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Breathe Easy: Pulmonary Care
Breathing issues can be scary. Stephen Szabo, Director of Cardiopulmonary / Respiratory Services, discusses common breathing issues and what to do for them.
Featuring:
Stephen Szabo, RCP
Stephen Szabo is the Regional Director of Cardiopulmonary and Respiratory Services for Tenethealth Central Coast Market, which owns and operates Twin Cities Community Hospital and Sierra Vista Regional Medical Center. In his role, Stephen is focused on building strong collaboration between both medical facilities and their respective respiratory practitioners, ultimately benefiting the communities within the central coast of California.Stephen has 35 years of experience in healthcare as a California Licensed Respiratory Care Practitioner. During his 35 years as a practitioner Stephen has worked in all areas of respiratory care including neonatal, pediatric, and adult critical care, as well as directorship. He has made a commitment to ensuring patients are the focal point of all healthcare decisions. With this in mind, he provides strategic oversight and maximizes resources to deliver an exceptional patient experience, and to facilitate excellent working environments for clinicians.Before relocating to the Central Coast in 1999, Stephen’s focus was Pulmonary Function and diagnostics. Additionally, he spent five years as a supportive member for a prominent Cardiothoracic Surgery Team. Stephen earned a degree in Respiratory Care, and studied Healthcare Administration at Los Angeles Valley College, and California State University Northridge, respectively. Transcription:
This program is a community service and is not intended to be a substitute for medical advice. Listeners having questions about their health, should make an appointment to see their personal physician. Any opinions or statements made during the program, are those of the individuals or physicians making the statements and are not the opinion or statements of the hospital.
Prakash Chandran (Host): Not being able to breathe properly can be really frightening. But luckily, there are treatments available that can help you improve lung function and maintain an independent lifestyle. We’re going to talk about this with Stephen Szabo, the Director of Cardiopulmonary and Respiratory Services at Sierra Vista Regional Medical Center and Twin Cities Community Hospital. This is Healthy Conversations, the podcast from Sierra Vista Regional Medical Center and Twin Cities Community Hospital. I’m Prakash Chandran. So, first of all Stephen, let’s start with some of the more common breathing disorders that you come across day to day.
Stephen Szabo, RCP (Guest): Sure, probably the most common that folks are aware of are asthma, and COPD. There’s a lot of publicity about these two lung diseases which is beneficial. You probably see a lot of commercials for different airway management medications and that’s great. Public education is wonderful and it’s probably one of the main treatments we suggest.
So, asthma, probably very common. People have heard of it throughout their life. It is a disorder or a disease that is treatable but not curable. It’s very common. Probably 20 million people have asthma in the United States. The most beneficial treatment plan for asthma is to be aware of your body. Be aware of the symptoms. The treatments are easy. They are generally inhaled medications. And to do this, takes seconds. So, first and foremost, if you notice your breathing is short, tight, short of breath, would be feeling fatigued, or winded with normal activity, getting up from the couch to get to the kitchen or walking from the car to the market; this is something unusual and you want to talk to your doctor about it. Also if you have a cough or you have noisy breathing, we call that wheezing; that’s a time to talk to your doctor about the possibility of having asthma.
Very similar to that is a disease called COPD. That stands for chronic obstructive pulmonary disease. In the old days, we referred to COPD as bronchitis or emphysema. Both of those disease processes are grouped together, and your doctor may refer to that disease as COPD. I’m grouping these together because treatment plans are very similar for these. The difference is COPD is avoidable. It is a progressive lung disease that happens over time, but it happens because you have exposed your body to irritants. The most common irritant is smoking. Other irritants would be working in polluted areas, being exposed to fibers, solvents, particulate matter and like that, that would cause your lungs to become irritated.
And not removing yourself from these irritants over time, causes this chronic disease.
Host: So, we will get back to asthma in a moment. But you mentioned that COPD is avoidable. Is there ever a time where some of the effects that you get from COPD or exposing yourself to these irritants become irreversible?
Stephen: Yes. Once you start to develop the symptoms of COPD; it is treatable, but not reversible. These symptoms continue to progress over time. It becomes harder and harder to breathe and ultimately, they can be fatal. So, that’s why early detection and treatment, if you think you have any issues like this is imperative. You have to really know your body and address this with a healthcare professional.
Host: You mentioned that you group these two asthma and COPD in a similar bucket because a lot of the symptoms are the same, wheezing, kind of getting short of breath when you are doing simple things; at what point should you go and see a doctor about this?
Stephen: Well, here’s how we look at it. If you notice your breathing – first of all, you shouldn’t notice your breathing. It comes automatically. It feeds your body with oxygen, your lungs do. They are a very remarkable organ for your body. So, if you notice your breathing; that’s one little trigger or risk factor. If you have a chronic cough. If you cough a lot, that would be daily, with or without mucus, if you notice that you are fatigued or short of breath just doing regular activities, as I mentioned earlier, getting up from the couch to go to the kitchen, or walking from the car into the market. If you have to stop or you notice your breathing during those times; that’s another risk factor. If you notice that maybe your lips have a little blueish tint to them, or your finger nailbeds have a little blueish tint to them; that’s a time to address these symptoms with your doctor.
If you notice your breathing is noisy, like wheezing. So, if you think about all these things and then you also have any of the risk factors; if you were a smoker, if you have a family member that has asthma or COPD, if you work around a heavy polluted area; definitely, these are times to talk to your doctor about that. That’s when you want to take some action. And your symptoms may be mild at first but if you have three or more of these symptoms; it’s time to take notice and go to your doctor. Early treatment is key.
Host: So, let’s talk about some of those treatment options. Let’s say that I notice for example, that I’m wheezing and I’m expressing some of the symptoms that you mentioned. I go to my doctor; what do they do? What treatment plan do they put me on here?
Stephen: Yeah, so you doctor will get a brief history to document your risk factors; your family history, your lifestyle history, your work history. They may order some diagnostic test which are very common and not painful. Probably the key test is something we call a spirometry. It’s a pulmonary lung function test. They are quite easy to perform. It’s basically the patient just breathing out into some equipment and the clinician who is performing the test will instruct the patient on various ways to breathe so they can take vital measurements of your lung capacity and probably more important, the flow rates or the speed that the air moves throughout your lungs.
So, you may also have a chest c-ray which again very painless, very easy to do. And your doctor will assess your lung function and the severity or lack of the COPD based on these diagnostic tests.
Host: Got it. and so once they make this diagnosis; what kind of treatment options are available? You talked about the inhaler for asthma but what about COPD and are there any more extreme treatments that are available to try to help fix things faster?
Stephen: Yeah. So, if you do receive a diagnosis of COPD; let’s focus on that first. There may be some lifestyle changes your doctor recommends along with any kind of medication treatment plan. So, of course, the number one thing we recommend is to keep your lungs clean. If you are currently a smoker, we really advise stopping smoking. If it’s difficult, talk to your doctor about smoking cessation programs. That’s really key. Another key lifestyle change is some exercise and routine exercise and that doesn’t mean running marathons or jogging. It could just be walking in your living room back and forth and you try to do that as many times as you can.
So, you don’t have to do anything strenuous but it’s just routine activity. And of course, over the weeks, you want to try to increase your endurance until if you are very severe, pretty soon, you can walk around the block. So, some kind of routine exercise is key. Taking your medications as prescribed. That’s also key and I’ll talk a little bit about medications in a moment. And then knowing your body. Maybe you have to keep a log of how your breathing is, how often you cough, sometimes there are home devices that are given that will help you easily measure your lung strength, and this is something to take note of and report back to your doctor if you see any changes.
So, as far as medications or pharmacology. Breathing medications are so easy to use. We see lots of commercials about inhalers and basically, that’s what they are. There are two different families of medications and depending on how your diagnostic tests show up, that will guide your doctor into what type of medication plan you need to take at home. And again, they are inhaled medications. Most of the time, they take about a second to do. You may have to do them once or twice a day.
There are other medication plans that may require a little more frequent administration maybe every four to six hours. But it’s nothing that will interrupt your lifestyle too much.
Host: Yeah, it’s really good to know that they are out there and yeah, I’ve seen my friends with asthma. It’s just a quick inhale and then that’s done. And just because as a layman asking, what exactly is happening when they do the inhaler? Is there a bunch of medication that’s in that inhaler that they are absorbing into their lungs? Like how does it actually work?
Stephen: Great question. So, there are two families. The most common family is what we call a bronchodilator. So, when you have asthma or emphysema; your airways become more narrow. In the case of asthma, an irritant which might be dog dander, dust, a cold blast of air; anything that your body feels is an irritant; will cause your lungs to respond in a way to try to protect themselves. And what they do is actually close down your bronchial passages in an effort to reduce the amount of irritant getting into your lungs. Unfortunately, that also reduces the amount of fresh air and oxygen going into your lungs.
So, even though they are trying to protect themselves; it is not beneficial to your entire body. So, when you inhale a bronchodilator; it causes the muscles that line your airways to relax, almost immediately. You might have heard the term rescue inhaler. These are medications that work within a minute to start to relax those muscles and open up your airways.
Another family of medications are called anti-inflammatories and they do just that. They get rid of inflammation or swelling that also go along with your body’s response to irritated lungs. Either the muscle spasming or the swelling, both decrease the opening, the size of your bronchial passages and again, that prevents air from getting into your lungs. So, both the medication plans help to open those airways up. The rescue inhaler does it very quickly. Maintenance medications don’t work as fast, but they work for a long period of time. They might last in your body up to 12 hours before you would need to re-dose.
Host: Yeah, thanks for that explanation. As we wrap up here, I want to talk about how we can be proactive to promote healthy lung function. I know you talked about a consistent exercise routine even just walking around in your living room. And certainly avoiding those irritants like smoking or things that are really going to irritate your lungs. But what else can we do to be proactive?
Stephen: So, you can know your environment. If you feel like you have sensitive lungs and have not been diagnosed; take note of the air quality outside. We are fortunate in our central coast are to live in relatively clean air but there still are days if you live near coastal communities where the sand dust kicks up and you can easily go online and review the air quality in your zone and there’s recommendations. If you have sensitive lungs; if the air quality is bad, they may recommend that folks stay inside or limit their outdoor activities.
Again, if you have a lifestyle that causes you to be in more irritating areas; you want to really key in, know your body, know when changes may be happening to your lungs as far as the amount you cough, how easily you get fatigued. I can’t stress enough how early detection and keying into symptoms that your body gives you, clues that your body gives you will prompt you to talk to your doctor. Again, asthma, COPD; they are very treatable diseases but if they go unchecked; sadly they can be fatal.
Host: Wow, okay, that’s really fantastic advice and I think the main takeaway here is be very proactive. If you start noticing some of these things; it never hurts to go in and get it checked out. Before we close here today; is there anything else that you wish that more patients knew before they came to see you?
Stephen: So, a lot of folks ignore the symptoms and I sound like a broken record here but ignore the symptoms their body, the clues their body is giving them. They discount being short of breath as just getting older or they are out of shape or some folks seek medical attention but they don’t follow up with the proper diagnostics so they may be given the wrong medications or medications that aren’t as beneficial as they could be. And in clinical practice; I do see that a lot and it’s tough. You might see a patient who has been treated for ten years but maybe not with the best medications. So, again, key into your body’s symptoms, follow up with your doctor, take medications as prescribed.
Host: Great advice. All right Stephen, I really appreciate your time today. That’s Stephen Szabo, the Director of Cardiopulmonary and Respiratory Services at Sierra Vista Regional Medical Center and Twin Cities Community Hospital. Thanks for checking out this episode of Healthy Conversations. For a referral to Stephen Szabo or another provider call the Sierra Vista Regional Medical Center and Twin Cities Community Hospital physician referral line at 866-966-3680. If you found this podcast helpful, please share it on your social channels. And be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Sierra Vista Regional Medical Center and Twin Cities Community Hospital. Thanks and we’ll see you next time.
This program is a community service and is not intended to be a substitute for medical advice. Listeners having questions about their health, should make an appointment to see their personal physician. Any opinions or statements made during the program, are those of the individuals or physicians making the statements and are not the opinion or statements of the hospital.
Prakash Chandran (Host): Not being able to breathe properly can be really frightening. But luckily, there are treatments available that can help you improve lung function and maintain an independent lifestyle. We’re going to talk about this with Stephen Szabo, the Director of Cardiopulmonary and Respiratory Services at Sierra Vista Regional Medical Center and Twin Cities Community Hospital. This is Healthy Conversations, the podcast from Sierra Vista Regional Medical Center and Twin Cities Community Hospital. I’m Prakash Chandran. So, first of all Stephen, let’s start with some of the more common breathing disorders that you come across day to day.
Stephen Szabo, RCP (Guest): Sure, probably the most common that folks are aware of are asthma, and COPD. There’s a lot of publicity about these two lung diseases which is beneficial. You probably see a lot of commercials for different airway management medications and that’s great. Public education is wonderful and it’s probably one of the main treatments we suggest.
So, asthma, probably very common. People have heard of it throughout their life. It is a disorder or a disease that is treatable but not curable. It’s very common. Probably 20 million people have asthma in the United States. The most beneficial treatment plan for asthma is to be aware of your body. Be aware of the symptoms. The treatments are easy. They are generally inhaled medications. And to do this, takes seconds. So, first and foremost, if you notice your breathing is short, tight, short of breath, would be feeling fatigued, or winded with normal activity, getting up from the couch to get to the kitchen or walking from the car to the market; this is something unusual and you want to talk to your doctor about it. Also if you have a cough or you have noisy breathing, we call that wheezing; that’s a time to talk to your doctor about the possibility of having asthma.
Very similar to that is a disease called COPD. That stands for chronic obstructive pulmonary disease. In the old days, we referred to COPD as bronchitis or emphysema. Both of those disease processes are grouped together, and your doctor may refer to that disease as COPD. I’m grouping these together because treatment plans are very similar for these. The difference is COPD is avoidable. It is a progressive lung disease that happens over time, but it happens because you have exposed your body to irritants. The most common irritant is smoking. Other irritants would be working in polluted areas, being exposed to fibers, solvents, particulate matter and like that, that would cause your lungs to become irritated.
And not removing yourself from these irritants over time, causes this chronic disease.
Host: So, we will get back to asthma in a moment. But you mentioned that COPD is avoidable. Is there ever a time where some of the effects that you get from COPD or exposing yourself to these irritants become irreversible?
Stephen: Yes. Once you start to develop the symptoms of COPD; it is treatable, but not reversible. These symptoms continue to progress over time. It becomes harder and harder to breathe and ultimately, they can be fatal. So, that’s why early detection and treatment, if you think you have any issues like this is imperative. You have to really know your body and address this with a healthcare professional.
Host: You mentioned that you group these two asthma and COPD in a similar bucket because a lot of the symptoms are the same, wheezing, kind of getting short of breath when you are doing simple things; at what point should you go and see a doctor about this?
Stephen: Well, here’s how we look at it. If you notice your breathing – first of all, you shouldn’t notice your breathing. It comes automatically. It feeds your body with oxygen, your lungs do. They are a very remarkable organ for your body. So, if you notice your breathing; that’s one little trigger or risk factor. If you have a chronic cough. If you cough a lot, that would be daily, with or without mucus, if you notice that you are fatigued or short of breath just doing regular activities, as I mentioned earlier, getting up from the couch to go to the kitchen, or walking from the car into the market. If you have to stop or you notice your breathing during those times; that’s another risk factor. If you notice that maybe your lips have a little blueish tint to them, or your finger nailbeds have a little blueish tint to them; that’s a time to address these symptoms with your doctor.
If you notice your breathing is noisy, like wheezing. So, if you think about all these things and then you also have any of the risk factors; if you were a smoker, if you have a family member that has asthma or COPD, if you work around a heavy polluted area; definitely, these are times to talk to your doctor about that. That’s when you want to take some action. And your symptoms may be mild at first but if you have three or more of these symptoms; it’s time to take notice and go to your doctor. Early treatment is key.
Host: So, let’s talk about some of those treatment options. Let’s say that I notice for example, that I’m wheezing and I’m expressing some of the symptoms that you mentioned. I go to my doctor; what do they do? What treatment plan do they put me on here?
Stephen: Yeah, so you doctor will get a brief history to document your risk factors; your family history, your lifestyle history, your work history. They may order some diagnostic test which are very common and not painful. Probably the key test is something we call a spirometry. It’s a pulmonary lung function test. They are quite easy to perform. It’s basically the patient just breathing out into some equipment and the clinician who is performing the test will instruct the patient on various ways to breathe so they can take vital measurements of your lung capacity and probably more important, the flow rates or the speed that the air moves throughout your lungs.
So, you may also have a chest c-ray which again very painless, very easy to do. And your doctor will assess your lung function and the severity or lack of the COPD based on these diagnostic tests.
Host: Got it. and so once they make this diagnosis; what kind of treatment options are available? You talked about the inhaler for asthma but what about COPD and are there any more extreme treatments that are available to try to help fix things faster?
Stephen: Yeah. So, if you do receive a diagnosis of COPD; let’s focus on that first. There may be some lifestyle changes your doctor recommends along with any kind of medication treatment plan. So, of course, the number one thing we recommend is to keep your lungs clean. If you are currently a smoker, we really advise stopping smoking. If it’s difficult, talk to your doctor about smoking cessation programs. That’s really key. Another key lifestyle change is some exercise and routine exercise and that doesn’t mean running marathons or jogging. It could just be walking in your living room back and forth and you try to do that as many times as you can.
So, you don’t have to do anything strenuous but it’s just routine activity. And of course, over the weeks, you want to try to increase your endurance until if you are very severe, pretty soon, you can walk around the block. So, some kind of routine exercise is key. Taking your medications as prescribed. That’s also key and I’ll talk a little bit about medications in a moment. And then knowing your body. Maybe you have to keep a log of how your breathing is, how often you cough, sometimes there are home devices that are given that will help you easily measure your lung strength, and this is something to take note of and report back to your doctor if you see any changes.
So, as far as medications or pharmacology. Breathing medications are so easy to use. We see lots of commercials about inhalers and basically, that’s what they are. There are two different families of medications and depending on how your diagnostic tests show up, that will guide your doctor into what type of medication plan you need to take at home. And again, they are inhaled medications. Most of the time, they take about a second to do. You may have to do them once or twice a day.
There are other medication plans that may require a little more frequent administration maybe every four to six hours. But it’s nothing that will interrupt your lifestyle too much.
Host: Yeah, it’s really good to know that they are out there and yeah, I’ve seen my friends with asthma. It’s just a quick inhale and then that’s done. And just because as a layman asking, what exactly is happening when they do the inhaler? Is there a bunch of medication that’s in that inhaler that they are absorbing into their lungs? Like how does it actually work?
Stephen: Great question. So, there are two families. The most common family is what we call a bronchodilator. So, when you have asthma or emphysema; your airways become more narrow. In the case of asthma, an irritant which might be dog dander, dust, a cold blast of air; anything that your body feels is an irritant; will cause your lungs to respond in a way to try to protect themselves. And what they do is actually close down your bronchial passages in an effort to reduce the amount of irritant getting into your lungs. Unfortunately, that also reduces the amount of fresh air and oxygen going into your lungs.
So, even though they are trying to protect themselves; it is not beneficial to your entire body. So, when you inhale a bronchodilator; it causes the muscles that line your airways to relax, almost immediately. You might have heard the term rescue inhaler. These are medications that work within a minute to start to relax those muscles and open up your airways.
Another family of medications are called anti-inflammatories and they do just that. They get rid of inflammation or swelling that also go along with your body’s response to irritated lungs. Either the muscle spasming or the swelling, both decrease the opening, the size of your bronchial passages and again, that prevents air from getting into your lungs. So, both the medication plans help to open those airways up. The rescue inhaler does it very quickly. Maintenance medications don’t work as fast, but they work for a long period of time. They might last in your body up to 12 hours before you would need to re-dose.
Host: Yeah, thanks for that explanation. As we wrap up here, I want to talk about how we can be proactive to promote healthy lung function. I know you talked about a consistent exercise routine even just walking around in your living room. And certainly avoiding those irritants like smoking or things that are really going to irritate your lungs. But what else can we do to be proactive?
Stephen: So, you can know your environment. If you feel like you have sensitive lungs and have not been diagnosed; take note of the air quality outside. We are fortunate in our central coast are to live in relatively clean air but there still are days if you live near coastal communities where the sand dust kicks up and you can easily go online and review the air quality in your zone and there’s recommendations. If you have sensitive lungs; if the air quality is bad, they may recommend that folks stay inside or limit their outdoor activities.
Again, if you have a lifestyle that causes you to be in more irritating areas; you want to really key in, know your body, know when changes may be happening to your lungs as far as the amount you cough, how easily you get fatigued. I can’t stress enough how early detection and keying into symptoms that your body gives you, clues that your body gives you will prompt you to talk to your doctor. Again, asthma, COPD; they are very treatable diseases but if they go unchecked; sadly they can be fatal.
Host: Wow, okay, that’s really fantastic advice and I think the main takeaway here is be very proactive. If you start noticing some of these things; it never hurts to go in and get it checked out. Before we close here today; is there anything else that you wish that more patients knew before they came to see you?
Stephen: So, a lot of folks ignore the symptoms and I sound like a broken record here but ignore the symptoms their body, the clues their body is giving them. They discount being short of breath as just getting older or they are out of shape or some folks seek medical attention but they don’t follow up with the proper diagnostics so they may be given the wrong medications or medications that aren’t as beneficial as they could be. And in clinical practice; I do see that a lot and it’s tough. You might see a patient who has been treated for ten years but maybe not with the best medications. So, again, key into your body’s symptoms, follow up with your doctor, take medications as prescribed.
Host: Great advice. All right Stephen, I really appreciate your time today. That’s Stephen Szabo, the Director of Cardiopulmonary and Respiratory Services at Sierra Vista Regional Medical Center and Twin Cities Community Hospital. Thanks for checking out this episode of Healthy Conversations. For a referral to Stephen Szabo or another provider call the Sierra Vista Regional Medical Center and Twin Cities Community Hospital physician referral line at 866-966-3680. If you found this podcast helpful, please share it on your social channels. And be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Sierra Vista Regional Medical Center and Twin Cities Community Hospital. Thanks and we’ll see you next time.