Kelly Fan, MD

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COVID-19 – ICU Care Medication Therapies

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Lung Disease – Obstructive Lung Disease Types

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COVID-19 – ECMO Overview

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Idiopathic Pulmonary Fibrosis – Management

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COPD – Severity

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COPD – Progression

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COPD – Causes

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Lung Cancer – Screening

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COVID-19 – ECMO and Mechanical Ventilation

Most ICUs have mechanical ventilation support, but only specialized ICUs at larger hospitals offer extra corporeal membrane oxygenation, or ECMO for short. ECMO is reserved for the sickest patients with respiratory failure when mechanical ventilation...

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Pulmonary Embolism – Risk Factors

What are the risk factors for pulmonary embolism and DVT? Certain patients are at higher risk for developing a pulmonary embolism or DVT. These include a prior history of blood clots, family history of blood...

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Pulmonary Embolism – Recovery

Most patients with a first pulmonary embolism will improve within three to six months and can stop taking anticoagulation medications after discussion with their physicians. As mentioned, certain risk factors and recurrent blood clots can...

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Pulmonary Embolism – Medication Treatment

Anticoagulation or blood thinning medication is a cornerstone of treatment for pulmonary embolism. Patients will usually require these medications for at least three months, but possibly longer, depending on the risk for a recurrent event....

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Pulmonary Embolism – Management

How is pulmonary embolism managed? The first step is to assess the stability of a patient. In stable patients with minimal risk factors and no comorbid medical conditions, anticoagulation medications can be started in the...

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COVID-19 – ICU Care

It’s a scary time for family members when a loved one gets hospitalized with COVID-19, especially when that patient requires intensive care unit or ICU level care. Most hospitals are limiting visitors to decrease community...

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Idiopathic Pulmonary Fibrosis – Overview

What is idiopathic pulmonary fibrosis or IPF? IPF is a lung disease of unknown etiology characterized by permanent and irreversible damage to the lung tissues itself. This is as opposed to a much more common...

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Idiopathic Pulmonary Fibrosis – Diagnosis

“The diagnosis of IPF can be difficult to make and requires a detailed clinical history and exam blood work to rule out other diseases that could cause pulmonary fibrosis. CT, chest imaging, and pulmonary function...

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COPD – Maintenance Inhaler Therapy

Similar to asthma, maintenance inhaler therapy is also important for COPD. Three classes of inhaled medications include inhaled steroids, beta2 agonists and muscarinic antagonists. These medications help calm inflammation in the airways and open up...

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COPD – Definition

COPD stands for chronic obstructive pulmonary disease. Similar to asthma and bronchiectasis, it’s another disease of the airways within the lungs. This is different than pulmonary fibrosis and the interstitial lung diseases, as well as...

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COPD – Chronic Condition

So COPD is a chronic condition and the management of patients really should be individualized for each patient depending on the severity of their disease, how well their lung is functioning and multiple other factors,...

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Lung Cancer – Treatment

Once the patient’s cancer is fully staged, decision is then made for treatment plan based on the patient’s health and their cancer stage. This discussion is often made in a multidisciplinary conference with specialists, including...

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Asthma – Degree of Severity

“So asthma is a very heterogeneous disease. This means there’s various degrees of severity from patient to patient and care really should be dedicated depending on where a patient is on their degree of severity....

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Pulmonary Embolism – Overview

What is a pulmonary embolism? A pulmonary embolism is a serious medical condition caused by blockage of the arteries in the lungs by a blood clot. An associated condition is deep vein thrombosis or DVT,...

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Lung Cancer – Types of Doctors

At most centers, pulmonologists are primarily responsible for the early detection and diagnosis of lung cancer, the staging of lung cancer and providing input on the treatment plan for the patients. Surgeons, radiation oncologists, and...

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Asthma – Curable

So asthma is one of these chronic diseases that is not ever completely curable. Now that doesn’t mean you’re going to be sick your entire life. That simply means that you always carry the disease...

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Asthma – Biological Therapies and Bronchial Thermoplasty

In the last decade, there’s been an increased understanding of the cellular pathophysiology of asthma. This has led to the development of biological therapies, which target specific antibodies, and signaling pathways that induce asthma symptoms....

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Asthma – Asthma Attack

“So what exactly is an asthma attack? An asthma attack, or asthma exacerbation more formally, is an increase in your baseline asthma symptoms. These symptoms will include increase in cough, phlegm production, chest congestion, wheezing,...

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Lung Cancer – Screening

“Lung cancer screening is a new preventative tool that was developed in the last decade. This screening protocol was developed based on a paper in the early 2010s, which showed that screening with patients that...

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Lung Cancer – Occurrence

Lung cancer is one of the deadliest cancers that remains difficult to manage. There are approximately 225,000 new cases and 160,000 deaths annually. Lung cancer is the second most common cancer in men and women,...

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Lung Cancer – Lung Nodules

What happens when a screening CT or a CT scan performed for another reason, shows a lung nodule? In pulmonary clinic, we see more and more lung nodules due to increased screening and general increased...

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Lung Cancer – Diagnosis

If the risk seems high enough that the nodule could represent cancer, the decision is then made to proceed with either a biopsy procedure or a PET-CT scan. The PET-CT scans can be considered a...

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Asthma – Inhaler Medication

“So proper use of inhaler medication is actually very important for long-term asthma management, especially if you’re someone with more moderate to severe form of asthma. It’s very important and critical to know the difference...

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Asthma – Inhaler and Nebulizer Machine

Proper inhaler technique is necessary to ensure the inhaler medications are delivered to the lungs and airways. Before leaving your doctor’s office with a new inhaler prescription, be sure you are confident about knowing how...

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Asthma – Grow out of it

So one common question we get asked a lot is, can I grow out of my asthma? A lot of patients will have childhood asthma and, indeed, they grow out of it. Important thing to...

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Asthma – Life Threatening

So in terms of asthma exacerbation, yes, this is a life-threatening condition. People, patients can die from asthma exacerbation. Chest tightness, wheezing, shortness of breath. All of these symptoms should prompt you to consider that...

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COVID-19 – Support Therapies

As we mentioned, the ICU allows for different types of support therapies to replace organ function. When the body is recovering from severe disease, it’s important to note that the fewer support therapies a patient...

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COVID-19 – Respiratory Failure and ICU Care Treatment

Specifically for COVID-19 patients, what is the most common reason for ICU level of care? COVID-19 is an infectious disease, primarily affecting the lungs, and therefore respiratory failure is the most common reason COVID-19 patients...

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COVID-19 – Recovery

Fortunately, many patients with severe respiratory failure and COVID-19 infection make a gradual recovery. The oxygen requirement via the ventilator decreases over time, lung function recovers, and the endotracheal tube can eventually be removed, allowing...

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Asthma – Treatment

Asthma treatment is tailored for each patient, depending on severity of their symptoms. In patients with mild disease, avoiding asthma triggers and having a short rescue inhaler, including the medication albuterol, levalbuterol or ipratropium to...

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Asthma – Overview

“Asthma is characterized by episodes of airflow obstruction causing chest tightness, wheezing, chronic cough, phlegm production, and shortness of breath. In between episodes, asthmatics can often feel normal without much, if any, pulmonary symptoms. Patients...

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Asthma – Management

So what are the basics of asthma management? Asthma is a chronic lung disease affecting 300 million people worldwide, characterized by reversible airflow obstruction, airway hyper-reactivity and airway inflammation. The reversible nature of the disease...

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Asthma – Diagnosis

Asthma is diagnosed with a combination of clinical history, physical examination, imaging studies, and laboratory tests. In straightforward cases, clinical history and pulmonary function testing is enough to make a diagnosis. Pulmonary function testing includes...

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Asthma – Cure

It should be noted that asthma is considered a chronic lung disease, unfortunately, without a complete cure. Most patients have mild disease that’s easily managed and will have no long-term impairment on lung function. However,...

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