Most of us take breathing for granted; it's something we do without conscious thought. However, if you run a race, or hold your breath for a long time diving in a pool, you know what it feels like to have trouble catching your breath. 

If you have a problem with breathing when you're not involved in a heavy physical activity, your primary care doctor is the first person you should contact. If your doctor suspects that you have a problem affecting your lungs, you may be referred to a pulmonologist who specializes in diagnosing and treating breathing and lung disorders. 

What is a Pulmonologist? 

A pulmonologist is a medical specialist trained in the evaluation, diagnosis, and treatment of disorders affecting the lungs and breathing. Pulmonologists are trained to conduct a range of tests to diagnose problems such as a narrowing or blockage of arteries in your lungs. They address problems using non-surgical treatments, such as an inhaler to relax airways, which makes breathing easier. When surgery is needed, the pulmonologist will refer patients to specialized thoracic surgeons. 

Reasons to See a Pulmonologist 

Your primary care doctor can treat you for symptoms affecting the breathing and lungs, such as a cough or trouble breathing due to a cold or pneumonia; however, if your symptoms are complicated or not responding to general treatments, your primary care doctor may ask you to see a pulmonologist. Complicated symptoms include shortness of breath or a chronic cough -- especially if you cough up blood. Abnormal chest x-rays may merit pulmonologist referrals as well. 

What Does a Pulmonologist Do? 

Pulmonologists are trained to diagnose a variety of illnesses, including: 

  • Sarcoidosis: A growth of inflammatory cells in the lungs 
  • Pulmonary fibrosis: Scarring of the lung tissue 
  • Lung cancer 
  • Obstructive lung diseases: Examples include asthma, emphysema and COPD (chronic obstructive pulmonary disease) 
  • Pulmonary hypertension: Narrowing of your lung's arteries 
  • Pulmonary embolism: Blockage in the arteries in your lungs, usually a blood clot 

Following diagnosis, a pulmonologist will refer you for further treatment. In some cases, the pulmonologist may treat your illness him or herself. For example, they may treat asthma, COPD and pulmonary fibrosis with medication and breathing treatments. For illnesses that require surgery, such as lung cancer or some cases of pulmonary embolism, the pulmonologist will work with a surgeon. 

Diagnostic tests a pulmonologist may conduct include: 

  • Blood tests to check for a variety of substances in your blood, depending on the illness the pulmonologist is trying to diagnose 
  • Chest X-rays to check for a variety of issues, such as narrowing of the pulmonary arteries 
  • Ultrasounds to check for things like blood clots 
  • Angiograms to determine how the blood is flowing in the arteries in your lungs 
  • MRIs to see a detailed image of the condition of the tissue in your lungs 
  • Biopsies of your lung tissue to identify whether you have pulmonary fibrosis or other conditions 
  • Breathing tests to determine how much air your lungs can hold and how fast you can breathe in and out 

How Is a Pulmonologist certified? 

Pulmonology is a subspecialty that doctors who have specialized in internal medicine can pursue. Individuals who want to specialize in pulmonology must first obtain a four-year bachelor's degree, then apply to medical school. Upon graduation from a four-year medical school program, doctors enter a three-year training program in internal medicine. 

The training as a pulmonologist consists of a two- or three-year fellowship program in pulmonology. At the end of that training, the doctor must pass a pulmonology board certification examination. 

Pulmonologists may establish an individual practice or join an office with other related specialists, like thoracic surgeons. They may also work in a hospital, where they're often associated with Intensive Care Units (ICUs). 

Referrals and Research 

If you're experiencing problems with coughing or breathing, start by talking to your primary care doctor. If your doctor suspects that you have a problem that a pulmonologist should take a look at, he or she may suggest a good pulmonologist, or suggest that you find the one you are most comfortable with. 

In either case, you may want to do some research to learn more about the specialist your doctor suggested and other specialists in your area. It's always important that you find the right specialist for your needs. 

You can search CareDash to find pulmonologists in your area or those that accept your health insurance. Additionally, you can read reviews, find out which hospitals the doctor is associated with, where they went to school and more to find the best match for you. 

Your First Meeting With Your Pulmonologist 

Your meeting with your specialist will be most productive if you have written down a list of symptoms. It's easy to overlook something that has been bothering you when you're in the doctor's office. 

In addition, it's always a good idea to make a list of questions before any doctor visit. Your doctors expect you to have questions, and when you write them down, it's much easier to get all the information you need. Here are some questions you may have: 

  • What is the most likely cause of my symptoms? 
  • What tests will you do to diagnose my problem? 
  • When will you be able to make a diagnosis? 
  • What should I do if my symptoms get worse? 
  • Do I need to make any changes in my lifestyle, diet or exercise? 
  • What other symptoms should I watch for? 
  • Will you send your findings and recommendations to my primary care doctor? 
  • A doctor's appointment can include an overwhelming amount of information. Anything you can do to be as specific as possible will make your appointment much easier and more effective. 

Keep in mind that specialists like a pulmonologist focus on one set of symptoms. If you have other medical issues, don't expect that your pulmonologist will be able to help you diagnose or treat them. 

If you feel that you and the pulmonologist will work well together -- great! If you have concerns, don't be shy about getting another opinion. You deserve to have a good working relationship with any doctor who will be managing your care.