Providing rapid access and turn around of
quality pulmonary function testing
Dr. Gordon Ford and Dr. Sid Viner share over 50 years of experience in specialist respiratory medical practice. As medical directors of Ford & Viner Pulmonary Associates they provide medical direction and oversight of all aspects of testing, interpretation of test results, and support in the integration of test results into patient care. Both hold specialty certification from the Royal College of Physicians and Surgeons of Canada and have Level IV accreditation from the College of Physicians and Surgeons of Alberta to interpret pulmonary function tests; the highest level of accreditation that can be obtained.
Pulmonary function testing is required to definitively diagnose many common and less common lung diseases, to assess disease severity, progression and response to therapy. Testing is also useful to determine the absence of lung disease in patients who have symptoms that may exist on the basis of lung or cardiac disease, lack of physical fitness, or illness affecting other body systems. PFTs may be required to assess or monitor patients who are risk of developing respiratory illness related to their workplace, and are key in screening for lung disease resulting as a consequence of smoking. Every test is interpreted by a pulmonary specialist physician.
The provision of accessible and timely state of the art pulmonary diagnostic testing, supporting physicians and other clinical care providers, for the integration of pulmonary diagnostics into patient care.
Doctors Ford and Viner have entrenched these values in their combined concept of medical practice and pulmonary lab testing facilities:
- patient-focused care
- accurate, reliable and valid testing
- accessible and timely scheduling and reporting
Spirometry is a relatively simple test to perform which provides several key measurements including FVC, FEV1, and FEV1/FVC.
Forced Vital Capacity (FVC) is the maximum volume of air you can forcefully exhale following a maximal inhalation.
Forced Expired Volume in one second (FEV1) is the volume of air exhaled in the first second of the FVC maneuver.
FEV1/FVC is simply the ratio of FEV1/FVC.
There are two main categories of lung disease: Obstructive Lung Diseases which are characterized by a reduction in FEV1/FVC, and Restrictive Lung Diseases which are characterized by a reduction in FVC with a proportionate reduction in FEV1 (normal or increased FEV1/FVC).
Spirometry also provides other measures that may be used to refine the interpretation.
Flow Volume Loop
The graphic display of flow plotted against volume provides important information regarding test performance and the presence or absence of lung (airway) disease. The appearance of the flow volume loop may suggest a normal state, or the presence of obstructive or restrictive lung disease. There are characteristic patterns and measurements that may point to specific types and severity of airway obstruction. Pre and Post Bronchodilator to assess whether or not airflow obstruction is reversible, an inhaled bronchodilator (salbutamol) is administered. Response to bronchodilator may be reflected in spirometry, flow volume loops, and lung volume measurements – that is, a flow and/or volume response. Presence or absence of a bronchodilator response is important in the diagnosis and treatment of obstructive lung disease(s)
While Spirometry measures the volume of exhaled air, it will not measure the total volume of air in the lungs remaining after complete exhalation. By calculating the amount of air left in the lungs (Residual Volume) it enables the measurement of the Total Lung Capacity. This measurement, further refines our ability to diagnose obstructive vs. restrictive lung diseases. Lung volumes should be measured at least on one occasion to make a definitive diagnosis of restrictive lung disease. In patients with obstructive lung disease, measurement of lung volumes (TLC, FRC, RV) is required to determine the presence or absence of hyperinflation and gas trapping. At Ford & Viner, lung volume measurements are obtained by using Body Plethysmography only, as it is the gold standard.
Diffusing capacity measures the transfer of a test gas from the air sacs (alveoli) of the lungs into the blood. Abnormalities in Diffusing Capacity may occur in diseases that effect the air sacs of the lung or blood vessels. Recent smoking or conditions such as anemia may also affect diffusing capacity.
Arterial blood gas analysis measures the level of oxyen and carbon dioxide in the blood, as well as acid base balance (pH). ABGs provide key information regarding the function of the respiratory system. ABGs are required to determine if a patient may require supplemental oxygen or other therapy.
MIPs and MEPs are measured as an index of respiratory muscle strength. Measurement of MIPs/MEPs is an important screening test where neuromuscular disease, or musculoskeletal abnormalities are suspected.
Methacholine Challenge Testing assess for non-specific airways hyperresponsiveness. In symptomatic patients, a negative methacholine challenge test rules out asthma with a high degree of certainty. This test may be useful in symptomatic patients where pulmonary function testing are non-diagnostic. Methacholine challenge testing may also be useful in diagnosis of occupational lung disease.
#102, 2675 – 36 Street NE
Located in the Sunridge Professional Building between the optometrist and the pharmacist
Parking available for $2
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Dr. Gordon Ford is a Professor Emeritus of Medicine at the University of Calgary (U of C) in the Division of Respiratory Medicine. He was in the first graduating class in the Faculty of Medicine at the U of C and received his MD degree in 1973. He completed his post-graduate training in Internal Medicine and Respiratory Medicine at the University of Manitoba and returned to the Faculty of Medicine, Division of Respirology, U of C, in 1979 as an Assistant Professor. Dr. Ford became a Full Professor of Medicine in 1993. He retired from the U of C in 2013, after 35 years of service.
Dr. Ford’s research interests include; clinical trials for patients suffering from Chronic Obstructive Pulmonary Disease (COPD), asthma, and respiratory infection. He has a special interest in pulmonary function testing, prescriptive exercise and pulmonary rehabilitation in patients with chronic lung disease as it pertains to Chronic Disease Management. He is an active member of the Division of Respirology, University of Calgary / Alberta Health Services and Ford and Viner Pulmonary Associates. Dr. Ford is married with three children, and three grandchildren.
Dr Sid Viner is a native Calgarian and specialist in Respiratory and Critical Care Medicine who has practiced in Calgary since 1990. He is a Clinical Associate Professor at the University of Calgary in the Department of Critical Care and Divison of Respiratory Medicine. He received his MD degree from the University of Alberta in 1983. After completing a rotating internship at the Holy Cross Hospital in Calgary, he completed post-graduate training in Internal Medicine, Respirology and Critical Care at the University of California, Los Angeles, University of Toronto and University of Pittsburgh. While maintaining a busy inpatient and outpatient clinical practice, Dr Viner is also actively involved in teaching within the Faculty of Medicine and in medical leadership and administration. With his colleague, Dr Gordon Ford, he started Ford and Viner Pulmonary Associates in 2010 recognizing the need for improved access to quality, community based pulmonary function testing in Calgary. Dr. Viner is married with 3 children.