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Specialist Respiratory Services
Dr Rob Nickels offers comprehensive respiratory services for all lung conditions including respiratory symptoms such as shortness of breath, wheeze, chronic cough. Dr Rob Nickels is highly experienced in the assessment and treatment of lung conditions including but not limited to asthma, pulmonary fibrosis, bronchiectasis, asbestos related lung disease, emphysema, sarcoidosis, COPD and lung cancer.
Dr Rob Nickels works closely with the General Practitioners in the Gold Coast and northern New South Wales regions to ensure the most appropriate assessment, treatment and ongoing management of a wide range of respiratory conditions is provided. Dr Nickels also reports many of the respiratory tests performed at the Ramsay Health lab at John Flynn Private Hospital.
You can be assured we have a commitment to excellence when it comes to the level of care we provide
complex lung function test (LFT's)
Complex Lung Function Tests also called pulmonary function tests or PFT's, evaluate how well your lungs are working. These tests examine your breathing and lungs.
They determine how much air your lungs can hold, how quickly you can move air in and out of your lungs and how well your lungs put oxygen into and remove carbon dioxide from your blood.
Complex Lung Function Tests can be used to diagnose and monitor respiratory illness and can also be conducted as a pre-operative risk assessment before anaesthesia and/or surgery.
bronchial provocation test with mannitol
This test is indicated for individuals where underlying asthma is suspected but where apparent asthma is not detected on spirometry. A Bronchial Provocation Test measures bronchial hyper responsiveness and is necessary for precise aetiological diagnosis in bronchial asthma.
It is now recognised as the gold standard provocation test in assessing airway hyperreactivity e.g. asthma, exercise induced asthma and cough variant asthma.
Lung function tests in children have taken on an increasingly important role in the evaluation of a child with known or suspected respiratory disease.
Lung function testing is an integral part of the evaluation and management of children wth respiratory conditions. The John Flynn Respiratory Centre has the latest state-of-the-art lung function equipment complete with visual images and graphics for testing children over the age of 6 year old.
Spirometry is the most common lung function test performed. It specifically meaures the amount (volume) and speed (flow) of air that can be inhaled and exhaled.
Often this test is performed before and after a bronchodilator is administered. Spirometry is indicated for many reasons including to diagnose or manage asthma, to detect respiratory disease in patients presenting with symptoms of breathlessness and to distinguish respiratory from cardiac conditions.
A bronchoscopy is an examination of your respiratory system including your windpipe and air passages with a telescope.
A bronchoscopy is sometimes necessary to examine the airways comprehensively as this cannot be seen accurately on 'x-ray' or 'ultrasound' and the respiratory physician may also need to take biopsies or samples of the lung tissue for testing.
A bronchoscopy can also assist in the process of diagnosis and in planning the best treatment for individuals with lung disease.
high altitude simulation test (HAST)
A High Altitude Simulation Test (HAST) is a lung function test specifically designed to assess an individual's fitness to fly with breathlessness or underlying lung disease.
During this test, we are able to simulate the low oxygen environment experienced while flying and measures any drops in oxygen levels while sitting and standing. If oxygen levels fall below 85%, in-flight oxygen may be recommended.
We can then determine whether oxygen will be required to be safe at altitude and if so, how much each individual needs.
maximum inspiratory and expiratory pressures (MIP's and MEP's)
Maximum inspiratory and expiratory pressures (MIP's and MEP's) is a crude measurement of respiratory muscle strength. There are groups of muscles used to breathe in (inhale) and breathe out (exhale). This test is designed to assess diaphragm weakness.
When these muscles become weak, it can cause problems with normal lung function and result in breathing difficulties.
The FeNO test, which stands for the fractional concentration of exhaled nitric oxide, is performed using a portable device that measures the level of nitric oxide in the air you slowly exhale. It is an objective measure of allergic / eosinophilic inflammation and is therefore an important tool to assist with the diagnosis and management of asthma. The data measured assists your doctor to monitor your asthma control, assess for changes in medications required and help to minimise exacerbations into the future.