Selected Podcast
Breathing in COVID-19
Stephen Szabo, Director of Cardiopulmonary/Respiratory Services and Licensed Respiratory Care Practitioner for Tenet Health Central Coast, discusses mask-wear, the impact of COVID-19 for those who already have a hard time breathing and pulmonary function testing.
Featuring:
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.
Stephen Szabo
Stephen Szabo is the Regional Director of Cardiopulmonary and Respiratory Services for Tenet Health 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:
Prakash Chandran: Because COVID-19 symptoms involve respiratory issues, it may be stressful if you or a loved one have had a history of breathing problems. Fortunately medical experts can help guide us towards safe treatments and find alternative ways to manage your respiratory health during this time. We're going to talk about it today with Steven Szabo, California, Licensed Respiratory Care Practitioner and Regional Director of Cardiopulmonary and Respiratory Services at Tenant Health Central Coast. This is Healthy Conversations, the podcast from Tenant Health Central Coast. I'm Prakash Chandran. So first of all, Steven, I'm curious as to, if there are any health reasons that prohibit an individual from actually being able to wear a mask?
Steven Szabo: Well, honestly, for somebody who's active and spontaneously breathing, there are not the CDC offers some recommendations for who should and shouldn't use a mask and it's kind of self-explanatory. They feel like children under two years old should not wear a mask. They may have trouble putting it on and off. It may cause some kind of breathing barrier for them. Also, this one's kind of general, but they say anybody who has issues breathing may want to refrain from wearing a mask and that's kind of general. So I think you have to know your own body. If you feel that the mask is limiting your normal activity due to maybe underlying breathing conditions you might have, then you probably want to check with your physician if this is a valid issue, but generally everybody else can wear a mask.
Host: Okay. That's really good to know. And for those people who already have a hard time breathing, how exactly does COVID-19 impact them?
Steven Szabo: Yeah. So let's take folks with some chronic pulmonary conditions and some common ones are COPD or asthma. Those are grouped together with emphysema type problems. They already have some lung insults or lung issues going on. And studies that have come out of say China, as they look at all the people who've been impacted are showing that those folks with underlying conditions have two times more the chance of having a severe illness due to the COVID virus versus other folks. You have to look at it as if having an underlying respiratory condition does not increase your chance of acquiring the virus. But if you do get infected, it does increase your chances of a more severe infection.
Host: You talked about underlying respiratory illnesses, just a high-level question. What are some of those? You said COPD, what are some others that people might want to be aware of?
Steven Szabo: Yeah. So again, commonly COPD, asthma, some folks have a condition called pulmonary fibrosis where the lungs are a little stiffer that affects their everyday breathing and definitely would make you more susceptible to a greater insult if you did become infected with the covered virus.
Host: Okay. Makes sense. And so, you know, I've heard of a respiratory therapist before. I am curious as to what role they play in the fight against COVID-19?
Steven Szabo: Yeah, they are kind of the unsung heroes. They are first responders with physicians and nursing staff. If an infected patient comes in and becomes very acutely ill, they will mostly be visited by a respiratory therapist. Respiratory therapist provide all the inhaled medications, they provide all of the more complex oxygen apparatuses. They also manage all of the invasive ventilation, which is commonly known as life support. And so they'll be treating the most sick patients that have been infected with the COVID virus.
Host: I see. So if I can just summarize, because I want to make sure that myself and our audience is able to understand for most people, even if you have these underlying respiratory issues, you should still be able to wear a mask, but you should be the judge of that if you're wearing it, and it's feeling very restrictive to the point where it's extremely uncomfortable, then you may want to talk to your physician and potentially not wear one. If you have an issue, then you will. The first line of defense is this respiratory therapist who is going to really work with you to kind of analyze the symptoms and then take you to the next step. Is that correct so far?
Steven Szabo: Absolutely, good job.
Host: So, moving forward from there, I've also heard of this pulmonary function testing lab. Can you explain what that is?
Steven Szabo: Not so much to do with our current pandemic issue, but pulmonary function testing is a way for healthcare professionals to assess the breathing of an individual. It's a very involved study, although it's easy to do, and it looks at people's lung capacities. And also more importantly, it looks at how air moves throughout your respiratory tract. If you do have one of these underlying pulmonary conditions that we spoke of, again, I'll pick COPD or emphysema because it's really in the media right now, people are familiar with that, that impairs your body's ability to move air throughout the lungs. And most importantly, get oxygen deep into your lungs, where it can transfer into your bloodstream. That's the name of the game? That's the goal of our breathing. If anything, impairs that such as swollen airways or an increased amount of secretions in your lungs that will impact your body's ability to do anything, any function walking around, moving, it affects every aspect of your life.
So pulmonary function test examines how air moves through your lungs, how any disturbances or obstructions will impact say your lung capacity or the ability to transfer oxygen into your blood. These are all specific measurements that we perform when you're doing a pulmonary test. And so why it's important is folks with underlying conditions are routinely on some type of medication that they will take daily. And this helps to maintain a good quality of life, but the effectiveness of the medications needs to be tested periodically. And that's what the pulmonary study
Host: I see. I was just going to ask about the frequency in which someone should get this tested. I imagine if you have an underlying issue such as COPD or emphysema, as you mentioned, that's something that's immediately tested, but then how often afterwards or after your initial test, should you then get it retested?
Steven Szabo: Great question. So the pulmonary studies are essential in the diagnosis of a problem. After that a physician may want to start on some medication and then recheck maybe in six months, once a routine has been locked down, you may be asked to perform the testing once a year. And then again, periodically, if there are any changes in your pulmonary status, if you notice that the medications don't seem to be working as well for you, then they might perform some Adlib testing to reverify that you're on correct dosages or correct substances.
Host: Okay. And just as we start to wrap up here, I wanted to ask you, you know, if someone listening to this has one of these issues, what advice might you have for them? You know, they're probably worried like, Oh my gosh, I have asthma. It's like, I have to be extra careful because then if I do contract the disease, it could be just a terrible experience for me. What is something that you might say to them to either help alleviate some concerns or any advice that you might give to keep them protected?
Steven Szabo: I think everybody, whether or not you have a lung condition right now is concerned about being exposed to infection. So if you do have some underlying issues, the advice is really to stay in, which is what we're telling most of the public avoid taking unnecessary travel, avoid being in large groups of people, try to use a mask. Again, if everybody uses a mask, it's more to protect your neighbor rather than protect you. It's like putting your hand over your mouth when you sneeze or cough. This is something our mothers have told us to do for years. Well, a mask is just that it's a permanent hanky or hand over your face to prevent you from spreading any germs you may have. If there's a big group of participation while it keeps everybody a little bit safer. So if you can't do that, you know, you want to try to maintain social distancing because studies have shown that droplets that come out of our mouth when we cough or talk, they travel through the air depending on the velocity, they're coming out, the speed that they come out.
And so, you know, if you stay six to nine feet away from people, well, those droplets will have floated to the ground before they can have a chance to get to you. So that's kind of common sense, wash your hands, try to avoid touching your mouth and your nose. Make sure you have plenty of medications on hand. This pandemic has caused a shortage in some medications, specifically some respiratory medications, because it impacts your lungs. And so make sure if you're at home, you have, you know, a good 30 day supply of your medications and you want take them as prescribed too, don't stop using your medications to try to save them. You want to keep your lungs healthy so that you're strong and resilient, should you come in contact with this virus.
Host: Yeah, it's really fantastic advice there. Is there any additional information you want to share about respiratory health during COVID-19?
Steven Szabo: Just, I suppose if you do have some underlying conditions, know your body, know when there's changes in your breathing, when it becomes heavy or difficult. If there's a change in your coughing pattern, these are all triggers that you may want to contact your primary care physician or come into an urgent care or an ER. There are a lot of self help tools out there on different websites. The American Lung Association say, and they have great instruction on tools that you can use at home to help kind of objectively judge your breathing. So you will know when there's been a change and you may need to contact your doctor. So those are probably the biggest takeaways is know your body, know when there's a change, and don't hesitate to seek medical advice.
Host: Steve, I think that's the perfect place to end. I really appreciate your time today. That's Steve Szabo, California licensed respiratory care practitioner and regional director of cardiopulmonary and respiratory services at Tenant Health Central Coast. Thanks for checking out this episode of Healthy Conversations. For referral to Steve Szabo or an additional information about pulmonary function testing lab, call the Tenant Health Central Coast physician referral line at (866) 966-3680. If you found this podcast helpful, please feel free to subscribe and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Tenant Health Central Coast. Thanks. And we'll see you next time.
Prakash Chandran: Because COVID-19 symptoms involve respiratory issues, it may be stressful if you or a loved one have had a history of breathing problems. Fortunately medical experts can help guide us towards safe treatments and find alternative ways to manage your respiratory health during this time. We're going to talk about it today with Steven Szabo, California, Licensed Respiratory Care Practitioner and Regional Director of Cardiopulmonary and Respiratory Services at Tenant Health Central Coast. This is Healthy Conversations, the podcast from Tenant Health Central Coast. I'm Prakash Chandran. So first of all, Steven, I'm curious as to, if there are any health reasons that prohibit an individual from actually being able to wear a mask?
Steven Szabo: Well, honestly, for somebody who's active and spontaneously breathing, there are not the CDC offers some recommendations for who should and shouldn't use a mask and it's kind of self-explanatory. They feel like children under two years old should not wear a mask. They may have trouble putting it on and off. It may cause some kind of breathing barrier for them. Also, this one's kind of general, but they say anybody who has issues breathing may want to refrain from wearing a mask and that's kind of general. So I think you have to know your own body. If you feel that the mask is limiting your normal activity due to maybe underlying breathing conditions you might have, then you probably want to check with your physician if this is a valid issue, but generally everybody else can wear a mask.
Host: Okay. That's really good to know. And for those people who already have a hard time breathing, how exactly does COVID-19 impact them?
Steven Szabo: Yeah. So let's take folks with some chronic pulmonary conditions and some common ones are COPD or asthma. Those are grouped together with emphysema type problems. They already have some lung insults or lung issues going on. And studies that have come out of say China, as they look at all the people who've been impacted are showing that those folks with underlying conditions have two times more the chance of having a severe illness due to the COVID virus versus other folks. You have to look at it as if having an underlying respiratory condition does not increase your chance of acquiring the virus. But if you do get infected, it does increase your chances of a more severe infection.
Host: You talked about underlying respiratory illnesses, just a high-level question. What are some of those? You said COPD, what are some others that people might want to be aware of?
Steven Szabo: Yeah. So again, commonly COPD, asthma, some folks have a condition called pulmonary fibrosis where the lungs are a little stiffer that affects their everyday breathing and definitely would make you more susceptible to a greater insult if you did become infected with the covered virus.
Host: Okay. Makes sense. And so, you know, I've heard of a respiratory therapist before. I am curious as to what role they play in the fight against COVID-19?
Steven Szabo: Yeah, they are kind of the unsung heroes. They are first responders with physicians and nursing staff. If an infected patient comes in and becomes very acutely ill, they will mostly be visited by a respiratory therapist. Respiratory therapist provide all the inhaled medications, they provide all of the more complex oxygen apparatuses. They also manage all of the invasive ventilation, which is commonly known as life support. And so they'll be treating the most sick patients that have been infected with the COVID virus.
Host: I see. So if I can just summarize, because I want to make sure that myself and our audience is able to understand for most people, even if you have these underlying respiratory issues, you should still be able to wear a mask, but you should be the judge of that if you're wearing it, and it's feeling very restrictive to the point where it's extremely uncomfortable, then you may want to talk to your physician and potentially not wear one. If you have an issue, then you will. The first line of defense is this respiratory therapist who is going to really work with you to kind of analyze the symptoms and then take you to the next step. Is that correct so far?
Steven Szabo: Absolutely, good job.
Host: So, moving forward from there, I've also heard of this pulmonary function testing lab. Can you explain what that is?
Steven Szabo: Not so much to do with our current pandemic issue, but pulmonary function testing is a way for healthcare professionals to assess the breathing of an individual. It's a very involved study, although it's easy to do, and it looks at people's lung capacities. And also more importantly, it looks at how air moves throughout your respiratory tract. If you do have one of these underlying pulmonary conditions that we spoke of, again, I'll pick COPD or emphysema because it's really in the media right now, people are familiar with that, that impairs your body's ability to move air throughout the lungs. And most importantly, get oxygen deep into your lungs, where it can transfer into your bloodstream. That's the name of the game? That's the goal of our breathing. If anything, impairs that such as swollen airways or an increased amount of secretions in your lungs that will impact your body's ability to do anything, any function walking around, moving, it affects every aspect of your life.
So pulmonary function test examines how air moves through your lungs, how any disturbances or obstructions will impact say your lung capacity or the ability to transfer oxygen into your blood. These are all specific measurements that we perform when you're doing a pulmonary test. And so why it's important is folks with underlying conditions are routinely on some type of medication that they will take daily. And this helps to maintain a good quality of life, but the effectiveness of the medications needs to be tested periodically. And that's what the pulmonary study
Host: I see. I was just going to ask about the frequency in which someone should get this tested. I imagine if you have an underlying issue such as COPD or emphysema, as you mentioned, that's something that's immediately tested, but then how often afterwards or after your initial test, should you then get it retested?
Steven Szabo: Great question. So the pulmonary studies are essential in the diagnosis of a problem. After that a physician may want to start on some medication and then recheck maybe in six months, once a routine has been locked down, you may be asked to perform the testing once a year. And then again, periodically, if there are any changes in your pulmonary status, if you notice that the medications don't seem to be working as well for you, then they might perform some Adlib testing to reverify that you're on correct dosages or correct substances.
Host: Okay. And just as we start to wrap up here, I wanted to ask you, you know, if someone listening to this has one of these issues, what advice might you have for them? You know, they're probably worried like, Oh my gosh, I have asthma. It's like, I have to be extra careful because then if I do contract the disease, it could be just a terrible experience for me. What is something that you might say to them to either help alleviate some concerns or any advice that you might give to keep them protected?
Steven Szabo: I think everybody, whether or not you have a lung condition right now is concerned about being exposed to infection. So if you do have some underlying issues, the advice is really to stay in, which is what we're telling most of the public avoid taking unnecessary travel, avoid being in large groups of people, try to use a mask. Again, if everybody uses a mask, it's more to protect your neighbor rather than protect you. It's like putting your hand over your mouth when you sneeze or cough. This is something our mothers have told us to do for years. Well, a mask is just that it's a permanent hanky or hand over your face to prevent you from spreading any germs you may have. If there's a big group of participation while it keeps everybody a little bit safer. So if you can't do that, you know, you want to try to maintain social distancing because studies have shown that droplets that come out of our mouth when we cough or talk, they travel through the air depending on the velocity, they're coming out, the speed that they come out.
And so, you know, if you stay six to nine feet away from people, well, those droplets will have floated to the ground before they can have a chance to get to you. So that's kind of common sense, wash your hands, try to avoid touching your mouth and your nose. Make sure you have plenty of medications on hand. This pandemic has caused a shortage in some medications, specifically some respiratory medications, because it impacts your lungs. And so make sure if you're at home, you have, you know, a good 30 day supply of your medications and you want take them as prescribed too, don't stop using your medications to try to save them. You want to keep your lungs healthy so that you're strong and resilient, should you come in contact with this virus.
Host: Yeah, it's really fantastic advice there. Is there any additional information you want to share about respiratory health during COVID-19?
Steven Szabo: Just, I suppose if you do have some underlying conditions, know your body, know when there's changes in your breathing, when it becomes heavy or difficult. If there's a change in your coughing pattern, these are all triggers that you may want to contact your primary care physician or come into an urgent care or an ER. There are a lot of self help tools out there on different websites. The American Lung Association say, and they have great instruction on tools that you can use at home to help kind of objectively judge your breathing. So you will know when there's been a change and you may need to contact your doctor. So those are probably the biggest takeaways is know your body, know when there's a change, and don't hesitate to seek medical advice.
Host: Steve, I think that's the perfect place to end. I really appreciate your time today. That's Steve Szabo, California licensed respiratory care practitioner and regional director of cardiopulmonary and respiratory services at Tenant Health Central Coast. Thanks for checking out this episode of Healthy Conversations. For referral to Steve Szabo or an additional information about pulmonary function testing lab, call the Tenant Health Central Coast physician referral line at (866) 966-3680. If you found this podcast helpful, please feel free to subscribe and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations, the podcast from Tenant Health Central Coast. Thanks. And we'll see you next time.