During the three-year training period, the fellows have exposure to the various disciplines of pulmonary and critical care medicine. I apologize. And we will kind of shepherd the patient along the way. And if you can, just kind of set the stage for us and tell us a little bit about nodules and masses, and what are they and how do people even know that they have such a thing in their lungs. I'm new here to the University of Chicago, and very thankful to be here. And then at that point, we would bring the patient back to the our laboratory. You know, and I was only being partially facetious when I said panic is kind of the natural-- because I think for a lot of people that's just the natural reaction. You know, it's not just like, yeah, you do this. Well, it certainly can. I love taking care of people, and I love to see them breathe better and feel better. But I love these. In addition to his dedication to his patients, Dr. Hogarth is committed to teaching, receiving the resident teaching award in 2020 and has been named a Distinguished Chest Educator several years in a row. Communicate with your doctor, view test results, schedule appointments and more. [MUSIC PLAYING] Hello, and welcome to At The Forefront Live. His work as been published in several peer-reviewed journals, including the Journal of Thoracic Disease, Respiratory Medicine and American Journal of Physiology, Lung, Cell, Molecular Physiology. Open for more information. We just talked a moment ago, and you're pretty new here. Open for more information. Sleep Medicine. Why aren't we just following the pathway down? So I'm excited to be here in the city, and part of this program. Go ahead, Ajay. You will get seen three to four weeks from now. And so the lymph nodes are where cancer would spread to first. I recently completed an interventional pulmonary fellowship, which brought me here. I am a Professor of Medicine here. You know, you mentioned that being covered by insurance. Yes, sir. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. We'll get you a speech card. It's usually about a half day's worth of time. So there's no cutting. So look, there's three ways to sample inside the lung. Maybe Dr. Hogarth, you can start. UC Health Pulmonary Medicine provides advanced care for a variety of lung and other pulmonary-related diseases. So my name is Kyle Hogarth. Every tumor, of course, has its own biology speed at which it grows. Can you kind of walk us through that? All kinds of fantastic information there. We're giving you the least amount of radiation, even for what's called a diagnostic scan. 11 millimeters is rather small. Why aren't we just following the pathway down? Can an 11 millimeter nodule be biopsied by that bronchoscope method through the throat? If it bothers you to come near the Medical Center, fine, let's do it via the computer. And either one of you can do that. But we're very careful about that. And then we go in with our scopes. AABIP/AIPPD Interventional Pulmonology Accredidation; AABIP IP Fellows Reading List; IP Fellows Case Discussion Monthly Series; 2023 IP Fellows Bootcamp; Upcoming Events. First, do no harm. Your lungs are going to be ultimately attached to your mouth. And hopefully, go home if nothing happens. But many times, you might notice something on an x-ray that's not part of the screening pathway. Hogarth was the first doctor in the Midwest to use the Monarch by Auris a robotic bronchoscopy navigation system with 3-D imaging technology built into a robotic scope that allows him to reach deeper into . Dr. Hogarth, do you want to start on that one? We even use-- in order to evaluate a patient's risk-- we use calculators to help evaluate that too based on a patient's history and imaging findings. We look at the airways and other parts of our computer modeling to see if that's something that we can get to. Oh, less than 5%, OK, let's slow down a little bit. So if you have an x-ray or a CAT scan, there is a chance that the word module or mass is going to show up in the report. Sue Hammerschmidt. And we will kind of shepherd the patient along the way. And the patient goes afterwards to a post-procedural area, where they recover. Media. But what I can also tell you is it's cancer, here's what stage it is. The University of Cincinnati Interventional Pulmonology (IP) Service is one of the 34 fellowship programs recognized by the American Association for Bronchology and Interventional Pulmonology (AABIP). In other cases, they are actually a cancer. Is that-- should you be frightened? And so Dr. Hogarth, we have another question from a viewer. It should be a CAT scan if you are eligible. Phone: 513-558-4831 Fax: 513-558-4858 Email: email@example.com But to delay any amount of care. Ajay Wagh, MD, MS, specializes in pulmonary medicinewith a focus in interventional pulmonology. Meaning, it's technically a cancer, but it's never going to necessarily bother you. For help with MyChart, call us at 1-844-442-4278. I don't know who wants to take that one. And I was fortunate enough, I think, gosh, it's been over a year ago. And that would be annually until they kind of exit out after that 15 years. See, this just shows how important it is that we do these programs here. I mean, the first thing is first, is we do have lung cancer screening, which we offer patients CAT scans if they're eligible and have a smoking history. And between the four of us, we're all in clinic at any given moment. And there we perform our procedures. Dr. Wagh is focused on using minimally invasive techniques for diagnosing and treating a wide range of lung and chest conditions, including stage lung cancer, chronic respiratory illness, complex airway disorders, pleural disease (pleurisy, pneumothorax, pleural tumors) and more. We could get you a plaque or something. And using some of the tools that we have. But generally speaking, a lung cancer-- when someone says to you, hey, we want to get a follow-up CAT scan, the reason they're suggesting that is that the nodule you have is so small or has characteristics that are so convincing that it's benign, that that two or three month interval that they've suggested-- if I'm wrong and it's actually a cancer, the amount that it's going to grow in that time period is so small that we've not lost anything. The Emory Sleep Medicine . And how urgently must patients act? Comments that do not apply, risk patient privacy, or are not appropriate are not posted. And so now you're going to go to the surgeon to be cured. But of course, there's biopsies. Pulmonologists D. Kyle Hogarth, MD, and Ajay Wagh, MD, talk about different ways physicians can detect and diagnose lung nodules and masses, including advanced bronchoscopy techniques that do not require incisions or surgery. 1:25 . Now, the low dose lung cancer screening has its own set of guidelines that helps us to monitor and follow any suspicious nodules. There are characteristics of nodules that make them more concerning for cancer, as opposed to less concerning. Oh, let me reinforce that. If your insurance company is not listed here, or if you have any other questions, please contact Managed.Care@uchospitals.edu. So we do want to remind our viewers, we'll take your questions for our experts. But in reality, if you're a patient, there's only two things. I do think that it's worth saying that complications are pretty rare with the scopes, the endoscopy that we perform. And that would be another area, I would imagine. Interesting. Interventional Pulmonology Fellowship Program Director. Some of them are blood based tests. The probability, if it's low enough, we don't want to do invasive things to you. For more information about the Interventional Pulmonology Center or to request a referral . Because in some cases, our plan for you is to get a follow-up CAT scan, is to do watch and wait. Exactly. And I think that's the first key step. So before we go and suddenly just remove a whole portion of your lung, let's slow down for a second and do things right. The fear always is that cancers are going to grow. But there's many other tests. At UF Health we have a very strong focus on interventional pulmonology with a program which has been in place for more than ten years, making it one of the oldest and strongest programs in . And that's a very important part for a cancer evaluation. So-- 4 Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina. The hospital is safe, the hospital is clean. And we do it through your mouth. So I always have to do this. We're still operating. (773) 702-1234, 2023 University of Chicago Department of Medicine, Center for Continuing Medical Education Tracker. Name Rank Section; Adegunsoye, Ayodeji: Assistant Professor Pulmonary / Critical Care Bag, Remzi But we do have avenues to help with that. UK Pulmonary, Critical Care and Sleep Medicine offers the full scope of inpatient and outpatient services involving the diagnostic evaluation and clinical management of respiratory disorders. You know, you said at the very beginning, I have a nodule, should I panic? Just type them in the comments section. You know, you mentioned that being covered by insurance. Well, that's nice. Star ratings and comments come from a number of survey questions. I mean, we do have telemedicine options. And so think of it like a sponge. And because I enjoyed working with people, I followed that up with going into medicine, and it just seemed like a perfect fit. Can you talk to us a little bit about what the patient experiences in this procedure? And we kind of-- we have a nice staff who will kind of walk the patient through what they should expect. And teasing out what's what is what Ajay and I do. And that's very important. You know, and I want to talk a little bit more about biopsies here in just a minute. 2023 The University of Chicago Medical Center. So when we're done, you go home. We work collaboratively with pulmonary medicine, critical care, allergy, thoracic surgery, medical oncology, radiation oncology, otorhinolaryngology and transplant specialists to provide you with a seamless care experience. Conditions & Services; It could be cancer. We're going to give you some strong recommendations. I'll also point out that our procedures, like Dr. Wagh said, are done under anesthesia. And that's very important. It's either cancer or everything else. Communication is important with the patients. We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. We're not going to just say, you must do this. And without a doubt, the possibility of cancer is what scares everybody. And remember, you can schedule your video visit by also going to the website. We're going to tell you a outlined plan that is backed up with data as to why we're doing this. And so part of our discussion is, what's the probability that this nodule that you have on your CAT scan-- is it actually cancer or not? You know what, I always tell people is there is a long list of things that the nodule could be. But a doctor may see something on a chest x-ray. Physician Recruitment McHenry, IL. And one that has a very low invasive potential. Fax: (773) 702-6500, Outpatient Practice: Just to echo what Dr. Wagh said. So talk to us a little bit more about the lymph nodes. University of Chicago, Interventional Pulmonology; Board Certifications. So-- go ahead, Dr. Hogarth, did you have something you wanted in? We can talk about imaging modalities. Age is usually 55 to 80. And that's a very important part for a cancer evaluation. 20 on the Best Hospitals Honor Roll. But of course, there's an 80% chance it's not cancer. We don't even have any camera people in here. After initially working as a hospitalist, he pursued a pulmonary and critical care fellowship at OHSU followed by an interventional pulmonary fellowship at the University of Texas MD Anderson Cancer Center. And thank you to our viewers for your great questions. You need to raise a fit. Faculty and fellows conduct research in a wide range of topics such as devices in sleep medicine and interventional pulmonary, laboratory studies in IPF fibroblast pathology or building new lungs for transplantation. And prior to that, I was a private practice pulmonary critical care doctor for six years. And every patient is different. So I want to get back to biopsies for just a moment. You were fantastic. And using some of the tools that we have. Well, the blood test actually showed that it's less than 5%. And we kind of-- we have a nice staff who will kind of walk the patient through what they should expect. Get an online second opinion from one of our experts without having to leave your home. Because the chance it's cancer is so low, and every invasive procedure always carries a risk. So Dr. Wagh, it was interesting because this is almost like a video game. But for many people are extremely, extremely slow growing cancer. And we also try to figure out, is it a lesion that requires biopsy? So I think first step is don't panic. And either one of you can do that. Under the direction of Alexander Chen, MD, the interventional pulmonology (IP) service cares for patients in both the inpatient and outpatient setting.. I'm in the studio all by myself, as you can see here. And so think of it like a sponge. It's so important. All rights reserved. I remember when Dr. Hogarth showed this to me. There's a surgeon, who's going to go in and cut part of it out. Chicago Chest Center/ The University of Illinois Chicago. What happens? UChicago Faculty Physicians Along with his clinical practice, Dr. Wagh is an active researcher. Is the evaluation and procedure that we've been talking about, is that covered by insurance as well? Because it has everything to do with the quality of the machine for the radiation that goes through. So we go through your mouth. That's why I'm not moving a lot, not that I move a lot anyway. And so the lymph nodes are where cancer would spread to first. And I would say the only other thing, as a pulmonologist, is if you smoke, try to stop. Mailing Address: Section of Pulmonary/Critical Care 5841 South Maryland Ave., MC 6076 Chicago, IL 60637. And they hear, oh my gosh, I've got a nodule. And so now you're going to go to the surgeon to be cured. So if we think you're at early stage cancer, that's great. Meaning, it's technically a cancer, but it's never going to necessarily bother you. But also cat scanning. Because I know this is a very complex situation. And smoking is certainly a problem, a historical problem that we're working to deal with every day. And we are lucky enough to have anesthesiologists who help take care of the patient during the procedure. We are a level 1 trauma center with 649 beds and the largest hospital outside the Chicago and St. Louis metropolitan areas. Well, I think that there's several possibilities. And every patient is different. There are characteristics of nodules that make them more concerning for cancer, as opposed to less concerning. And that's sort of when we take a look at the CAT scan very closely. So if you need an appointment, give us a call at 888-824-0200. Just type them in the comments section. But you know, I think that there's so many different possibilities when it comes to management that we're quickly learning how to utilize technology, even in telehealth, to help patients get what they need. Yeah, there's several possibilities in that regard to evaluate these. So if you have an abnormality, the other thing that sets this place apart is if you call a regular hospital and say, hey, I've got a lung nodule, can I see somebody? But can you kind of walk us through what people can expect before, during, and after one of these procedures. First, if you smoke, please quit. 2018 Apr 17 . And then afterwards, once we settle on a date, the patient comes in. And so I do think it needs to be corrected that you should not get a chest x-ray as a screening tool. The University of Chicago Medicine. I want to know you're an early stage cancer. And we're also going to just keep radiating you. But also don't ignore it, and don't delay it. And what we've gained, of course, is for all of those scans, that nothing changed and you avoided an unnecessary invasive procedure. Additionally, he authored a best-selling textbook on bronchoscopy as well as written numerous book chapters and clinical guidelines pertinent to the management of patients with lung cancer. Chicago Chest Center/Suburban Lung Associates offers a 1 year fellowship in Interventional Pulmonology in collaboration with the University of Illinois (UIC) Division of . Absolutely. So you're going to get way more bang for your buck literally as a scan by coming here. And then at that point, we would bring the patient back to the our laboratory. [MUSIC PLAYING] Hello, and welcome to At The Forefront Live. So my name is Kyle Hogarth. And we get the tissue that we need. is seeking to recruit a Pulmonary and Critical Care Physician to join our robust team of highly experienced providers.This position requires coverage in the outpatient office located at 5 Palisades Drive, Albany NY and inpatient coverage at St Peter's Hospital Albany, NY including weekend call at Samaritan Hospital in Troy, NY. Website. And the national standard is roughly five weeks. Or it could be a telemedicine visit. And between the four of us, we're all in clinic at any given moment. Make sure everything looks right, that it would be safe to proceed. You know, we go, oh, it's a 20% chance. You know, it's not just like, yeah, you do this. We're going to tell you a outlined plan that is backed up with data as to why we're doing this. So a little bit of a fan club going here, but that's awesome. So you're going to get way more bang for your buck literally as a scan by coming here. So we want to-- I mean, we want to do this for everybody. And you two, and your teams, are really good at helping people through that situation. And at that point, they'll meet the anesthesiologist, the nursing staff. But there's many things it could be. So typically we'll have a clinic evaluation. Now, solid nodules, depending on the size, there are guidelines that suggest the interval of scans. There's all kinds of different tests. UChicago Medicine and Ingalls Memorial offer a broad range of challenging clinical and non-clinical career opportunities doing work that really matters. And I would imagine in this-- I've got to word COVID of in here, because you know, it's what we're talking about everywhere. In other cases, they are actually a cancer. And smoking is certainly a problem, a historical problem that we're working to deal with every day. You're out. So this is an actual question. And how urgently must patients act? And where this matters is, of course, if I go and prove that it's not a cancer, then rather than being cut open and proved it was not a cancer-- which is great it's not cancer, but you've been cut open. So I'm going to have you answer the question, but also kind of explain what she's asking here. Let's have each of you start off by introducing yourselves to our audience, and tell us a little bit about what you do here at UChicago Medicine. Program accreditation is under the joint auspices of the American Association of Bronchology and Interventional . What Dr. Wagh and I do is a procedure called bronchoscopy. What you're never going to hear from us is to say, now there's nothing to do, leave. So, I really believe in great communication and teamwork. Because why would I put you-- why would I cure you of something that's never going to harm you? Panicking, obviously, is never helpful. Yes, sir. What are some of the options to evaluate lung nodules and lung masses? He has done the most cases in the United States and has authored numerous publications on this topic. And you two, and your teams, are really good at helping people through that situation. There's also what's called a needle biopsy. Interesting. The University of Michigan as a . And we also try to figure out, is it a lesion that requires biopsy? Interventional Pulmonology at Hoag is an important part of the multidisciplinary approach to diagnosing and treating the complexities of lung cancer. Interventional Pulmonary - American Association for Bronchology & Interventional Pulmonology Dr. Kumar Gaurav joined Cancer Treatment Centers of America (CTCA), Chicago in October 2021. And our complication rate is the lowest amongst the three. No, it's a great question. And this is important. For help with MyChart, call us at 1-844-442-4278. Interventional Pulmonology & Advanced Bronchoscopy; Lung Cancer; Lung Transplant; Pulmonary Embolism; Pulmonary Hypertension; Sleep Disorders; . Interventional Pulmonology Secondary Specialty. Meet the Doctor. Can you kind of talk to us a little bit about that, and walk us through that? Referring . It's an oath both of us took. And sign a few papers. And we want to remind our viewers that today's program is not designed to take the place of a visit with your physician. We use that CAT scan, build a three dimensional map of your lungs, and we drive to the spot where that's at. Oh, let me reinforce that. Well, I think that there's several possibilities. That's a great question. Medical school: St. James School of Medicine Anguilla, Park Ridge, IL Residency: University of Illinois College of Medicine, Peoria, IL Professional interests: ARDS, sepsis and infectious lung diseases. If you're concerned about cancer and there's an intermediate pre-test probability, based on a calculated evaluation, then we can potentially offer a blood test or something else that may potentially reduce the risk. Elizabeth says, I've had several bronchoscopes done by Dr. Hogarth, he's amazing. Only clean air in the lungs, please. Referring Physician Access Line: . The question is, how quickly do cancerous lung nodules grow compared to other types of cancer? You're going to go home. I'm not happy that I have to tell you it's cancer. Our list of accepted insurance providers is subject to change at any time. And how minimal it actually is? So talk to us a little bit more about the lymph nodes. Dr. Murgus specialty extends to a wide range of central airway disorders, including tracheal stenosis, tracheobronchomalacia, excessive dynamic airway collapse and airway obstruction from cancer. The University of Chicago Medicine 5841 S. Maryland Avenue Chicago, IL 60637 | 773-702-1000 Appointments: 1-888-824-0200. We are proud to have an interventional pulmonary laboratory with full-time dedicated . His clinical interests include advanced and therapeutic bronchoscopy, lung cancer, pleural diseases, and critical care medicine. And so those are our mainstays of imaging. You're going to go home. Even the show that we're doing right now, you two are remote. Absolutely, yeah. And you don't want to. You can't eat after midnight. Go ahead, Ajay. October 29, 2020 . And that could be in person. So that's nice. That's another thing that you probably want to caution people about. I can't even imagine what that would be like if you're worried that you have cancer, and then you're told you have to wait for an extended period of time. We're still operating. I mean, the first thing is first, is we do have lung cancer screening, which we offer patients CAT scans if they're eligible and have a smoking history. But we also want to explain to you what we're going to do to actively follow you. Interventional Pulmonology, Northwestern University, Feinberg School of Medicine, Chicago IL 2015-2016 Pulmonary and Critical Medicine, UC Davis Medical Center, Sacramento CA 2012-2015 Professional Memberships Right? Now, a question. Today there are better insights into cancer and other lung diseases. But in reality, if you're a patient, there's only two things. There's all kinds of different tests. It's a wonderful website. In close collaboration with faculty from oncology, thoracic surgery, otorhinolaryngology, anesthesia and critical care medicine, the interventional pulmonology service is actively involved in the diagnosis, management and research of patients with histologically malignant and benign central airway disorders, pulmonary nodules and pleural disorders. About. And was fortunate enough to start the bronchoscopy program here, and the Nodule program. Dr. Wagh, you mentioned as a pulmonologist you tell people stop smoking. Amit, I hope I'm pronouncing this correctly. I work here, I go home, I kiss my children. Along with his strides with bLVR, Dr. Hogarth was the first physician in Illinois to perform bronchial thermoplasty, a FDA-approved technique to treat severe asthma. His clinical and research interests include minimally invasive diagnostic and therapeutic interventions for patients suffering from benign and malignant airway obstruction. We look at the airways and other parts of our computer modeling to see if that's something that we can get to. And that's sort of when we take a look at the CAT scan very closely. And obviously, you know, even with minimally invasive surgery, it's still a surgery. Elizabeth says, I've had several bronchoscopes done by Dr. Hogarth, he's amazing. All kinds of fantastic information there. And remember, you can schedule your video visit by also going to the website. A lung mass can be a frightening discovery.