Top Lung Health: Recent Episodes

Dr. Stefan Cristian Stanel

Easy-to-understand information about lung diseases, treatments and health improvement. We discuss asthma, COPD, pulmonary fibrosis, symptoms, inhalers, medication, research news. Stefan Cristian Stanel is a pulmonologist in the UK specializing in ILD. Website: https://www.toplunghealth.com/ YouTube: https://www.youtube.com/c/DrStefanCristianStanel

While care is taken to provide accurate information which is evidence-based and rooted in clinical practice, the podcast and associated content (articles, videos, social media posts etc.) does not constitute medical advice in individual cases.

In this episode, tips to quit smoking FOREVER.

You can also watch this as a video on YouTube here: https://youtu.be/lagLuANUC5g

Most long-term smokers want to quit but it is extremely difficult due to the addiction having multiple components: physical, psychological, and social. Understanding these components needs to be a first step towards overcoming them. Breaking some habits while fighting cravings may be one of the hardest things you can do, but well worth the health benefits.

Smoking is a gamble with your healthy years of life. It significantly increases the risk of lung, heart, and vascular diseases while reducing your chances of leading a healthy life. To quit smoking permanently, you need to deconstruct and address each component of the addiction as it relates to your own situation.

Physically, nicotine is a very addictive substance. It changes brain chemistry, leading to cravings and withdrawal symptoms like irritability, anxiety, and agitation. To combat this, it's crucial to understand your smoking habits. Journaling your daily cigarette consumption and noting the time of the day you smoke can help gauge the level of addiction in your case (to know where you are starting from). Setting a quit date in the future and then working up to that date to gradually reduce the frequency and quantity of smoking can readjust the brain's chemistry back to normal. It can be helpful to see a smoking cessation specialist to consider Nicotine Replacement Therapy (e.g. nicotine patches, gum, lozenges or inhalators) or medications like bupropion, varenicline or cytisine if you need extra help in dealing with smoking cravings.

Psychological addiction is a huge component of smoking. Smoking often becomes a ritual associated with specific activities (such as drinking coffee, driving) or emotions (smoking to combat anxiety or stress). Journaling can sometimes help you identify these associations, to enable you to gradually break unhealthy habits over time. Sometimes, being ill or hospitalized, travelling and becoming absorbed by other major life events (such as the birth of a child) can inadvertently break these patterns, providing an opportunity to quit.

Social factors can also make quitting a challenge. Not joining friends for smoking breaks at work or social events can create a fear of missing out (FOMO) or feeling excluded. If this is hard to avoid, you could just join your friends but not smoke, even if it may be hard. Knowing that you may occasionally be slightly mocked or teased, and reacting in a neutral, non-defensive way, can make your friends accept and eventually support your decision to quit. Over time, others may even come to respect your decision and seek your advice.

smoking #quitsmoking

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Answering a bunch of questions about COPD, emphysema and inhalers.

You can also watch this as a video on the YouTube channel: https://youtu.be/ghNRzXhNhZ4

The questions and comments that I discuss cover some of the following topics:

side effects of inhalers
healthy living versus going on inhalers
explanation what is emphysema and chronic bronchitis
can you be addicted to / dependent on inhalers ?
zephyr valves for emphysema - how would they work and why they are not for everyone
does everyone need pulmonary rehabilitation or to see a specialist pulmonologist ?
the power of healthy habits to help improve outcomes of chronic respiratory conditions#toplunghealth #copd #emphysema

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Answering a question about reducing corticosteroid treatment (prednisolone) in sarcoidosis.

You can watch the video on YouTube here: https://youtu.be/j4u7om2X1Ds

Reductions in the dose need to be done gradually, as the body no longer produces its own steroids after a lengthy treatment. By gradually reducing the dose, we give the body a chance to resume it's own physiological steroid production. In some cases the reduction needs to be very slow. Steroid-sparing medication also has a good effect in sarcoidosis, but it has a different side effect profile. In many cases it can be safer long-term, but this depends on a case-by-case basis. I would highly recommend a careful discussion with your doctor about the right strategy in your case, as everyone is different. In the cases of long-term immunosuppressive medication, there is always a balancing act between controlling sarcoidosis and minimizing side effects.

sarcoidosis

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Some words of encouragement if you have been diagnosed with a lung condition. A comment received on my channel summarizes the situation very well: there is a lot that you can achieve just with lifestyle changes in managing lung conditions.

You can watch the video on YouTube here: https://youtu.be/HjKKdqJFShE

Of course, not all the problems can go away with just diet or exercise, but in some cases this can make a huge difference.

It's important to work with your doctor to be on optimal treatment but to not give up and hold on to the hope that your own lifestyle changes can also lead to even better results.

healthylifestyle

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How to improve your life to be healthier and more fulfilled? Healthy living sounds easy on paper, and many books will try to sell you on the right diet, exercise program or smoking cessation strategy.

Watch the video on YouTube here: https://youtu.be/yyr-9w3Bs40

I personally feel everything starts with the "mental". If you are grounded, self-aware and happy in your own skin, you will naturally make healthier choices. If you struggle with anxiety or certain personality traits this may lead you to cope by adopting unhealthy behaviors (smoking, drinking excessively, eating compulsively, not sleeping enough etc.). We could all do with being more aware of our own mental patterns, and to listen to what our body is "telling" us. In many cases we already feel what we need to be doing, but our thoughts shape unhealthy behaviors instead. Hope we can be more honest with ourselves.

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What do you need to know if you have been diagnosed with COPD (chronic obstructive pulmonary disease)?

See the video on YouTube here: https://youtu.be/at9-kVqoay0

In this video I try to reassure you that the treatment for COPD can be effective, especially if you implement certain lifestyle changes to stop the progression of the condition. The main step to take is to stop smoking (if you are an active smoker). Also, if you are exposed to dusts and fumes in your work or home, please consider reducing the amount you are inhaling (changing the workplace activities, ventilating your space well, using respiratory protection etc.).Other important things are to keep active, have a good diet and healthy weight, and to have regular check-up with your doctor. If you also have other health problems, these would also need to be treated effectively, as it can complicate the management of COPD. Taking inhalers correctly is important and if you are struggling with inhaler technique, try to see videos online or ask your doctor for some feedback and guidance (take your inhaler with you to consultations).

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What to do if you are diagnosed with asthma? How to best manage asthma to control it long term.

In this episode I go over important treatment and lifestyle tips to deal with having asthma.

Watch the video on YouTube: https://youtu.be/er4Vc2YCwps

With adequate treatment, support and a healthy lifestyle, most people who have asthma should have relatively normal lives.

Chapters:

(03:06) What treatments may be given?

(07:55) Understand what asthma is

(10:01) Know your asthma triggers

(11:46) Written asthma action plan

(14:33) Know how to use inhalers

(15:58) Good diet

(18:07) Healthy weight

(19:07) Exercise

(20:16) Good sleep

(22:21) Regulate your circadian rhythm

(25:03) Smoking

(27:03) Vapes and e-cigarettes

(28:59) Indoor air pollution

(32:01) Seek support

(34:18) Asthma is not your identity

(36:49) Conclusion

asthma

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What can you do if you receive a diagnosis of an interstitial lung disease (ILD)? How can you deal with this chronic lung disease?

Watch the video on YouTube: https://youtu.be/t0V_hvpfack

In this episode I cover what the diagnosis can mean for you, information your doctor and healthcare team may give you, how to better understand your diagnosis and treatment options. I talk about non-medication options: oxygen therapy, exercise programs (pulmonary rehabilitation), reading about your diagnosis, support groups, finding health information online, psychological support and other relevant issues. Interstitial lung diseases can include diagnoses such as idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), sarcoidosis and many others. Not all of these conditions behave in the same way so it is important to find the right information in your case. Whenever you do not understand your diagnosis, ask your healthcare team to clarify this so that you can make better health choices.

interstitiallungdisease #ild

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In this episode - 12 reasons why your asthma is not controlled. You can watch the video on my YouTube channel, here: https://youtu.be/BnfdGKgmrsE

Asthma is a variable condition with good and bad days. Asthma attacks and flare-ups are driven by increasing airway inflammation.To have better asthma control you may consider the following: 1. Having good Inhaler technique2. Being on a controller medication that reduces airway inflammation3. Learning how to recognize worsening symptoms4. Having an asthma action plan (written) on how to deal with complications and attacks5. Quitting smoking!6. Reducing ongoing exposure to allergens that are triggering asthma attacks in your case7. Considering whether the asthma is occupational (i.e. related to something in your workplace) 8. Reducing and treating acid reflux with diet and medication as necessary9. Keeping an overall lifestyle and diet10. Reviewing your sleeping patterns, as disrupted sleep and shift working have been associated with worse asthma11. Maintaining a healthy weight12. Having regular follow-up with your healthcare team

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This episode is about antifibrotic treatments for pulmonary fibrosis. You can watch the video on my YouTube channel, here: https://youtu.be/5FHP_EoX1NM

Two medications are available (pirfenidone and nintedanib). These drugs may be prescribed for the following indications:1. Idiopathic Pulmonary Fibrosis - both pirfenidone and nintedanibVideo about IPF: https://youtu.be/RNnVtCP3ae02. Progressive Fibrosing Interstitial Lung Disease (PF-ILD) or Progressive Pulmonary Fibrosis (PPF) - nintedanib only3. Systemic sclerosis associated interstitial lung disease (SSc-ILD) - nintedanib onlyVideo about SSc-ILD: https://youtu.be/huecgJrXURIThese indications may change over time, and new medications may become approved. This information is valid as of April 2023. Please check with your doctor for accurate information in your case.Antifibrotic medications do not "cure" fibrosis, but they can slow down the progression of the disease. This means that in the long run, being on the medication may be better than not having it. Lung function would be preserved for longer. There are some potential side effects to antifibrotics that I discuss in the video.

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Reacting to a comment about never using antibiotics. You can watch the video on my YouTube channel, here: https://youtu.be/LyCejRAxA3wThere is always a risk of selecting bacterial species which are resistant to antibiotics. However, it in many situations, antibiotic use has very clear guidelines. Most doctors actually are quite careful in prescribing antibiotics to prevent the emergence of "superbugs".

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Familial pulmonary fibrosis means that there are several cases of pulmonary fibrosis in the same family (among blood relatives). You can watch the video on my YouTube channel, here: https://youtu.be/3wrvocYf0AoI discuss this situation, genetic predisposition, telomeres and telomere related genes and what all these mean for families in which several people appear to have similar conditions (such as pulmonary fibrosis). Familial pulmonary fibrosis (FPF) may sometimes be referred to as familial interstitial pneumonia (FIP) or familial interstitial lung disease.

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What are some common causes for breathlessness? Why do you get short of breath on exertion? The video is available on my Youtube channel, here: https://youtu.be/V3d6iTuu0CUI talk about deconditioning, anxiety, lung diseases, heart failure, pulmonary hypertension, anemia. If you are breathless, try to see your doctor to understand what is going on, in case there may be a medical explanation, and to choose the right treatment.

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What is pulmonary fibrosis (scarring of the lungs)? In this episode I provide a thorough overview and highlight the difference between progressive and non-progressive lung fibrosis, causes, getting a clear diagnosis, follow-up over time and treatment.

Causes of pulmonary fibrosis may include: severe lung infections, such as tuberculosis (TB); systemic/autoimmune diseases; environmental factors, such as dusts, hypersensitivity to various things - bird proteins, mold, humidifiers, farm workers, compost, saw dust - literally anything; undetermined causes (idiopathic pulmonary fibrosis - IPF).

The diagnosis is usually made using a combination of tests, which may include: imaging - HRCT, respiratory tests (lung function tests), blood tests, bronchoscopy, lung biopsy. The results are then typically brought to a multidisciplinary discussion (MDT) where several specialists make the final diagnosis.

Treatment involves many components - it is not just medication. If the fibrosis is extensive or there is a risk of progression, it is extremely important to have regular check-ups with a doctor in order to carefully observe the fibrosis over time. This is usually done by repeating lung function and imaging over time, as well as monitoring symptoms.

Sometimes no treatment for fibrosis may be recommended or there may not be effective therapy available, and in such cases symptomatic treatment may sometimes be given.

Eliminating the cause is extremely important. Stopping smoking usually helps, as well as paying attention to causes from the environment, in case there is a component of hypersensitivity (birds, moldy hay, animals, agriculture etc.).

Medication usually involves anti-inflammatory or antifibrotic treatment, which is chosen depending on the cause of the lung fibrosis. Anti-inflammatory agents may include corticosteroids (e.g. prednisone) or immunosuppressants (methotrexate, mycophenolate). Antifibrotic drugs which are currently approved include nintedanib (Ofev) and pirfenidone (Esbriet). These are both indicated for idiopathic pulmonary fibrosis (IPF), while nintedanib (Ofev) can sometimes be used in other forms of progressive fibrosis (which meet certain criteria).

Oxygen therapy is also very important as a form of treatment, to correct low levels in the blood and ensure that other organs such as the heart are operating efficiently.

Pulmonary rehabilitation by maintaining physical exercise is extremely important. Keeping fit to the extent possible will ensure that the body will cope with the reduction in lung function better.

Treatment of symptoms may involved having medication for chronic dry cough or shortness of breath. Treatment of associated diseases which may contribute to these symptoms is also essential (i.e. it is not always only the fibrosis causing the symptoms). Psychological counseling and cognitive-behavioral therapy can help with anxiety and panic attacks which may occur due to sudden episodes of breathlessness and changes in lifestyle.

Participation in clinical trials helps drive the science of pulmonary fibrosis forward and may offer early access to innovative therapies. Taking part in research also means that the condition is observed more carefully, with regular lung function and consultations.

I do encourage patients to join local support groups and patient associations in order to meet others coping with pulmonary fibrosis and get updates from a patient perspective. Some of these groups can be found by asking at the local hospital or on social media (i.e Facebook).

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How to improve cough at home after a cold or a chest infection. Get rid of your cough faster by allowing your airways to recover faster:

1) use soothing lozenges, honey or tea

2) keep well hydrated

3) avoid very dry air in your home

4) get rid of excessive nasal secretions (ex. saline nasal wash)

5) control acid reflux by being careful with your diet

6) stop smoking if you are a smoker

7) keep your room well ventilated to breathe clean air

Once you feel better, try to go outside for fresh air as much as possible.

Remember you can watch most episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

Twitter: Stefan Cristian Stanel (@scstanel) / Twitter

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Asthma Q&A session about some of the questions I received on my YouTube channel.

Remember you can watch most episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

Twitter: Stefan Cristian Stanel (@scstanel) / Twitter

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Inhalers cause weight gain? It is a common question and search topic online. Many inhalers do contain a low dose of corticosteroids, however this dose is usually too low to cause any significant side effects throughout the body. Inhalers allow the medication to be delivered directly to the airways, where it acts directly. Most inhaled medication is not absorbed at a significant level in the rest of the body. This is unlike tablets, which need to dissolve in the body's fluids at a sufficient concentration to cause an effect in distant organs. Weight gain directly linked to inhalers would be extremely unlikely.

Most often there are other issues at play, such as deconditioning. People with chronic respiratory disease often end up being less and less active due to their symptoms. This in turn leads to muscle wasting and worse capacity to exercise. It is a vicious circle that can be hard to break. Similarly, other concurrent medical problems may contribute to weight gain.

Remember you can watch most episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

Twitter: Stefan Cristian Stanel (@scstanel) / Twitter

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A live explanation about familial pulmonary fibrosis (FPF) or familial interstitial pneumonia (FIP). Familial cases can be caused by variants in something called telomere-related genes. Telomeres are repetitive sequences of DNA at the end of chromosomes which protect the DNA during cell division. Chromosomes are structures in the nuclei of cells which contain the DNA in a tightly packed form. Familial pulmonary fibrosis can appear at the same time as other conditions (not related to the lungs) which also share a telomere-related issue.

See the video in higher resolution directly on YouTube: https://youtu.be/qbiiKctxpU8

Remember you can watch most episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

Twitter: Stefan Cristian Stanel (@scstanel) / Twitter

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In this episode, I discuss some commonly asked questions about pneumonia treatment. Simple episodes of pneumonia normally do not require a lot of treatment and can be safely managed at home. Typically, an antibiotic is prescribed, with or without some other treatments to help manage symptoms.

The antibiotic is the main treatment for the bacterial pneumonia and should be taken as prescribed. Some antibiotics are only taken once daily, while others can be given twice or three times daily. Taking your antibiotic more or less often than prescribed is usually not a good idea. The timing of the antibiotic depends on its pharmacological properties (how long it takes to clear it from your body). Your doctor will generally give you a prescription for the right amount of antibiotic at the right time and only adjust this if you are not really feeling better.

Probiotics (medications to protect your gut flora) are sometimes also given with the antibiotic or recommended by your pharmacist. These are not often required as they are not a guarantee that you will not get digestive side effects from the antibiotic. Some antibiotics are more likely to affect the gut flora than others. I would recommend you talk to your doctor to see if a probiotic would be indicated in your case.

Vitamin supplements are also not necessary for most people who get pneumonia, as long as they have a healthy diet and lifestyle. There is a lot of marketing around supplements, but most people don't actually need them.

Finally, a chest X-ray is not generally required to check if the pneumonia is gone. If a chest X-ray film is done too early after pneumonia, it will still likely show abnormalities, as it usually takes up to 6 weeks for the images to return to normal. Therefore, in most cases of pneumonia, a follow-up chest x-ray is not immediately requested. Your doctor may however ask you to repeat the X-ray a few months after in case they have any specific concerns.

Remember you can watch many of these episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

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A comment about persistent cough and taste abnormalities after COVID. How long to wait until seeing a doctor about the cough?

A residual cough is very common after chest infections including COVID. Normally if the cough lasts for more than 6-8 weeks with no sign of improvement it may be a good idea to ask for a medical opinion in your case. Most often there may be some ongoing inflammation that may improve with time or it could be sustained by other issues you may be having (such as acid reflux, post-nasal drip from chronic rhinitis etc.). Sometimes the cough may be the sign of a complication from the chest infection or something more serious. Knowing the cause of the cough is the most important thing (if it is not going away on its own).

You should always see your doctor if you are worried about your health!

Remember you can watch many of these episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

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What can be done if despite a theoretically correct asthma treatment there are still many symptoms? This is common, as current asthma inhalers are usually prescribed correctly based on international guidelines (such as GINA Asthma - https://ginasthma.org/). Therefore, even non-specialist doctors are usually able to prescribe the the right inhalers.

If there are still symptoms present or many asthma attacks, several issues may be happening:

inhaler technique may not be optimal
the prescribed doses of medication may not be enough
there may still be environmental triggers for the asthma at home or at work
repeated viral infections may be worsening the airway inflammation and leading to a loss of asthma control.

Remember you can watch these episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Find more information on the website: https://www.toplunghealth.com/

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This is a discussion and guide for those who may be suffering from COPD or know someone who is. Chronic obstructive pulmonary disease is a condition affecting the airways and the lungs, marked by shortness of breath on exertion and chronic productive cough. These symptoms tend to get worse over time and this leads to much suffering. COPD is a combination of chronic bronchitis and emphysema.

World COPD day is marked in 2022 on 16 November. It is a moment to raise awareness of this condition, to get more people to check their lungs and diagnose it early. It is a preventable condition for the most part, especially if we all avoided smoking and environmental air pollutants, both indoor and outdoor. #worldcopdday

This is an unedited episode (as most of my content is) because I am trying to explain these concepts in a friendly, human way, while still following a structure that I hope is easy for you to follow. I am always looking for ways to improve my content, so if you have any suggestions, please connect with me and let me know.

Find more information on the website: https://www.toplunghealth.com/

Watch episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

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In this episode I discuss about using corticosteroids (such as prednisone / prednisolone etc.) for asthma exacerbations (flare-ups). Based on a question I received on the YouTube channel I talk about reasons for using steroids and if this treatment would result in complete improvement of symptoms during a worsening of asthma control. I also explain why the effect of these corticosteroid burst lasts for a while longer than the actual prescribed treatment duration.

Find more information on the website: https://www.toplunghealth.com/

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When are inhaled corticosteroids (ICS) used in the treatment of COPD (chronic obstructive pulmonary disease)? Inhaled corticosteroids are normally a treatment for asthma, however they are useful for people who have many COPD flare-ups (exacerbations) and more severe COPD. The question in the video specifically talks about using Flovent (fluticasone) in addition to Anoro Ellipta (a combination of two bronchodilators).

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Ep. 7 - Using saline nebulizers and other forms of salinity to treat respiratory conditions. I discuss normal saline (0.9%), hypertonic saline, going into salt mines and if salt pipes serve any purpose. Some salt-based inhaled therapies have proven efficacy (saline nebulizers). Salt pipes don't seem to be worth it in my opinion. Also I would be wary of dubious health claims regarding unusual benefits of "Himalayan salt".

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What is the best time to take your inhaler? Morning, afternoon, evening? Does it matter? Some inhalers only require once daily use, while others can be twice daily. Some inhalers have a faster onset of action compared to others. All these details are important and doctors will usually take them into account when giving you your prescription.

As most people are normally most active during the day, the morning is likely to be the best time to use inhalers which are only taken once daily, although there is no strict rule around this. This is because the peak concentration of the active substance in the airways will be in the hours after inhalation and this concentration will then slowly decline throughout the day.

If your inhaler is taken twice daily (i.e. one puff in the morning, one in the evening), this suggests that the maximum effect of the inhaler will last for around 12 hours. There is no sharp cut-off however and in some instances a twice daily inhaler may only be prescribed once daily (if your doctor believes this would be enough in your case).

Find more information on the website: https://www.toplunghealth.com/

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Do inhalers help in the recovery period after chest infections? This is a common question, as many people struggle with some lingering symptoms in the weeks after a respiratory infection (viral or bacterial). There may be a residual cough which may last for up to 6-8 weeks and in some cases there may be some wheeze. If your doctors suspects that there is some ongoing airway inflammation or hyperresponsiveness, they may prescribe an inhaler for a few months to help your recovery. This is not useful for most patients, but for some it can help. It is important however to only use inhalers in this situation if it is indeed your doctor's recommendation. Please see your doctor for personalized health advice.

Find more information on the website: https://www.toplunghealth.com/

Watch episodes as videos on my YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

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Restriction means the lungs cannot expand fully, therefore they cannot be fully inflated with air.

In this episode I discuss many potential causes for restrictive lung disease, answering a question received on the channel. A restrictive pattern can be found on routine spirometry or sometimes more complex lung function tests are performed revealing lower than expected lung volumes (restriction).

This can be due to issues outside of the lungs (chest deformity), pleural thickening restricting lung movement etc. Sometimes there may be a neuro-muscular disease which causes restriction. Within the lungs, there may be pulmonary fibrosis (scarring of the lungs), which again has very many causes. Sometimes restriction can be due to long term complications of infections such as tuberculosis.

Treatment for lung restriction aims at treating the cause as much as possible. Sometimes there are not many effective therapies. Maintaining respiratory muscle strength is essential.

Find more information on the website: https://www.toplunghealth.com/

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A question I received on my YouTube channels about whether someone could have a mild form of asthma without knowing or having a formal diagnosis. This is a common situation actually, especially if asthma appears a bit later in life (which is entirely possible). Symptoms of asthma can include: wheezing, chest tightness (constriction), coughing. These symptoms usually come and go, with good days and bad days (variable chest symptoms). Mild asthma attacks can be triggered by inhaling dust or pollens you may be allergic to. I would highly recommend that if you are having respiratory symptoms or breathing difficulties, to seek some advice from your doctor, to see what is going on.

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In this episode I try to raise awareness of occupational lung diseases. These are very preventable if respiratory protection is used (i.e. particulate filter masks). Many people work in dusty or otherwise unhealthy environments. It is important to try to work in well ventilated areas, to use respiratory protection, seek advice from your employer and doctors if you are developing respiratory problems at work. Very important to think long term! What will your breathing be like in 10-20 years?

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Stefan Cristian Stanel (@scstanel) / Twitter

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I reflect on the fact that some medical problems unfortunately cannot be fixed and it is important to live a healthy life to the extent possible. Life is very precious and even though we have better and better treatments each day, there may always be a health issue that won't have an effective therapy. Doctors may be able to keep the game of life going, but it is important to be aware of the fact that it shouldn't take a health scare to start living a healthy life. We should live a good life every day, to use the precious time that we have wisely.

The website: https://www.toplunghealth.com/

My YouTube channel: https://www.youtube.com/c/DrStefanCristianStanel

Stefan Cristian Stanel (@scstanel) / Twitter

Send in a voice message: https://anchor.fm/stefan-cristian-stanel0/message