fasenra, Nucala, Tezspire, and Dupixent Injections

Synagis injections for infants with extreme immaturity and infants with congenital heart disease and congestive heart failure who meet the criteria established by the American Academy of Pediatrics.

Xolair injections for patients with severe persistent asthma who meet the criteria established by the FDA.