If you've had a child take a pulmonary/lung function test before... a question

[AimeeM]

Nico's cardiologist wants him to do a pulmonary function test, with his pulmonary team, before he decides on which diagnostics to pursue (he's trying to be as non-invasive as he can) on his end.

At Nico's last pulmonology appointment, the doctor decided he wasn't ready for the test. This was about 6 months ago (Nico was a "newer 5 year old"). He's due for another appointment, but we've made no progress with the windmill toy the pulmonologist had us using to "ready" him for the test, and I have little doubt that he will be allowed to take the test - the doctor seems to use this as a readiness indicator.

Now, the pulmonologist did not seem to think it abnormal that a 5 year old couldn't do the test... but if he still can't do the windmill, 6 months later, is this indicative of that he isn't ready for the TEST, or (is it more indicative of) that he wouldn't PASS the test?

Also, how old was your child when he was able to do the test?

[Daria]

I'm not sure why they wouldn't let him try the test.  It's not that complicated.

 

I think it's probably an indication that he wouldn't be able to follow the directions of the test, waiting to start breathing at a certain time, start of breathing hard and go as long as you can, etc . . .  So the results wouldn't be of value.

[applethyme]

DS will be turning 7 in a few weeks.  He has pulmonary function tests every 6 months and has since he was 5.  His pulmonologist says that these are "practice" tests as she doesn't feel that they are 100% but give enough information to have value.  DS loves taking the pulmonary function tests as he gets to blow in a tube and on a computer screen can make toast pop up or a balloon pops.  It makes a HUGE difference with who does the test.  DS pulmonologist is very familiar with DS and makes sure that only certain people perform his test. 

[Χά�ων]

That is you g for a PFT. My son took it at 7 and they were reluctant because he was young. They said they wanted the kids to be at least 8 years old. His doctor asked that they go ahead to establish a baseline.

 

He was slightly below average at 7 and average at 8.

 

Could they have him work with an OT or speech therapist to develop the skills to due the test? at the very least they may be able to say if he is unable or just too young still.

[Spryte]

DS is 11, and the tests are much easier and probably more accurate now. I don't recall his age when we started (he tests every 3 - 6 mos) but I believe he was approx 4 or 5.

 

Like a PP, it makes a big difference who administers the test. Some people are better with that age group than others.

 

As for the waiting, I think it's the following directions and being able to control one's breathing well enough. It's not an easy test. But fun. The kiddo here always enjoys it. Crazy kid!

[AimeeM]

I'm not sure why they wouldn't let him try the test.  It's not that complicated.

 

I think it's probably an indication that he wouldn't be able to follow the directions of the test, waiting to start breathing at a certain time, start of breathing hard and go as long as you can, etc . . .  So the results wouldn't be of value.

I'm not sure - he wouldn't let him take it as his last appointment, citing that he "wasn't ready".

[AimeeM]

That is you g for a PFT. My son took it at 7 and they were reluctant because he was young. They said they wanted the kids to be at least 8 years old. His doctor asked that they go ahead to establish a baseline.

 

He was slightly below average at 7 and average at 8.

 

Could they have him work with an OT or speech therapist to develop the skills to due the test? at the very least they may be able to say if he is unable or just too young still.

Yeah, I don't know. He (the pulmonologist) seemed to want him to take the test, but said he wasn't ready. I know that DS' previous pulmonary team, had said that it wouldn't happen until 6 or 7 - at the youngest - because of "readiness", but his old pulmonologist left, and now we have a newbie who doesn't seem to care for Nico's long-term care plan. Don't get me started on that, though :P

[Tap]

If it is just a basic spiromety test, I wouldn't be surprised either way about a 5 yo being able to do it.

The person has to be able to blow out forcibly for a sustainable amount of time. To make it fun, I have seen different programs use visuals. I have seen houses that you blow down like the bad wolf of fairy tales and I have seen birthday candles. (There were different choices as well but those are what dd chose).

Dd16 has never been able to blow them all down, even on a good day... with her inhaler. At 16, she would have to do the test several times and then they would take the most consistent readings.(Not due to skill level, but due to low lung function) If a 5yo was blowing inconsistamtly (as you would expect if they can't even do a peak flow meter), I don't know if they would hold value in he results or not. Then you could actually have bad data....no just no data.

I am guessing that the doctor sees no point in charging you for a test that your child won't be able to blow hard/long enough to get an acurate reading.

If the other doctor is asking, then maybe they will try. But I wouldn't be surprised if he said "not ready" and refused.

[Spryte]

Coming back to post again, I asked DH and he thinks DS was six when we started those tests. I think he's right, I had it mixed up with an allergy diagnosis. Oops!

[Seasider]

One of mine took that at age 6, and then at every regular appointment. Perhaps I'm remembering this wrong, but I don't understand why Nico wouldn't be allowed to give it a try. The tech administering the test should be able to judge how well he followed instructions. Is there a separate fee each time they blow? I felt like it took a few tries for my kid to fully understand what was being asked of him at first, but it soon clicked. If the administering tech felt like Nico didn't fully understand, it doesn't seem like he'd "fail," but rather have it noted that the test was inconclusive and should be reattempted at a future visit. Is the doc trying to avoid an unnecessary charge to you, or perhaps a "waste" of his time?

 

Perhaps you're talking about something totally different than I remember, but the test my ds took is as described (blowing out birthday candles on the screen).

[lollie010]

DS had his first at 5 and the tech commented that he did excellent at following directions and would get an accurate result. He should be allowed to try at least.

[prairiewindmomma]

We practiced several times first.

[Terabith]

My youngest has been doing it since she was four without any problems.  She did enjoy trying with different scenarios (3 Little Pigs, windmill, blowing a kite across a screen, etc). 

[sbgrace]

One of mine did well with it at 5, maybe a bit earlier actually. The other still struggled at 10. His focus is a major problem. One pulmonologist wouldn't use his scores at all, and I think this did affect (negatively) the treatment plan. He was 8/9 at the time. Maybe he was so bad it wasn't possible. Probably. The newer one does use his scores. The machine records effort, and she sort of calculates how that number will affect others, and one number in particular is not affected by his poor following of directions. In other words, she works around his inability. He's probably unusually difficult. We do practice at home, and I think it helps.

[Trilliums]

My son has his first one when he was 14 or 15 and he still had a hard time at first.  The nurse started to get kind of annoyed at him.  For him anxiety is the culprit.  Anyways, just chiming in that the first time can be hard for all kinds of age groups.  

Best wishes to your son!