Dr. Joseph Paprota, the pulmonary Critical Care Specialist at Mount Sinai Specialty Care in Key West and Miami joined Good Morning Keys on KeysTalk 96.9/102.5FM this morning to talk about pulmonary care.
What is pulmonary care?
Dr. Paprota said, “I focus primarily on the lungs, any disorders that may affect the lungs, such as asthma and COPD, which are the two most common disorders, but we also will also help to diagnose lung cancers and any industrial or occupational related lung disorders. The primary occupational problem in the Keys tends to be related to concrete dust.”
What about coral dust?
Dr. Paprota said, “Coral dust is a tough a tough one. I don’t think coral dust is actually from coral. It seems to be related to the tides and the mangroves. So when the tide goes out, the salt and other things that’s in the sea water dries out and then gets aerosolized. It definitely causes a problem for people with underlying lung disease, especially asthma.”
Can living in the Keys help people with COPD?
Dr. Paprota said, “The air quality down in the Keys is typically cleaner than it is up here in Miami, but depending on what way the wind’s blowing, the Keys tend to get, especially when it’s coming out of the north, a lot of pollen, and then once they start burning the sugar cane fields down in Cuba, that can cause some significant problems as well when the wind comes out of the south.”
What other pulmonary maladies are seen in the practice?
Dr. Paprota said, “Asthma is probably the big one, along with COPD. Asthma is an inflammatory lung disorder and shows up as wheezing and coughing, oftentimes, will be confused with a viral infection. People come and say, hey, I keep getting this virus infection a few times a year, and it ends up being asthma that just wasn’t diagnosed. COPD is the other big one. COPD is primarily due to smoking.”
Is there a genetic link in pulmonary disease?
Dr. Paprota said, “There are a few, particularly with pulmonary fibrosis, which is a diffuse scarring process of the lungs. That has clear genetic linkage, as do some cancers. Asthma probably does run in families as well.”
What are some symptoms of a pulmonary disorder?
Dr. Paprota said, “Most people will show up in the office or seek care due to shortness of breath. That pretty much runs through most of the pulmonary disorders, along with coughing, wheezing, phlegm production.”
Are there any preventative measures that could be taken?
Dr. Paprota suggested, “Avoiding smoke is the primary preventative strategy when it comes to COPD and asthma and pretty much any disorder. It doesn’t necessarily have to be cigarette smoke, any carbon based combustion products can really injure the lungs. Avoiding industrial dusts, particularly cement, silicone, stone workers, that, that sort of thing. It’s a lot of common sense, really.”
Technology has certainly advanced beyond the iron lung.
Dr. Paprota said, “I think the last person to be maintained on the iron lung just died. I remember reading that, but no, the negative pressure ventilators, which is what that’s called, are really not used at all these days. Most people get placed on a positive pressure ventilator or respirator.”
Mount Sinai is on the cusp of technological advances.
Dr. Paprota said, “We’re pretty much on the cutting edge of just about everything right now. When it’s related to pulmonary, most of the diagnostics done in pulmonology are either lab work or by biopsy, and we’ve got excellent surgeons here who are able to do minimally invasive procedures to get us pieces of the lung and give us a real diagnosis. Before that required pretty sizable surgeries. Now we can get these tissue samples, either with a simple scope or a small incision.”
Critical care is also Dr. Paprota’s specialty.
He said, “Most pulmonologists also work in the field of Critical Care Medicine, which basically takes care of the sickest people in the hospital. These are people with sepsis, shock, respiratory failure, on ventilators, heart problems, severe congestive heart failure, those sort of things. Most of the COVID deaths were related to the pneumonia that COVID caused, that typically had people on ventilators for very long times.”
How did Dr. Paprota get into medicine?
He said, “It was my family physician. I was pretty impressed, and really looked up to them. The being able to be on the cutting edge and always having things change was very becoming to me. I tend to get bored, so having things change, and I’m more of an analytical, scientific type of person than an art minded person, and it seemed to fit well and I like to talk, so I enjoy the patients.”