Breath Bowling

I recently visited the pulmonologist, to check on my lungs.  I've reached a point in my tempo runs where the bottom of my lungs constrict, and the back of my throat gets tight.  Makes it a little harder to breathe, but nothing I haven't really dealt with before.  However, with the amount of running I've been doing, I expected that I'd be seeing a marked improvement in my lung capacity.  At least, I would expect that the breathing gets easier at some point, right?
My pulmonologist referred me to a lab for testing, something called a "complete PFT" to do a workup on my lungs, to rule out asthma.  Since I'm an allergy sufferer, there was a chance that the lung situation is not necessarily chronic.
So off I went to get a chest x-ray, and to visit the Lung Lab for a workup.
And I can honestly say it was one of the more memorable experiences I've had in the hospital.

I arrived in the morning and was the only patient in the lab, along with another pulmonologist and a Russian technician, who were processing reports at their desks.  The lab had a small, clear-paneled booth (reminiscent of a telephone booth) with long plastic tubes attached to a cardboard-tube contraption hovering near a chair (bolted inside the booth) which you face while seated.  Outside the booth is a computer that generates statistics of your testing, and nearby is a chair where the pulmonologist of the Lung Lab sits and yells at people all day long.

I've been yelled at in my life, but it's usually been within the context of leaving milk out of the breakfast table, or being coached through sprint repeats on a track; it's rather absurd to have a medical professional screaming loudly at precise intervals while pressing on the back of your lungs while you are fully conscious and in no hurry whatsoever.

"And now breathe out, evenly, ok, now IN DEEP DEEP BREATH KEEP GOING and now OUT! BLOW OUT! KNOCK DOWN THOSE PINS KEEP GOING KEEP GOING ok and inhale deep, ok good...."

The first step in a "complete PFT" (Pulmonary Function Testing) involves forcefully inhaling and exhaling into the cardboard tube.  Meanwhile, a computer shows you an animated image of a bowling ball which, no matter how forcefully you exhale, never reaches the pins at the end of the pixelated alley.  It's rather disheartening, but the doctor assures you that your lung capacity is 100%, very healthy.  This is after he's also introduced himself to you three times already, shook your hand thrice-over, and has meticulously explained the statistics that are populating on the spirometer read-out.

The second step involves inhaling a methacholine aerosol mist that causes the airways to spasm, while the doctor inquires about what you do for a living.  Then you're supposed to try and knock those pins over again while he screams, even closer, in your ear.  For asthma sufferers, the capacity usually drops by 20%.  (Mine only dropped 8%, so that was good news.)  After 5 rounds of misting and breath bowling, you feel slightly dizzy, which is (as the pulmonologist joked) "exactly how he likes his women."  Afterwards, he asks if you need a glass of water, which you politely decline, because you're surrounded by an arsenal of unknown prescription drugs and a loud, forgetful lung doctor who seems to enjoy dropping double entendres.

In between methacholine rounds, small talk reveals that the doctor likes to spend his weekends outside the city, and refers you to the best apple orchard in Vermont.  While you may assume that perhaps small talk might relieve the yelling, each round involves more laborious coaching, as if yelling these breaths out of you will make you birth a lung baby.  He asks again after round four if you need a glass of water, and despite your refusal, brings over your abandoned iced coffee, mentioning it's probably not the best thing to be drinking during this sort of test, but puts the straw up to your lips anyhow because you're "still looking piqued."

The last step in the PFT is removing all the mist you've unsuccessfully (judging by your bowling score) exhaled by way of a bronchodilator.  "Lips sealed, nice and tight... just stay like that for three more minutes." He mentions that he should do a recording of his voice, or perhaps you could do a recording, so he could save his lungs from having to coach people all day long on their breathing.  But he's not sure you would have the time, because he's not even sure "if you are single."  You might give a tight-lipped smile, hoping he has a report to process.  Probably, he will begin arguing (loudly) with the Russian technician about COPD instead.

After reviewing your computerized read-outs of your exhalations, he will assure you that your test is pretty normal, and that there is a small percentage of a chance that it could be a false negative, but you can rule out asthma, most definitely.  He will then regale you with the story of how, once, he was on a bike ride in Vermont and got chased by a pack of wild dogs, to the extent where he was sprinting so fast that he felt a touch constricted in his lungs and thought it "was probably a touch of EIA", and that your experience was probably much like his, so you simply "shouldn't push so hard."

You may neglect to mention you are training for a marathon, and cover up your smirk with a cough, compliments of the bronchodilator.  You might then pick up your bag, thank him, and make a hasty retreat for the door.

"Don't forget to go back to your doctor!" he will yell at you from down the hall.

All very strange, you will think.  But your doctor will be able to tell you soon if you need an inhaler before you go out and push too hard in the future.  Hopefully she won't yell at you about it.