Overview Pediatric respiratory diseases come in many forms — from cystic fibrosis and sleep apnea to asthma, allergies and chronic lung disease — each needing a highly specialized approach to treatment. Through specialty centers and clinics, as well as with an active physician practice, the Pediatric Pulmonary Division at Stony Brook Children's provides expertise and a wide range of clinical services to appropriately and effectively address respiratory disease in infants, children and adolescents.
Stony Brook Children's Services – Stony Brook Medicine
Stony Brook Primary Care – Patchogue
Stony Brook Primary Care – Islip
Stony Brook University Sleep Disorders Center
Our Team The Pediatric Pulmonary team is led by Catherine Kier, MD, a highly respected physician/researcher/educator. She and other pediatric pulmonogist, Katharine Kevill, MD work with two pediatric nurse practitioners and a group of dedicated medical professionals to provide comprehensive, individualized care for patients starting with the initial assessment and diagnosis through setting a plan of treatment and performing interventions and follow-up care. In the case of cystic fibrosis (CF), where more and more patients are living well into adulthood, this follow-up care can last the course of their lifespan. The team also works closely with other departments throughout the hospital including pediatric hematology/oncology, pediatric gastroenterology, pediatric endocrinology, the neonatal intensive care unit and the pediatric intensive care unit.
In addition to serving patients, all members of the clinical team are engaged in pediatric pulmonary research and education. Meet the team:
Diagnostics. Leading-edge diagnostics include full pulmonary function testing, spirometry, exercise and cold air challenge, allergy skin testing, and allergy blood testing, all of which are performed in Stony Brook's fully accredited laboratory.
Cystic Fibrosis Center. The Division houses one of only 115 cystic fibrosis (CF) centers in the country accredited by the Cystic Fibrosis Foundation. CF accreditation is a rigorous process that evaluates all aspects of care from the laboratory services available, to the credentials of the clinicians and the quality of research. Stony Brook's program addresses cystic fibrosis via a multidisciplinary team approach. The cystic fibrosis team includes physicians, nurse practitioners, respiratory and pulmonology function therapists, social workers, a nutritionist, and a genetic counselor.
Stony Brook is also one of 16 cystic fibrosis centers that is part of a leadership and learning collaborative sponsored by the Cystic Fibrosis Foundation. Members share quality improvement initiatives, evidence-based care practices and results of ongoing studies designed to provide better patient care. In 2009, Stony Brook presented an initiative that improved pulmonary function by 10 percent—a goal achieved within six months, Currently, Stony Brook is examining the link between nutrition and pulmonary function.
In addition, because the lifespan of cystic fibrosis patients has been steadily improving, with an average life expectancy of 38 years, cystic fibrosis is undergoing recategorization—from a genetic fatal disease to a genetic chronic disease. Pediatric pulmonologists are incorporating caring for adults into their practices. In 2009, Stony Brook received a three-year grant from the Cystic Fibrosis Foundation to train adult primary care physicians to also become adult cystic fibrosis specialists. Currently Frederick J. Reindl, MD, is undergoing this training.
Pediatric Sleep Disorders Center. This accredited pediatric sleep center evaluates and diagnoses pediatric sleep disorders including obstructive sleep apnea, respiratory disorders, insomnia, parasomnias such as night terrors and sleepwalking, and behavioral problems relating to sleep. As a university-based center, it provides clinical care and research, as well as offers a sleep fellowship program to train other physicians. This means that the community has access to the very latest protocols. Stony Brook's Sleep Disorders Center is run by Dr. Catherine Kier, who is also board certified in Sleep Medicine, and was trained at the University of Pennsylvania, home of the country's first sleep division.
Location: Stony Brook University Sleep Disorders Center
Infant Pulmonary Function Testing. With premature babies surviving at younger and younger ages, there has been a rise of chronic lung disease in infancy. Stony Brook specializes in diagnosing and treating this disorder in the smallest and most vulnerable patients, and is the only hospital on Long Island and one of the few in the country with the expertise and the technology to perform infant pulmonary function testing, or iPFT. This testing can uncover such conditions as bronchopulmonary dysplasia, congential abnormalities like diaphragmatic hernia, and bronchiolitis. Stony Brook also performs cystic fibrosis screenings on infants using the iPFT equipment, which simulates the more traditional breathing test typically given to children at age five and above.
Location: Stony Brook University Medical Center
Bronchoscopy Services. Available on an inpatient and outpatient basis, Stony Brook provides bronchoscopy through a pediatrics special services unit to patients who experience acute or chronic breathing difficulties. This service is tailored to the needs of the individual patient, from infancy through adolescence. Location: Stony Brook University Medical Center
Genetic Testing. The Department of Pulmonary partners with Stony Brook's Genetics Division to offer a number of tests to identify hereditary respiratory disorders. Tests include sweat testing and genetic testing for cystic fibrosis. The genetics testing laboratory is fully accredited and offers the latest and most accurate tests available.
Genetics. Location: Stony Brook Children's Services – Stony Brook Medicine
Allergies and Immunology. Stony Brook offers medical evaluations, diagnostic testing and treatment options for allergic diseases such as asthma and allergic rhinitis, sinusitis, atopic dermatitis, eczema, food allergies, insect sting allergy, allergic conjunctivitis, and hives, as well as testing and treatment for disorders of the immune system such as common variable disease and hypogammaglobulinemia.
The allergy team takes a long-term management approach to these conditions, and treatment includes education on the disease process, use of equipment, environmental and dietary modifications, and self-management techniques.
Locations: Stony Brook Children's Services – Stony Brook University Medical Center
Stony Brook Primary Care – Patchogue
Patient Resources Stony Brook Medicine has taken a leading role in educating the community about asthma and works closely with the American Lung Association of Long Island and the Asthma Coalition of Long Island.
Stony Brook is also an active member of the Cystic Fibrosis Foundation of Long Island, and participates in education, fundraising and special events, including the Great Strides annual walk.
Cystic Fibrosis Accreditation Stony Brook's Cystic Fibrosis Center is one of just 115 centers nationwide accredited by the Cystic Fibrosis Foundation. This means that the center offers comprehensive care and the latest protocols following Cystic Fibrosis Foundation guidelines.
Center of Excellence Stony Brook is a designated Center of Excellence by the New York Department of Health for cystic fibrosis and genetic testing.
Definitions Allergies - Allergies are abnormal reactions of the immune system that occur in response to otherwise harmless substances. Normally, the immune system responds to foreign microorganisms or particles by producing specific proteins called antibodies. These antibodies are capable of binding to identifying molecules, or antigens, on the foreign particle. This reaction between antibody and antigen sets off a series of chemical reactions designed to protect the body from infection. Sometimes, this same series of reactions is triggered by harmless, everyday substances such as pollen, dust, and animal danders. When this occurs, an allergy develops against the offending substance (an allergen.)
Asthma - Asthma is a chronic (long-lasting) inflammatory disease of the airways. In those susceptible to asthma, this inflammation causes the airways to narrow periodically. This, in turn, produces wheezing and breathlessness, sometimes to the point where the patient gasps for air. Obstruction to air flow either stops spontaneously or responds to a wide range of treatments, but continuing inflammation makes the airways hyper-responsive to stimuli such as cold air, exercise, dust mites, pollutants in the air, and even stress and anxiety.
Chronic lung conditionsCystic Fibrosis - Cystic fibrosis (CF) is an inherited disease that affects the lungs, digestive system, sweat glands, and male fertility. Its name derives from the fibrous scar tissue that develops in the pancreas, one of the principal organs affected by the disease.
Sleep apnea - Sleep apnea is a condition in which breathing stops for more than ten seconds during sleep. Sleep apnea is a major, though often unrecognized, cause of daytime sleepiness. It can have serious negative effects on a person's quality of life.