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Pulmonary & Critical Care Medicine

Meet Our Physicians

Medical Office Building 2, Suite 190
401 Bicentennial Way
Santa Rosa, CA 95403
Map and Directions

Monday through Friday
8:30 a.m. to 5 p.m.


Pulmonary Function Lab

COPD Education Class

Sleep Apnea Lab

Why Am I Coughing?

A cough can last up to 8 weeks after an upper respiratory tract infection or a cold. Chronic cough is defined as cough lasting longer than 8 weeks. If your chest x-ray is normal, the most common causes of chronic cough are:

  • upper airway cough syndrome (UACS, also commonly referred to as post-nasal drip)
  • asthma
  • gastroesophageal reflux disease (GERD)

It is usual to treat one, or all, of these causes of cough with medications, even when “typical” symptoms are not present. Current or prior smoking is also a common cause of cough. Your physician may refer you to see a lung specialist if the cough is not improving with therapy.

American College of Chest Physicians Patient Education: Chronic Cough

What is Chronic Obstructive Pulmonary Disease?

Chronic Obstructive Pulmonary Disease (COPD) is a condition which prevents the lungs from functioning properly. The airways in the lungs become obstructed. Pulmonary obstructive diseases include: chronic bronchitis (damaged lungs produce excess mucous), emphysema (lung passages lose their flexibility to push air out), and chronic asthma (airway passages remain inflamed and constricted). A patient with COPD may experience coughing, increased mucous in the airways, shortness of breath, and wheezing. A major cause of COPD is smoking.

The goal of the COPD Case Management Program is to help patients better manage COPD through education, medication adjustment, and case management. This is achieved by creating a personal plan, teaching patients how to breathe and exercise properly, monitoring medication, and giving patients the opportunity to participate in our 12-session, Pulmonary Education Classes.

Our Chronic Obstructive Pulmonary Disease Program:

To enter this program, patients must be referred by a Pulmonologist and able to:

  • Participate in an exercise program (treadmill, stationary bike, free weights, and arm ergometer)
  • Walk/stand without human assistance for 20 minutes (using a walker is OK)
  • Understand and follow simple instructions Patients must not smoke and meet one of the following requirements:
  • Forced expiratory volume less than 60%
  • A recent COPD-related ER/hospital visit


What is Asthma?

Asthma is a lung disease where the lung airway becomes inflamed, begins to swell, and causes difficulty breathing. Individuals with asthma experience difficulty breathing due to allergy, exercise, or other environmental factors or triggers. Asthma affects nearly 20 million Americans (American Lung Association, April 2004).

What You Can Do?

Follow “Best Practices” (high-quality treatment recommendations) to help manage:

Asthma symptoms :

  • Use your long-acting inhaler (i.e., ProAir ® ) even if you are feeling fine
  • Use your short-acting inhaler (albuterol) only as needed for asthma symptoms
  • Let your physician know if you are using your albuterol more than twice a week for asthma symptoms not related to exercise.

What If I Have a Spot on My Lung?

You may have been told you have a “spot” on your lung, or a pulmonary nodule. This can be as small as a grain of rice (commonly found on CT scans) or the size of a walnut, or larger. Pulmonary nodules can be infection, scar from old infection, or cancer. Depending on the size, location, and characteristics of the nodule, different tests can be done to find the cause. Your physician may refer you to a lung specialist to help with diagnosing the nodule. Further testing may include one or more of the following:

  • serial imaging (repeat CT scans over time)
  • positron emission tomography (PET) scan
  • bronchoscopy by a lung specialist
  • biopsy by a radiologist
  • biopsy by a surgeon

It is important to remember that most very small nodules are not cancer. Nodules smaller than a marble are usually too small for biopsy, and need to be followed over time. Nodules that are stable for two or more years are considered benign, meaning they are not cancer.

American College of Chest Physicians Patient Education: Pulmonary Nodule

Tests Performed in the Pulmonary Department

1.  Pulmonary Function Test

Lung function tests (also called pulmonary function tests, PFTs, Spirometry) check how well your lungs work. The most common test measures how quickly you can move air in and out of your lungs. Other tests can determine how much air your lungs can hold, and how well gases (like oxygen and carbon dioxide) are used in our lungs. These tests help your physician diagnose specific lung diseases, measure the severity of lung problems, and check to see how well a specific treatment is working.

Important Information Before Your Lung Tests:

  1. Do not smoke 6 hours before the test.
  2. Do not take your long-acting inhalers, such as Advair (fluticasone/salmeterol), Dulera (mometasone/formoterol), Qvar (beclamethasone), Serevent (salmeterol), or Spiriva (tiotropium) the morning of the test.
  3. Do not take your short-acting bronchodilator, such as ProAir (albuterol), Combivent or Atrovent (ipratropium), six hours before the test.

Lung Test – Patient Instructions and Questionnaire

Your Results

The information collected during the tests is looked at by a pulmonologist, and the results are sent to the physician who asked for the test. If you would like to know the results of your pulmonary function test, contact your physician at 707-393-4044. If you would like a copy of your test results, you can contact Medical Secretaries at 707-571-3770, or visit the Santa Rosa Medical Secretaries to file a request.

2.  Bronchoscopy

After seeing a pulmonologist, he or she may recommend a bronchoscopy to help with making a diagnosis. This involves inserting a small flexible lighted tube into the lungs via the nose or mouth. Once in the lung, we can collect fluid samples from the small air sacs (alveoli), perform biopsies of the airways, lung tissue, lymph nodes, or retrieve foreign bodies. Bronchoscopy is a same-day procedure performed in our clinic under conscious sedation.

Important Information Before Your Bronchoscopy:

  1. Register at the window in Suite 190, East Building, first floor, 10 minutes before your appointment.
  2. Do not eat breakfast the morning of your bronchoscopy. Pills with sips of water or juice are ok – no coffee or tea.
  3. You will not be able to drive afterwards. You must bring someone into the clinic with you who will drive you home. If you do not bring someone with you, we will not do the procedure.

Staying Safe During Your Procedure:

Here are some of the ways we will work with you to make sure your care before, during, and after your procedure is as safe as we can make it.

  1. Infection Prevention: Clean your hands with soap and water or a waterless hand sanitizer before eating, after using the restroom, after coughing or sneezing and whenever hands are soiled. As you health care providers to clean their hands before providing care.
  2. Falls: You are at risk for falling whenever you have been sedated for a procedure. Please do not get up without assistance.
  3. Procedure: You doctor and the staff caring for you will appropriately identify you and the procedure for which you and the procedure for which you are scheduled. We will provide you with written discharge instructions when you leave our unit, including a phone number to call if you have questions or concerns.

If you have any questions, or need to reschedule your appointment, call 707-571-3755.

Learn More about your Procedure:  Throat and Lung ExamBronchoscopy (Emmi)