Awesome. Awesome. Well welcome. All right. My friend seven Oh one now I’m late now. I’m late. All right. Young man. If you hear any cursing this evening, please know it’s illegal, so don’t do it. Okay. Whatever I say, don’t do it. Okay. You’re going to wind up like me. All right. My friends said tonight, we’re going to talk about COVID-19. So my name is Noah Greenspan, a lot of new people here tonight. So if you don’t know who I am just to let you know, I’m the program director of the pulmonary wellness and rehabilitation center in New York city. I’m the author of ultimate pulmonary wellness. I’m the founder of the pulmonary wellness foundation. I have almost 30 years as a cardiovascular and pulmonary rehabilitation specialist, almost 20 years as a New York state EMT including the time in 2003 during SARS where I was working a graveyard shift in Queens, New York, one of the hotbeds of SARS.


So I have some experience in this area. One of the things one of the reasons why I want to talk about COVID and why I love talking about Kobe, not love talking about COVID. I hate talking about coal, but I wish we didn’t have any reason to talk about COVID, but one of the reasons why I think it’s so important and why I broadcast every day on COVID and have been doing that since day one is because there’s so much, so much misinformation out there. So much misinformation, so much conflicting information, so much politically shaped, financially shaped, other shaped information that it’s really hard to know. What is real and what is not real. So tonight I want to talk about my experience and I want to talk about my experience with COVID patients. And I want to talk about what I know from my career, and I want to talk about how to keep you safe.


Okay. I have no political agenda tonight. Not that I don’t have a political agenda but we’re not going to talk politics. Anything I say to you is going to be based on my experience and is going to be based on helping to keep you safe, helping to keep you healthy. One thing I’ll say is that a huge amount of people here are from my community, okay. Our community of cardiovascular and pulmonary disease. And one of the good things, if there is anything good to come out of COVID is that we as a community have been preparing for this moment for right. And the good news is that all the same things that you do, and we do in order to prevent the common cold in order to prevent pneumonia in order to prevent the flu in order to prevent an exacerbation of our underlying lung disease or heart disease, or this, that, the other thing are all the same things that we need to do in order to prevent COVID.


Okay. Now there’s a lot of people out there who think COVID, isn’t real. There’s a lot of people out there that think COVID is some kind of deep state political agenda or a hopes or a Gaslight. I live in New York city. Okay. Right. In Midtown Manhattan. And I can tell you that I personally know 25 people who have died of COVID-19. Okay. So it definitely is definitely not a hoax. Okay. We closed the pulmonary wellness and rehabilitation center on March 10th, earlier than the city was shut down. And the reason why we did that is because my single greatest priority is my patient’s safety. And I did not feel comfortable taking a risk that my patients would have to get on the bus, get on the train, get in an Uber, come to Manhattan where they’d have to get in an elevator park in a garage, come up to the pulmonary center when we don’t know what’s going on yet.


Okay. And to this day, I will say that there are still many, many more unknowns than there are knowns. Okay. So that’s also what makes it very tricky. So a lot of people don’t understand why is this so difficult? Why doesn’t anyone know what’s going on? We’ve dealt with Corona viruses before, but this is, what’s known as a new novel Corona virus, which means it’s one that we haven’t seen before. It’s new, it’s novel, it’s unique. So it’s not like SARS. It’s not like murderers. It is, it is a Corona virus, but it’s a new brand. Okay. And each time we have a new brand of Corona virus, we must learn to adapt. So essentially we came into this Corona virus hit hard, it hit fast, it spread quickly. And so we had to learn from scratch, how to deal with this. And one thing I’ll say is that I give the medical community, the doctors, the nurses, the healthcare professionals credit, because as tough as this was as terrible as this was, as many people have died and gotten sick.


These people, these real heroes, you know, have gotten up to speed very, very quickly. Okay. If you think about it, it’s only been six months. And you know, when they talk about nine 11, we talk about the number of people that die. But when the fire department talks about it, they call it the single biggest rescue effort and fire department history because of how many people got out. And I’ll say that, you know, as many that we’ve lost and as many people as have been sick so many more have been saved so many more, have been prevented from getting sick. So many have been prevented from dying by our medical community and also the measures that we take in order to keep ourselves safe. So again COVID is not gone. Okay. And it’s very scary when we have a condition like this and the, you know, the, the cities are opening again, right?


So initially we heard that, you know, this is how it’s, it’s transmitted. Initially. We’ve heard Nita mask don’t mean need a mask. You can catch it this way. You can’t catch it this way. This is what we need to reopen. But now we’re reopening, even though we haven’t seen the criteria that was initially set out as being safe to reopen. And now because of Memorial day because of protest because people ran right out, we’re already seeing spikes and I expect to see more spikes. Okay. I expect to see more people getting sick. I expect to see more people dying from this. And I don’t say this to scare you out of your mind. Okay. I say this to hopefully scare you and convince you into your right mind so that you will take the precautions necessary to keep yourself safe. So we’re going to talk tonight about we’re going to talk about prevention first.


Okay. I’m not going to go over numbers. I’m not going to talk about statistics because you could turn on any channel, open, any newspaper, flip to any website, and you’ll hear the gloom and doom of all these different things. That’s not what tonight is for tonight is for practical information to teach you how to prevent getting sick, to teach you how to get through it. If you have had COVID before to teach you how to get into the best shape possible in the quickest time possible, and also to rehabilitate, to get you back to normal life as quickly as possible first and foremost prevention. Okay. when we talk about prevention or when I talk about prevention, we have to think about possible exposures. And there are going to be situations in which you have a possible exposure. And it doesn’t necessarily mean a probable exposure.


Okay. So for example, I go to the grocery store, okay. Going to the grocery store is an absolute prob possible exposure. And when I say a possible exposure, I mean, it’s possible that you’re going to be exposed to Corona virus. Now, how do you not get exposed? You’re home alone. Okay. You’ve been quarantined. And the reason why we say 14 days, and really, I say 14 to 17 days is because this is the range of possibilities. Okay. In which you can be asymptomatic or from the potential time of exposure to the time that you could start showing symptoms and be sick. Okay. So that means if you go out today and go grocery shopping, it could be 17 days from now. It may not be until June 27th, that you start to show signs and symptoms. Okay. Now here’s the thing. Two days ago, the who not the rock band, the world health organization did something in which they said they made an announcement in which they said that.


Guess what? For people that are asymptomatic, you’re probably not contagious. Okay. Now all along, we’ve been hearing, guess what? You don’t have to have symptoms in order to be contagious right now, all of a sudden after X number of months and after we’ve all been home alone, quarantining locked up, social distancing, et cetera, et cetera. We find out, Hey, guess what? Now you’re not contagious. If you’re not showing symptoms, show of hands. How many people now that you know, that feel comfortable going out? Because if you don’t have symptoms, you’re not contagious. Show of hands. Who’s comfortable. All right. I don’t see any hands so far. Nobody. Right? So point number one, I’m not comfortable either. Okay. So I would trust. I would actually choose. I would actually trust the actual, who I’m more than I trust the world health organization. I would trust the rock band more than I trust the world health organization.


I don’t want to say that to bash them. I say it just to make a joke, but to say that, in my opinion, a lot of the information that comes out is speculation. And a lot of the opinion that comes out in a lot of the announcements that get made are announced before we actually have real clinical evidence of these things. So for me it’s like saying, well, you know bacon is bad for you. Bacon’s bad for you. Bacon’s bad for you. Bacon’s bad for you. Bacon’s bad. Hey, guess what? Bacon’s good for you. And you go bacon, bacon, bacon, bacon, bacon, bacon, bacon, right. Don’t run out and think that because there’s no symptoms. All of a sudden you’re like, wait a second. All this time. You’ve been telling me bacon is bad for you. It’s definitely bad for the pig. Okay.


It’s definitely bad for the pig. But all of a sudden, when you see a drastic, flip-flop like this, it makes you wonder. And it also it makes you, it, it challenges your confidence and it decreases your confidence in the people that were supposed to be relying on to give us good information, right? It’s like, if your parents tell you that, you know, the Easter bunny is coming tonight, and then you see your dad and he’s got like a bunny body, but his own head, it makes you question the Easter bunny. It’s like, if the tooth Berry, you know, if you see your mom putting some money under your pillow, it makes you question these things and the world health organization, the CDC the government. Okay. And, you know, I say that, that part of the problem is that we don’t have a unified response.


So all the States are left to kind of do their own thing. And there’s many agendas out there. Okay. There’s a lot of different agenda. So there’s political agendas, there’s financial agendas. There’s certainly medical agendas. There’s social agendas. But what I’m going to try to give you is the straight dope tonight, the straight science. Okay. So the simplest way, and we’ll go from least risky to most risky. So how many people are, are quarantining at this moment? Show of hands. How many people have been in quarantine since the beginning? Okay. Okay. So let’s talk about this. So we’re going to use for, in the interest of me not having to say 14 to 17, 14 to 17 times a night, we’re going to say for 14 days, okay. Is a, is a possible incubation period. So what does that mean? That means that from this point forward, from this point for 14 days, I could be completely asymptomatic.


Now I can have an exposure that exposure could be as simple as somebody delivering food to my home. It could be as simple as me going to the grocery store. It could be as simple as my husband or wife goes to work and comes back every day. Right? Anytime that you come in contact with another person that’s had contact with the outside world, that is a potential exposure. And again, not a probable exposure. Okay. But a potential exposure. And I’m going to tell you why for this entire time, I have taken the most cautious approach to this of all. Okay. For me, my whole life is built on risk management. Okay. And on keeping people safe and erring on the side of caution. And I tell people, if you err, on the side of caution you to always err on the side of caution, because we’re going to assume that something is the worst until proven otherwise.


So for example, if you get chest pain or pressure and you’re wondering if it’s the chicken salad that you had at lunch today, or it could be your heart, well, guess what? I’m going to treat it. Like, it’s your heart until proven otherwise, because odds are the chicken salad that you had at lunch. Isn’t going to kill you. Okay. So if we treat it like, it’s your heart and it turns out that it’s just gas, no harm, no foul. Right. But one of the biggest symptoms of having a heart attack is denial. Okay. Say, no, I’m okay. Okay. I’m okay. Now you want to go to the hospital now I think I’ll just take a Tums. Right. But if you treat it like, it’s your stomach and it turns out to be your heart. Well, then we have a problem. So my situation and my advice will always be to err, on the side of caution.


And my advice will always be to do no harm first. Okay. So potential exposure doesn’t mean probable exposure. Now, why is this so important? Because the stakes are very, very high here. Right? Initially when this first started, we heard that who’s at risk, the elderly people with preexisting conditions, heart disease, lung disease, cancer, diabetes, obesity, right? Another way of describing that there, there was a George W. Bush joke. Okay. And George W. Bush was at an event one night and he said, some people call you the elite. I call you my base. Right? So some people call, call you the high risk category. I call you any day at the pulmonary wellness and rehabilitation center, because the elderly patients, people with respiratory disease, people with heart disease, people with preexisting conditions and in particular, multiple medical conditions are exactly who we’ve been treating for the last 30 years. So we have to take it seriously.


Okay. So that was the initial, that was the initial guidance. So what happened? Anyone who was healthy? Anyone who was young, anyone who didn’t have any preexisting conditions automatically took that to mean that they were immune. Okay. But even if you’re immune, okay. And even if you’re not at risk, which we know to this day, that nobody’s immune, right. As far as we know, nobody’s immune, you can still potentially have a mild case of the virus and transmit it to somebody else. And you know, until we have much, much better data, that’s my story. And I’m going to stick to it, meaning that I’m going to assume that you don’t have to be actively having symptoms at this time. And I’m going to assume that you don’t have to be old and you don’t have to be sick in order to potentially get the disease or to pass it on to somebody else. That’s the safest way of doing it. Okay. Any questions so far?


Okay. So let’s start with this so safest way. Okay. I am home alone. Nobody comes. Nobody goes, if I am negative, there’s no way I’m getting the virus. Okay. So I am home alone. Nobody comes, nobody goes, if I am negative, there’s no way I’m getting the virus. My husband, my wife, my girlfriend, my boyfriend, my children are here with me. It sounds like I have a harem of all different types of people. Right. But the idea is that if we are all quarantining together, we are one unit. Okay. As long as nobody comes in, nobody goes, so let’s say our unit consists of mom, dad, uncle, aunt, and sister. Okay. And I say that only to show you that the unit can be anybody. Okay. We all stay. We’ve been for at least 14 days. Nobody’s come, nobody’s gone. We don’t have the virus.


We have no way of getting the virus, the virus. Isn’t going to sneak under your door and get you. It’s not looking for you. Okay. It’s waiting for you. Okay. So what does that mean? It means that as long as you don’t have any possible exposures, it means you’re not going to get the virus. Same thing with the flu, same thing with the common cold, same thing with pneumonia. Okay. If you don’t come in contact with it, you can’t get it. Simple fact of life. Now let’s take one of those people. Okay. Let’s say sister, okay. Sister is still working. So sister is going in and out. Guess what sister is ruining it for the rest of us. And that’s, what’s a problem with this kind of condition or this kind of disease is that people who don’t, aren’t being careful or people who don’t have a choice, but to quarantine or don’t have the option of, of quarantining.


They’re ruining it for the rest of us. Okay. And I don’t say that with criticism, but I want to say thing I’m being facetious in a way, but it’s true. Okay. So that’s why it’s really important for all of us to not just think of ourselves. Okay. And not just thinking, am I potentially at risk? And we know that everybody’s at risk, but I’m young, I’m healthy. I’m an athlete. I’m immune. I’ve never been sick, blah, blah, blah, blah, blah. But if I go to work every day and come back every day, then everybody in my unit is no longer quarantining. Okay. So no, everybody, there has a potential exposure because let’s say I am a checkout girl. Okay. And you notice some I’m flipping these things around. I’m telling you things that can, I’m obviously not a checkout girl, but let’s say I’m a, I’m a unicorn.


And I work at a grocery store checking people in and out. Right? So every single person that comes by me okay. Is a potential source of exposure, not a pot, not a probable source of exposure, but a possible source of exposure. And that means that every person who comes and has you know, some type of exposure, there is a potential exposure here. So if you think about the way that people used to talk about STDs, right. Or HIV, or any other opportunity where you have the potential to exchange button, blood, or, and, or body fluids with another person, it’s like their partners are your partners and the, your possible exposures are everybody in your units exposures. Okay. And again, I know that sounds terrible. Trust me, I’m not here to only give you bad news. And we’re going to turn this story around in a little bit and tell you how to best take, take care of yourself.


But that’s the idea. And anyone who says to you, it’s like people at least 10 times a day, I get a phone call from somebody who says, you know, my aunt is coming to visit me from California. Do you think that’ll be okay? There’s only one answer to that. Maybe. Maybe yes. Maybe. No. Okay. I have no way of knowing, but I’ll give you a, a question of, so what somebody said today, they said once his girlfriend to come from Philadelphia to stay with him in New York, this person has cop date. So the questions you have to think about when these, when you’re making these decisions is okay. If this person comes, how are they going to get here? So in other words, if the person is in Philadelphia right now, and they’re traveling to New York and the person has been home alone for three months, and they’re going to take their own car, that’s parked in their driveway and drive right to my house and come into my house.


That’s a very low chance of exposure, right? Philly to New York, very short trip. I don’t have to stop on the side of the road for gas. I don’t have to stop to go to the bathroom. I don’t have to see any other people. You have a house where I can pull right in. I don’t have to pull it into a garage. Right. And I come to your house. That’s okay. You’ve also been quarantining. Okay. So that means you’re good. I’m good. Boom. We’re good. Now we’re a unit. We work together. But if you think about all those different ways that I said that you could come, come from Philadelphia, let’s say it’s coming from Philadelphia to Florida. Right? So coming from Philly to Florida, you’re going to have to stop a number of different times, right? Let’s say for argument’s sake, you’re not bold. And you’re not going to stop on the side of the road to go to the bathroom.


You’re actually gonna use a rest stop. Right? So you’re going to touch a door. You’re going to come in. People are going to be around you. You’re going to go to the bathroom. You’re going to use the urinal. You’re going to use the sink. Hopefully. you’re going to come out again. Okay. These are all potential exposures. And we don’t know what the probability of exposure is. Okay. But let me put it in perspective for you. I’m going to give you a philosophical question now because the stakes are so high. We have to think like this. Okay? You love jelly beans. How many people love jelly beans. Sheila. Don’t yawn on me. It’s going to make me on. Okay. You love jelly beans Fe. I’m going to, can I unmute you Fe? Alright. I can’t fake. Can you unmute yourself?


There we go. All right. Faye. It’s your birthday. You love jelly beans, right? Yes. You have a favorite flavor. Red and yellow. Red and yellow. Alright, Faye. I come to you on your birthday. When’s your birthday? October 3rd, October 3rd. And I say, Fe, I bought you this giant giant jar of red, red and yellow. You said? Yes. Okay. So I bought you a gigantic Costco size jar of red and yellow jelly beans. Now there’s only one thing Fe one of the jelly beans in here is going to kill you. If you eat it, how many jelly beans are you going to eat? Zero. Exactly. How many people would eat any of those jelly beans? Raise your hand. That’s the point? Okay. So the idea is if I give you 5,000 jelly beans, okay. It doesn’t mean that the probability of you getting that one, unless you’re definitely eat them all yourself, right?


It may not have to be a high probability, but if you do it, the stakes are high. And that’s why we have to take this seriously. Okay. We’re not talking about an allergy ladies and gentlemen, give it up for Fe for having a birthday, October 5th and eating red and jelly red and yellow jellybeans, October 3rd. Sorry. so the idea is that that’s what we’re talking about, right? So there’s a lot of people who are pretty cavalier about this and who are like, well, you know there are you know, people are gonna, people are gonna die, but we have to open the economy. People are going to die, but we have to make money. People are going to die, but guess what? That’s a part of life. Listen, you know, we hear the numbers and I think it’s extremely possible that we, when we hear numbers like a hundred thousand, 107,000, 110,000, it’s like that doesn’t even cross our mind or register for most of us, the staggering number of people that 110,000 people are, but it’s like 35 times the number of people that died in the world trade center.


Okay. But that number doesn’t mean anything if you don’t know any of those people, but if that person is your mother, all you need is one. If that person is your father, all you need is one. If that person is your brother or your sister or your best friend or your teacher or your doctor, all you need is one. And so anyone who says to me that they don’t think this is real or anyone that says to me that they think this is some kind of hoax. I say, come to New York city and spend a day in the emergency room or spend a day on an ambulance. And you’ll know very quickly that it’s not a hope again. I know 25 people personally, including patients friends, thank God. None of my family members has been affected. But one of my closest friends lost his father and his brother.


Okay. So even if the numbers, just to imagine how that person’s life changes for forever. So my point is, I don’t care if I have zero money. Okay. I would rather live on the streets with no money and be hungry and have my family alive. And with me then saying like, okay, we have to do this. Okay. So again, my point is, the stakes are high and you have to take it very seriously. And even though whether it’s the president or your governor or your mayor, or the person at the store where you buy your lottery tickets, a mom don’t don’t believe that guy he can’t be trusted. But the idea is we have to make decisions that we know are smart. We have to listen to people we trust, and we have to understand that we have to make the decisions that are best for us safest for us and my agenda for myself, for my family.


And for all of my patients is to keep you alive and to keep us alive and to keep us healthy during this pandemic, you have one job and it’s to come out on the other side and we’ll pick up the pieces after that. Okay. And to put things in perspective, when I hear people protesting, you know, on their right to get a haircut or to go to the casino or to get a massage, et cetera, et cetera. When you think about Anne Frank, who spent over 700 days in a small annex hiding from, you know, the Nazis, I mean, it puts things in perspective. We want to stay alive. Okay. I’m looking around. None of you, none of your hair looks, looks that bad. Let me just go screen to screen to make sure.


Yeah. I see a couple of doozies out there. Don’t get me wrong. A couple of you. I see what’s going on. I know, I know you didn’t wake up like that. I know. That’s like several stars, stars like this everyone’s right now going like this. Let me look at my as much. Notice mine is freshly done and freshly cut, but I did it myself. Okay. But I’d rather be bald than have coronavirus. Okay. Here’s the thing. Okay. It’s not worth it people. Okay. At some point we’re going to come through this. Okay. But we have to get to the other side. If you go out, it doesn’t matter how much money you have. If it kills you, your game is over. Okay. And that’s it. How do we prevent it? Okay. First and foremost, social distancing. Okay. We have to stay away from people.


And how many feet do you think you have to stay away from people? How many people think it’s one foot, two feet, five feet. Six feet. All right. So maybe it’s six feet. Okay. Maybe it’s six feet and I’ll explain it to you. What I mean by that? Okay. So how has this transmitted, we’ve heard every way humanly possible, right? We’ve heard that it can come out in droplets. We’ve heard that it can come out in air. We’ve heard that it can stay on a surface. We’ve heard, but it can linger in the air. Okay. I swear. I don’t think we know a hundred percent for sure. And I’ll tell you, one thing is that this is a super variable disease. Okay. And what I mean by that is that I see people and they all have different stories. And when they contract this illness, they could go from anywhere from being asymptomatic, to having mild symptoms, to having moderate symptoms.


Some people don’t even know they had it. Some people go from being perfectly healthy to being in the ICU. And I see a lot of different symptoms and I see a different progression in different people. Now I’m starting to see different groups that kind of look like each other. Okay. But until I’m a hundred percent sure that it can’t stay on a surface. Okay. That it, and again, I have my thoughts. Okay. I have my thoughts that it, maybe it can maybe a camp, but again, it’s like, I have people argue with me to say, well, you should wash your hands for, for, for 30 seconds. And if I say 30 seconds ago, 30 seconds. But I was told it’s I only have to do it for 20 seconds. Like, think about the logic of that. Right? Like, do you want to make the argument that I want to save 10 seconds, but take the chance that I could get Corona virus.


We don’t know, but let’s assume that you can get it from somebody sneezing in your face. Let’s assume that you can get it from somebody coughing in your face. Let’s assume that you pumped out for somebody sneezing in their hand and then shaking your hand. And then you scratching your nose or your mouth let’s assume that it might linger in the air. Let’s assume that it might be around on surfaces. Okay. The idea is if we take the precautions and the precautions are not that serious. Okay. They’re serious. But the precautions are not anything it’s not like saying get into a metal suit of armor. Okay. It’s not like saying go out in the street, wearing a full body condom. Okay. It’s like wash your hands, wear a mask, stay a little bit further away from people that is worth the effort. Right. Of not getting coronavirus.


Now here’s the thing. Okay. I’m six feet. I say, stay as far away as you can. Why? Okay. And I know my mom’s on here and I know she’ll appreciate this. Okay. If you come from a family of super sneezers, like I do six feet is the tip of the iceberg friends. Okay. Because I know that I’ve seen people in my family sneeze and spit a Skittle clear across the yard. Okay. So the idea is a minimum of six feet, but that doesn’t mean that if you’re eight feet away, you’re definitely protected. There’s no definites in this thing. So err, on the side of caution and don’t measure it out and be like five foot 11, six foot I’m six foot, one inch away. And therefore and therefore I’m safe. It’s not a guarantee. Okay. Same thing. I love it. When I hear people say things like stay away from people who were sneezing and coughing.


Okay. That’s an awesome strategy except that most people I know, don’t say everybody, please prepare because in 30 seconds I am about to sneeze. Right? Sometimes you know it a little bit ahead of time, but the average person, they could sneeze out of nowhere and it could be a 20 foot sneeze. So stay as far away as possible. Okay. Now here’s the thing. Let’s talk about masks. Huge controversy. Okay. Not for me. For me. It’s a very simple, no brainer. Okay. I’ve said it since day one. I’ve said it every day since, and I say it through today. I believe people should be wearing a mask or a face covering. If you have a preexisting condition, you definitely should. And even if there was no such thing as Corona virus, if it was flu and cold season cold and flu season pneumonia season, and you’re going to your doctor’s office or you’re going on public transportation, you’re going to take the bus or the train or you’re going on a plane.


Then I’m going to give you the same advice. I think you should mask. Okay. Now I don’t know about you, but a lot of people will take this concept and they’ll say, well, when I’m wearing a mask, I protect you. And when you’re wearing a mask, you protect me now that’s true. But don’t discount the fact that if I am wearing a mask that is also protecting me. Okay. Now I don’t know about you, but Corona virus, no Corona virus, common cold, no common cold flu, no flu. I don’t like people standing close enough to me that I can feel their breath. I don’t like people standing close enough to me that if they happen to spit accidentally, it’s going to land somewhere on me. Okay. And I am known as a germaphobe. Okay. I wasn’t always a germaphobe. I became a super germaphobe.


When I wrote the chapter in my book about prevention of infection, because I was like, wow, this stuff could be anywhere. And the truth is it can be anywhere. So the idea is you take the subway in New York city and you hold onto that pole. And you’re only as clean as the last 500 people that were holding onto that pole before you now, why do we talk about not touching your face? Whereas my grandma Pepe used to say don’t Potch. Cut your face. Okay. That’s a Yiddish word for don’t play around with your face. Okay. She used to say it because she didn’t want me to get zits. Okay. It didn’t work. Okay. But why is the face so important? The face is so important because I could have a whole handful of Corona virus in here in my hand. And if I keep it out here and I run to the bathroom and I washed my hands or I use a good antibacterial, well guess what?


I’m still not getting coronavirus. Okay. Corona virus is going to enter through the mucus membranes. And that means the eyes, the nose or the mouth. So the idea is, let’s say I shake your hand. You have Corona virus. Now it’s on my hand. Okay. You want to? And I don’t know, but the grossest analogies seem to be the best. Right? So it’s like, let’s say I have some poop on my hand. I shake your hand. Now it’s on your hand. Don’t touch your face. It’s the same thing. Right? It’s the same thing. Now here’s the thing, the mask. Okay. Let’s assume it could be on surfaces. I touch this surface. It’s on my hand. If you don’t want to be so gross, you can think of it as ink or paint. Right? So you touch it. You’ve got the ink on your hand. Anything that you can potentially touch. There’s a great commercial in which kids are taking a test in school and they say, pass up your papers and they show you like with the ultraviolet light, what’s on the paper. Same type of thing. Okay. But the thing is that we can protect ourselves, protecting your face to mask, but not to mask. First of all, if you’re going to cough in my face or sneeze in my face, I would rather you do it. Okay. We’re going to take a little poll here.


Somebody is going to sneeze in your face from two feet away. How many people would prefer to have nothing on their face and have the sneeze come right in your face. That’s choice. A or choice B is you’re wearing a mask. When you get hit with that sneeze from two feet away. That’s choice B. So how many people would prefer to have nothing on their face? Nobody so far. Nobody. So wait, Tanya, I don’t know. Are you, are you fanning yourself? Are you saying you want somebody to sneeze right in your face? I think you’re fanning yourself. Alright. How many people would rather wear a mask when somebody sneezes in your face? Okay. Me too. Right? Why? Because you just sneezed in my face. My face after I smack you. I want to take this mask off. Okay. Because I can throw it away. And guess what?


If much of the sneezes here, I still have to wash my hands. I still have to wash my face, but guess what? At least it didn’t go in my mouth or my notes. Okay. Trust me. I’ve seen this happen to people. Okay. I’ve done chest physical therapy for 25 years where the goal is to get somebody to cough up mucus in your face. I worked on an ambulance where things happen unexpectedly. So this protects both of us. Okay. Now, if there’s two of us, here’s the best analogy for this. Okay. It’s a gross one. Okay. It’s another gross one, but it makes the point. So I’m going to give you the three good ones. So far I asked before I asked about, you know, I asked about these I asked about the jelly beans. I said, if there’s one jelly bean, okay. Out of a thousand, that’s going to kill you.


We’re still not going to eat the jelly beans. Okay? I told you that if I have poop on my hands, okay. You don’t want it on your hands. Don’t touch me. Okay. With this mask. If someone sneezes in my face, I can take this mask off. Here’s the reason why we both need to be wearing a mask. Okay. Imagine we’re together. Whereas my grandmother would say, let’s say you and I are friends and neither one of us are wearing pants. Okay. Just to let you know, for those of you that are here for the first time, I like to make things awkward. Okay. I live in the awkward, it’s where my it’s it’s my comfort zone. Okay. But let’s say neither one of us are wearing pants. And one of us PS on the other one, right? It sounds gross, but it could happen. Okay.


Especially if you’re a kid that’s bad for you right now. Let’s say you’re wearing pants and I pee on you. Okay. Now you can take those pants off. Right? And you can wash yourself off and you’re still going to get less pee on you. Then if you weren’t wearing pants now let’s say I’m also wearing pants. I’m wearing pants. You’re wearing pants and IP. How many people want choice? Number one, choice a is neither of us is wearing pants. Choice. B is I’m not wearing pants. You’re wearing pants and choice. C is, we’re both wearing pants. Jane Martin is that you nice to see you, Jane. Alright, so Jane let’s I don’t want to put you on the spot, but Jane Martin is a famous CLPD advocate, author. Jane, would you rather neither of us, one of us or both of us? I won’t take it personally. She want both of us, like you’re not, un-muted both wearing. Jane wants both of us wearing pants. Okay. Jane? I don’t take that personally. We’re still friends. It’s okay. And Jane is going to come back and be on our webinar when your new book is out, right?


Yeah. Right. Perfect. It’s coming out soon. So here’s the idea. That’s why the more people wearing masks the better. Okay. So the thing is that with all of these different things, the more things that you do to protect yourself, the less chance you have of contracting the virus. Okay? The less things you do, the riskier, your behavior, the greater chance you have of contracting the virus. Any questions so far? Let me go just to the chat for a few moments. Beth says, please ask them to stay muted unless they need to interrupt or ask a question. Lots of new names. I told you I live in the awkward he’s on fire, but I know they didn’t mean me. I know they went Donnie vapor. Thank you for your music. My pleasure, Mary. Thank you, Martha Carr. I am new to this group. I had COVID, which has impacted my lungs.


I’m looking for ideas to help you. Help me recover. You will get them tonight. Joan, do you think timeshares are safe using masks, walking six feet apart and only take out food. All right. Great question. So that’s about what we’re talking about now. So at timeshare, okay. Are they safe using masks, walking six feet apart and only take out food? The question is who was in that time share before you and how effectively did they clean and disinfect the timeshare? Okay. So if a whole bunch of people were there, if there were seven people there before you, one of them had COVID signs and symptoms and the rest of them didn’t were asymptomatic, but they could have had a probable exposure because they stayed in the same time. Share with somebody else. Then the answer is, I think you are potentially at risk or you probably at risk.


We don’t know. Is there a probable exposure we don’t know. Is there a potential exposure? There’s a potential exposure. Anyone who tells you there’s no potential for exposure doesn’t is not telling you the truth either because they don’t know or they don’t want to worry you or they have another agenda. Okay. And so the idea is if you want to stay safe, how would you stay in a timeshare? Okay. I recently was staying in a place. I had I was with somebody that I was quarantining with. Okay. So my unit, we knew that we were safe. Another unit that we knew they were safe, came and stayed with us. They stayed upstairs. We stayed downstairs. Okay. Cooked at different times, using different things, spent most of the time, outdoors, social distancing. So we tried to minimize the exposure as best we can, but there was still a potential exposure there.


So the answer is, do you think timeshares are safe? I don’t know if you’re talking about the entire club and like, if you’re at a hotel. Okay. And there’s a timeshare and there’s other people who have time shares and you’re going to go to the pool and you’re going to come in contact with people. Are you going to come within six feet of people at the pool at the, you know, the buffet or things like this, or even just in passing, there’s a potential exposure there. So you asked me to, if I think it’s safe again, the best answer I could give you is that there’s a possible exposure. Not a problem, not a probable and not a definite sick, not non exposure. I just read dr. Fowchee say, you can, can be infected by asymptomatic patients. I agree with that a hundred percent.


I believe you absolutely can. And until it’s proven that no symptoms means no shedding a virus, then I will err, on the side of caution. If the only time I go out is for a short walk, but I’m mast and gloved every time. Does that mean that you’re still quarantining. Alright, ma sorry, but no you’re not still quarantining. Okay. Masking glove. It’s it’s great. It’s, it’s better than no mask and it’s better than no glove, but it’s not foolproof. Okay. You’re not wearing an N 95 mask. Even an N 95 mask is not foolproof. And it doesn’t mean again, is it? I’ll give you a couple of examples recently. I flew, okay. I recently flew from New York city to California and anyone who knows me was like, I can’t believe you are flying of all people, but you know what? I had a reason to do it and I had to know for myself.


Okay. So I like to talk about things that I know that I see myself, that I have experience with that I do, but I said, you know what? I know it’s taking a risk, but I’m, I’m willing to do it. And I’m gonna do it very, very carefully so that when I give people advice, I can give them good advice from personal experience. First experience JFK. Okay. I pull up to the terminal. Nobody’s there, nobody’s there. Okay. But first of all, I took an Uber from my apartment to the airport. So now let’s just talk about this step by step. So you get an idea of what kinds of things you need to think about. I leave my apartment outside my apartment. There’s a door that I have to open to get to the stairs. Then I have to open the door to my building.


Then there’s another door to my building. Any one of those is a potential exposure. If somebody with COVID either touched it, coughed on its knees done. It’s been on it, et cetera, et cetera, et cetera. If you believe that it could stay in the air. If somebody with COVID just left right before me and they were coughing on their way out, it’s a potential exposure, right? So if you want to stack the odds or you want to put things and weigh them out on a scale, then I got into an Uber. Okay. In New York city, I’ll tell you how I minimize it. Okay. There’s Uber’s and there’s Uber upsells. Right? And understand that, that saving money. Wasn’t my number one priority here. Okay. Staying safe was so there’s an Uber XL. And what Uber XL means is it can hold many more people. It’s a bigger vehicle, right?


So it means I can stay further away from the driver. I’m wearing a mask. I’m wearing gloves. I wore a raincoat over my clothes. Okay. So that anything I come in contact with would be on this raincoat. And at a certain point I could get to the airport or get to my gate and take off this raincoat. Okay. Get a cheap raincoat. I can take it off, throw it away. And then everything under me is protected. I’m in New York city. Most of the Uber drivers have a partition up and that’s great. Some of them don’t mass or some of them will have their math down under their chin. Okay. I asked them to put it on. I open all the windows. Why? Because when you open the windows, you’re diluting any potential transmission with all this air outside. And it’s like, again, not to be gross, but if you pee in the ocean, that’s a lot less damaging than peeing in the bathtub.


Right. So same thing. So get in a car, open the windows, potential source of exposure. Nobody was at the airport. I didn’t see one other person going through security, but at the end of security, you put your stuff. So I put my laptop in a bin. I put my bag on the thing. I had to take my sneakers off, put them in a bed. Right. The bins were not washed in between people. Right. So is that a probable exposure? Not necessarily. Is it a possible exposure? Yes. Okay. Then I got my bag searched. Okay. Don’t be alarmed. I get my bag searched at least 90% of the time that I travel. I don’t know why I’m like the Kanye West of airline travel, but my bag is constantly searched. Okay. So before I could say anything, the woman’s going through my bag with a pair of gloves and I asked her, would you mind changing your gloves?


And she said, I just put them on. Now. Maybe she did. Maybe she didn’t. Okay. But she opened my bag. Okay. Went through my stuff. So if she had anything on her hands on her gloves, then that’s now potentially in my bag. Is it probably in my bag, Terry? I know your cat likes to get fresh during the webinars. Please keep it backside facing you. But the idea is that it’s a potential. Okay. Then my sunglasses fell off and the other at TSA agent pick them up for me also with a glove tan. And I went, Whoa. And he picked them up with a glove tan. Now for all I know that guy could have searched 26 other people. Okay. Alright. Washed off my bag, washed off everything. Now I travel with a big, a tub of antibacterial wipes and sprays and creams and masks.


Okay. And anytime I come in contact, I will soak myself in it. I will, I will do that. Okay. Now coming back from LA. Okay. I learned from my first experience. Okay. And what I did this time was I doubled up every area, every part of my clothing. Okay. So I went through the machine where you have to put your arms up like this. Okay. And nothing went off, but I’m the Kanye West of airline travel, which means that they’re going to Pat me down anyway. Okay. So they Pat me down and he’s like, I have to Pat you down. And he’s like, do you have anything in your pockets? I said, no. Do you have anything metal? What about your phone? No, no, no, no, no, no, no, no, no, no, no, no, no. All right. I’m going to Pat you down anyway. Just for the fun of it.


Okay. Pats me down with gloves. Okay. Front back. Okay. Now he said he just put those gloves on. Do you change the gloves in between every passenger? Probably not. So I’m skeptical of that. You know what I did, I had two shirts on, so I immediately took my shirt off, threw it in the garbage. Okay. I wore a cheap, old shirts that I was going to throw out. Anyway. I luckily just spilled a whole cup of coffee on it the day before, so I didn’t care. Okay. And I throw it away, saved myself. Okay. Get to the flight, get to my seat, wiped down everything with gloves on wipe, everything down, wipe everything down, wipe everything down, spray it down, wipe down my neighbors. See nobody was sitting next to me. Thankfully, American airlines, Alaska airlines, and both fantastic. Okay. So if you do have to travel and I don’t recommend that people do travel, but if you have to travel, there’s ways of doing it.


Okay. So you see, these are all ways of potential exposure. I land. Okay. I have to open the car door. I have to go to, to wherever I’m going. And then for 14 days after that, I have to warranty. Okay. Because if we say 14 to 17 days, I could be completely asymptomatic, but I could still be transmitting that virus. And I don’t want to be bringing my virus from New York city to California. Okay. So I’m going to stay by myself. And only when I’m comfortable that I do not have this am I going to be comfortable seeing other people now, California, where I was Santa Monica is totally different energy than New York city. Okay. In New York city, it’s like, we walk around. Everybody’s like suspicious of each other. It’s like a bunch of rats. We just look at, we look at each other and today I saw a rat in my backyard, coincidentally, for the first time ever.


Okay. The rats are getting bold. Okay. But the idea is we’re suspicious. There’s people all around us in Santa Monica. There’s plenty of space. Everything is beautiful. There’s nature. Everywhere. People are wearing a mask. There’s social distancing until the protests. And then hardly anybody was wearing a mask. Hardly. A lot of people were wearing masks. Hardly anybody was social distancing because it’s hard during the protest. But I understand, okay. I understand that sometimes you have to do things and just understand that you might be taking a risk. So the idea is social distance wash your hands frequently, disinfect your hands. Frequently, avoid people who are sick, avoid people who are sneezing, coughing belching, any, anyone expelling anything from their body. I try to avoid anyway. Okay. But the idea is take precautions. Any questions so far about this? So mob, the answer is if you only go for a short walk, outside is not the risky part. Okay. So when you’re outside in the air, it’s not that likely that you’re going to it. It’s still possible, but it’s not probable. I worry more about the elevator. I worry more about when you have to touch things to get in and out.


It’s a name, Brenda. Hey Brenda, Hey, I just had a I didn’t mean to interrupt you, but I just had a situation. I thought I’d get your advice. On terrible months ago, I was getting ready to get the valves put in and I did all the tests. They are not all, but some of the testing and faxed it to the man. And then he said, when it gets going good, he would let me know. And yada yada, well then the Corona thing came through and they shut everything down. Okay. Now he just called me and says, and he started up again. And now San Antonio has been declared an emergency area because of all the Corona stuff there. But what basically I would have to do is I can ride over with Heather and get my test, my Corolla test, and then come back and get, go into the hospital and Spanish bed all day. They’re getting all those stairs. He wants me to do with Heather. And the way I look at that, I’m putting Andrew in an awful position, you know, because she has to go back and be with her husband and her kids and all that. And I’m just, I don’t know. I guess I’m getting CGD cause I’m just not sure it’s the right time yet.


Yeah. It’s a tough call and I’m sure many of us can have an example, if not exactly like that. Similar to that, I am suppose to have a hip replacement. I am supposed to have a knee replacement. I want to have the valves, et cetera, et cetera. I want to go to rehab, et cetera, et cetera. The idea is that you know, everything is about risk and benefit, right? So the question is, is there going to be a huge potential benefit from the valves? Yes, but you’re right. So you’re getting in the car with Heather. Okay. You’re going to the hospital. It sounds like you’re going to have multiple tests, which means you’re going to be in multiple departments, which means you’re going to be in contact with multiple staff members who are also in contact with multiple patients. Okay. And then, so you come back and that chain is now with Heather and now Heather, just by nature of driving you there and driving you home is potentially putting her family in that chain.


Okay. I don’t think I’m exaggerating when I talk about that. Okay. That’s the potential. It’s a tough spot, you know, and we all have these things and we say, well, you know, I haven’t seen my grandchildren in four months. I haven’t seen my parents in three months. I haven’t seen my sister, my brother, I haven’t gone through her. But again, the question is, what is the potential risk of doing it? What is the potential benefit of doing it? What is the potential risk of not doing it? What is the potential benefit of not doing it? So if you said, you know what, I have a 80% occlusion in my coronary arteries and if I don’t get this done in the next four weeks, I’m probably gonna have a massive heart attack. Well, that’s a huge risk of not doing it. Okay. And that kind of makes the case, okay.


I would probably lean towards trying to do my best to do it. But if it’s something that like, well, are we going to put it off for three months or, or six months until we have some clarity and until the hospitals get better and incidentally, the hospitals have gotten much better and the healthcare professionals has gotten much better since the beginning. It really making sure we’re safe. But again, the question is, if you don’t have to do it, you don’t have to do it. You know, are you putting yourself at risk by potentially it yet? Or are you putting yourself at risk by not having the valves for COPD? Not really. Not really. So again, we all have these questions and these are questions that I recommend. You know, you talk about with your doctor, you talk about with your family, you talk about with other healthcare professionals and a lot of people talk about, you know, you can’t obviously have a procedure by telehealth, but you can have an exam where you can have a doctor’s visit, especially if it’s a doctor that, you know.


And so I would say, start with that. And if the doctor says, Hey, I absolutely positively need to see you. That’s a different story. But then there’s also ways to plan these things out. So for example, if I, if I need to you know, make an appointment with a doctor, I would say this, I would call ahead and say, listen, this is me, Brenda. You know, I’m a high risk person. I really don’t want to be sitting around your waiting rooms. So what I’d love to do is have Heather drive me right up front. If you could call my cell phone when you’re ready for me and then put me right into a room. Okay. So I don’t have to sit there with anybody else. I’m going to mask up and I’m going to glove up. And when I get into the room, I’m going to disinfect the room in the same way that I would get on a plane. And I know it sounds crazy, but we want to protect ourselves. Okay.


And the other thing is, you know what, you know what a hospital has a lot of sick people. Okay? So again, it’s going to have a high concentration, a higher likelihood than let’s say, if you went to someplace else. Okay. So you’re right. But these are the kinds of ways that we have to think about these things and problem solve them. I’ll tell you a funny story. So about a year ago, I had a bump on the back of my calves that every morning as I was brushing my teeth, my dog monkey would lick the bump. Okay. Now every, you always hear these crazy stories. Like the cat diagnosed breast cancer, the cat diagnosed breast cancer. The cat knew it. The doctors didn’t know what the cat knew it. So I thought to myself as to, you know, maybe monkey knows something that I don’t know.


I said, I better get this checked out, go to the doctor. Doctor checks it out, says I’m not worried about that. He says, I’m worried about this thing above it. Okay. Take something off my leg. I wound up with a staph infection. Okay. I’ve had the same doctor for 25 years. Same dermatologist. We graduated almost at the same time. This guy’s a cool cucumber. Okay. He was nervous. He was nervous. I knew I had a situation because this guy I’ve never seen him nervous in 25 years, he was nervous. But one time I went to see him. He said, I really, I was showing him, I was sending him photos every day. He said, you know what? I need you to come into the office. I need to look at it. The person at the place goes to put me in a room. She says, Oh, you know what?


Somebody, nobody cleaned up this room yet. Let me clean it up. Then you can come in. She goes to the table, rips the paper off, pulls out some more exam paper on the table and says, okay, there you go. I said, you don’t disinfect the table underneath that little piece of paper. She says, no, it’s a new piece of paper. I said, you know, I’m here because I have a staph infection on my leg. Maybe I caught it here, you know? But that’s the kind of thing that we have to think about. So when we talk about exposures, okay, so what’s going to make it more likely. So it’s going to be more frequent exposures. It’s going to be longer exposures and it’s going to be higher concentration of exposures. And when we talk about higher concentration, we’re talking about people who have a lot of shedding going on, and we’re talking about close contact to people, which is why so many healthcare workers have gotten sick because they have frequent exposures because they have close contact exposures.


And because they have prolonged exposures. And even if we do our best, okay. And when I say healthcare professionals, I’m not talking about myself. So when I talk about people, don’t get the idea of like, well, you know, he keeps complimenting himself. If I’m going to compliment myself, it’s only going to be about my looks. But, but the idea is that that’s why so many healthcare workers are are sick. The people who are on the front lines, the EMT, the paramedics, the nurses, the doctors who are in close contact with multiple people, with high concentrations, frequent exposures, et cetera, et cetera, et cetera. And those are the things that you have to think about when deciding do I go to the Piggly wiggly or not? That’s for my Southern friends.


I know, hi, this is, yeah. I never, you know what? We never got a chance to meet as many times I’ve been in New York, but I know these last few times I’ve been sick. You know, I went to the organization, vaginal and nail in that group. But anyway, yeah, I just wanted to say that I got swapped. Of course I was good. I’m good. Thanks. Faithful to go. And my apartment complex a year. The hall, I won’t go, I have my mask, my gloves, everything. I won’t touch the elevator on level and my gloves on, do I need a mask walking up and down with nobody in the hall or do I keep it and just put it on when they, when somebody comes fast? Me


Great question. And unless somebody knows something that I don’t know, the answer is, I don’t know. Okay. Because the question is, the question is, okay, did somebody just go out in the hall? Yeah. Where are they? Coughing and sneezing. Can the virus remain in the air? Even if it’s, you know, even if it’s not just big droplets, can it remain suspended to me, if that’s the case, I’m going to err, on the side of caution, why wouldn’t you wear a mask in that situation? Right. Right. So if the answer is, you know, put this on a, you know, it’s like 50 cent has a song, have a baby by me become a millionaire. Right. It’s like, have don’t weigh a mask, become a, COVID become a COVID victim. You know, why would you take a chance on that? Right. Why would you take a chance? And the things very often that people want to argue about, it’s like a say, is that really a big deal?


Like, is this really a big deal to wear this? When it protects me from it’s like saying like I am going and I, you know, we’re, we’re at the circus and we have the guy over there and he has a Falcon. Right. And he wants to do a trick he’s on the other side of the arena. And he asked you to hold your arm out, but he wants you to put on a special arm, a leather thing on your arm. Right. So that when the fan lands on you, he doesn’t rip your arm off. Right. Who’s gonna be like, you know, what do I really have to put that thing on? When the Falcon lands on my arm, these are the kind of, these are the kinds of questions we ask ourselves. Right. So guys, we’re not talking about hang now we talking about a potentially lethal virus. So if the question is, do I put this mask on or do I take my chances? I’m putting the mask on.


Yeah. I had the mask on when I hit the elevator key. I had gloves on,


Okay, let me teach you a glove trick. Let me teach you a very simple glove trick. Okay. And with masks and gloves and these types of things, I think people should try to buy in bulk because again, like my mask is here. Okay. So if I put it in my bag, if I put it, people doing this right, you should be changing these things frequently. That’s why this argument over PPP, PPE is so important because all these things are supposed to be single patient use. I use this mask with you. I throw it away. I don’t put it back on my face and get back on an ambulance to treat the next patient. Right. But let me teach you a super glove trick. Okay. Because we know gloves, ripped gloves can tear. Gloves can get wet. Gloves can do this. When you know, you’re going to be out for a while, put on three gloves on your chant, put on three gloves on each hand.


Okay. You take them off and that’s it. Right? So now I’ve touched something. I’ve come in contact with it. I peel my glove off. I put it in the garbage. I’m still protected, right? Because it’s hard to take a glug glove off. And then now I have to dig around. Now my hands empty. It’s hard not to, to balance something or, or, or, you know, to not touch something. So these are just little tricks. And again, I’m going to give you the safest information. Now. Some people think I’m a nut. It’s okay. I don’t mind.


I think it’s great because I’m not out that much. So yeah. I’m at home. I’m at home. Okay. I fractured my hip in March. So the doctor couldn’t do the after surgery. X-Ray because it’s covert thing. So I’m going to see Tuesday. So when I called and I got the appointment, I said, what time? Then the receptionist told me the time who’s going to be there. How many people? Just stuff that I have two people at a time, it’ll be you and someone else. I say, well, that’s how they should do it. I say,


TJ, if TGI Friday’s can, can buzz you when your table is ready. Then I don’t think it’s too much to ask for a hospital to buzz you when it’s time for you.


Absolutely. She said, when you walk in here, you’ll go directly to the back to the doctor. Okay. I told that’s the only, and I said, if I walk in there and it’s different, I’m not coming in.


Yeah. And, and listen, don’t get me wrong. I’m not trying to scare you. And I’m not trying to bad mouth anybody. Okay. I’ve had a few interactions with healthcare professionals. 99.9% of them are fantastic. 99. And people are really tuned up for this now. So, you know, again, I give the medical community tremendous credit because these people got up to speed in lightening time. Okay. Can you talk about three months and six months to change the way that you do everything? These people deserve credit. But let me tell you one thing that snuck up on me. Okay. A few weeks ago, I, I wanted to find out if I had antibodies because in late December, early January, I flew the person sitting next to me, looked like she had malaria was coughing all over me, sneezing all over me, blowing her nose, putting them in the, putting the dirty tissues in the magazine holder, you know?


And I got sick within a few hours. Okay. I got sick within a few hours. So I thought, you know, looking back on it a lot of people, a lot of doctors look back on their cases now and say, Hey, you know, this was in January or February. Maybe it was COVID. But I said, let me go check for antibodies. Okay. So I went to this place, super careful when first thing in the morning they let me in and they say, okay, we’re going to take your temperature. And they pulled my mass down and stuck a thermometer in my mouth. So guess what? I don’t think they should be taking temperature that way. Right. And this thing is not necessarily, but I’ll take it at home. Ask me to take it at home. Everybody have a thermometer. So the idea is, you know, you have to be on your toes and you know, the thing is with certain things Mmm it’s like, you can be right.


999 times with if you wrong, one sick. It could be, you know, it could be serious. So you have to be careful with this is a full face shield, more protective than glasses and a mask. So a face shield doesn’t, doesn’t take the place of a mask. Okay. because a face shield is coming down, you know, something could still get up under the face shield. So you would wear a mask and a face shield, but wear a mask and, or a goggles are going to be more protective for you are going to be in a, in a situation there’s going to be potential splashing. Okay. So somebody sneezes on you coughs on you, you know, spits on you. If you’re, if you’re in someplace where somebody could be bleeding or, or urinating or defecating, that’s what the mask is for. So something doesn’t come.


I mean, that’s what the face shield is for. So, you know, the question is, is it better than, than, you know, goggles? It covers more of your face, but it doesn’t replace the mass. So it’s mask and face shield. You know, but again, if it’s going to be, and let me tell you something else, there’s something in medicine called universal precautions. Right. And what universal precautions are is that we treat everybody as if they have something that can be transmitted, right? Because we don’t know people’s history. And especially in EMS, you could roll up on somebody on the street. They could be homeless, they could be a drug addict. They could have been in an accident. They could have anything could happen. We don’t know them. We don’t always know their name, let alone a medical history. But if we assume, and we take universal precautions and act as if this person is potentially contagious, then by all means we are protected.


Okay. If we don’t take universal precautions, then we are not protected. And again, the idea is, err, on the side of safety and air on the side of caution alright, other questions. My at my acute care site, I’m going to answer this set of questions and then we’re going to go to recovery and then we’re going to go to rehab. Okay. And the good news is even if you haven’t had COVID a lot of the things that I’m going to talk about in terms of recovering from COVID and rehabbing for covert or the same things that are beneficial for anybody, with any type of cardiovascular, pulmonary condition, or just anyone in the general population. So if you haven’t had COVID don’t run anywhere yet. At my acute care site, we have been screening, screening, asymptomatic patients, and our entire city has been screening I’ll forward.


The results. When the study is published, we are not finding asymptomatic patients in our city that are positive. And we are finding viable virus is about eight days. However, in outliers may shed longer. I will forward a study. I read this morning about shedding, forget where it was. Okay. Again, so, so Michelle, here’s what you’re saying. You’re saying that you’re testing people. Most people who are asymptomatic are not positive. So you’re not seeing a lot of people that are positive who didn’t have any symptoms, which means a lot of the people that are positive, most of them had symptoms again. Awesome. Okay. But we don’t know for sure yet again, so, you know, that’s encouraging just like, you know, it’s encouraging, it’s encouraging that, you know, that the more likely person to shed is going to have symptoms and encouraging that viable virus is about eight days.


Okay. But you say, however, in outliers or however, what if it’s like how many people here watch Seinfeld or ever watch Seinfeld remember the one with Keith Hernandez where someone got spit on and they said there had to be a SPE, a second spitter. Okay. They made it like JFK or they said that had to be the perfect Loogi. Okay. So the idea is that yes. Under it, it’s awesome to hear that it’s probably only, you know, a maximum eight day incubation period, but again, I want to err on the side of caution when it’s something that’s potentially life and death, Panetta is what I would advise people to do for ultimate safety. Again. Good advice. Good information. I don’t think it’s proven yet. I don’t think it’s definite yet. And again, I think there’s more things that are maybe suspected or not known or unproven than there are proven.


So there’s going to be evidence. There’s going to be research that comes out and that’s what I’m waiting for. I’m traveling home from train now to auto mass and gloves all the time. Now car and shop for repairs. So hotels, et cetera, any you know yeah. I have a lot of advice. Okay. But I’m not going to answer. If you go to our website,, there are dozens of hours of Corona virus info and article that I wrote about staying safe with coronavirus on the Corona virus tab. So www pulmonary, pulmonary wellness foundation who walked back on that statement yesterday? Yeah. They walked out, they walked it back very quickly because as soon as they said it, probably somebody said, Hey, you better get your ass out there and walk that statement back. But when I heard it, I was like, Oh man Nope.


All alright. A face shield. We talked about it. I have a great story about not taking risks to share. We will hear it at some point, but we’re already at an hour and 15 minutes into this. I just have to be done by, by 2:00 PM tomorrow. So don’t worry. I’m going to answer questions. My concern is that sooner, rather than later, I’ll have to go out. Maybe a root canal fell and broke my arm. Whatever some emergency, I lose sleep thinking that at any moment I’ll need help. That will cause my death, John. I get it. Okay. I get it. But here’s what I would say to you. I would say there’s no sense losing sleep tonight. If you don’t have any appointments tomorrow. Okay. There’s no sense losing sleep tonight. If you don’t have any appointments all this week, that means sleep tight.


And it means that when you are ready to do one of these things, it means let’s be fun. It means let’s follow all the instructions. Let’s take every precaution. And if people have questions about this or they have a specific event you know, feel free to either come to one of the Facebook lives or come to one of the support groups or email me. I’m happy to help you troubleshoot these things. Okay. And again, I, something that I think is probably one of the more risky things I flew. Okay. I took every precaution. I knew what I had to do. I came up with a plan. I executed the plan here I am. This is day eight, still healthy. Okay. So there’s ways to minimize the risk, John. And that is what we want to do. We want to take every precaution possible, but you’re right.


At a certain point, we probably have to get out. And one thing I will say to you, okay, is that you, you fear like it’s something that’s going to cause your death, the, the, the, the death rate. Okay. People they’re getting better at treating. Okay. They’re getting better even though there’s no specific medicine treatments, we’re learning more every day. Okay. So I understand your concern. Should you be concerned? Should you take precautions? Absolutely. Yes, but you can’t stay up every night worrying about something that may or may not be okay. So we can talk about that. That’s where, you know, support group comes in. That’s where meditation comes in. That’s where dr. Richard Brown’s healing power of the breath comes in. That’s where Lunesta comes in. But you can’t drive yourself insane. Right? Panic doesn’t help any situation. So, you know, the idea is let’s learn as much as we can about it.


Okay. We’re going into a battle. Let’s take every precaution. Let’s use all the tools we know, and I’m happy to help you with that. I understand John, why you would feel that way? Someone said somewhat sounds silly, but what about mail and packages that are delivered? Originally? We were told that the virus could live on cardboard for four days. If we were staying home 24 seven, but get our mail and pick a box. So should we be disinfecting our mail on packages? It doesn’t sound silly. Okay. Because initially when it came out, what we heard was, Hey, this thing can live here. Leave your packages. So what did I do? I I went to get my mail. Luckily I’m friends with my mail carrier. I go across the street. It, the post office happens to be right across the street from my house, wear a mask, wear gloves, take a bag, please drop it in the bag, close the bag, come home, open the bag, dump my stuff out, leave it outside for a week because nothing was that urgent.


Okay. Take off my gloves. Take off my mask, wash my hands, take a shower, change my clothes. The question is we don’t know a hundred percent. Okay. Now they’re saying it’s less likely that it lives on surfaces, but let’s say it is. Let’s say you got a particularly, let’s say the person who delivered. I mean, I did think of something today that I hadn’t thought of before, which is that, well, if that’s the case, maybe we would probably probably see a lot more delivery. People getting sick, right. A lot more mail carriers, a lot more FedEx, a lot more you get, and I’m not saying none of them have gotten sick, but I would think that it would be, you know, that would be a super risky, risky, risky job. And we’d see a lot more people getting sick. But again, maybe we’re immunocompromised, okay.


Everything reaches a tipping point. So if you’re Immunicon, if your immune system can take a level 51, you know, emergency and you get just by freak chance, let’s say all the, all the odds stack up against you and you hit a level 52 emergency. Well, why take that chance? So if it’s no big deal, when the stuff comes in the house, take something spray it, let it dry, open it. We’ll open it with gloves, open it with a mask. You’ll feel better. I’ll feel better. Right? And then you don’t have to think about it. Why would you want to do it? Open it right away. And then for 14 days, you’re going to be wondering if you touch something that you might’ve touched your face on again, not just your physical health, but take care of yourself. Mentally, take care of yourself. Emotionally, do things that aren’t going to support yourself.


Not things that are going to particularly drive you nuts. So no, it doesn’t sound silly. I would say, take the precautions. You’ll never get in trouble by being too careful. You’ll only get in trouble by not taking careful, you know, being careful enough. And again, why worry about it? Why worry about things. If you don’t have to, there’s enough real things to worry about. So if you can minimize that risk and minimize the risk. I understand John. I moved all my routine medical appointments to late August. I finally went for a walk in New York city, not wearing masks. I find too many people, even in New York city, not wearing masks. Yeah. I walk around. There’s a lot of people not wearing masks. There’s people wearing masks over here. Guess what? That doesn’t help. There’s people wearing masks silver here that helps even less. The new trick.


I’ve seen people doing this week mask over here so they could smoke. What can I tell you? What can I tell you? I mean, it’s, it’s just one of those things. And again, it’s not like a seatbelt, right? This is where if I don’t wear my seatbelt, you know, I’m taking care of myself. This is like where we can undo other people’s seatbelts. And that’s what makes this tricky. Yeah. What’s the best thing to do if you absolutely must go to an appointment, I have to go to interventional radiology at Hershey medical center. What can I do to minimize the risk? Again, all the things we talked about. And I have a lot of stuff. A lot of stuff about this, but you want to okay. If I didn’t have to go, I wouldn’t, especially since my four husband who goes to work every day has been living in the garage since March 24th to protect me.


God bless him. Okay. That’s a good husband right there. He’s been living in the garage to protect you. So what are you going to do? Same thing. You’re going to mask up. You’re going to glove up. You may wear even, you know, I like ponchos. I think a poncho is a valuable thing, because guess what? If you get something on it, you take it off and throw it right. Ponchos like five bucks. Okay. and then you have to communicate with the people in the place. Okay. Communicate with the people in the office and say, listen, I have this, I have that. I’ve COPD, pulmonary fibrosis. I have NTM. I have bronchiectasis. I am high risk. What are we going to do to minimize this? I’ve had to have emergency repairs and the apartment workers came with gloves and masks. Great. another thing you could ask them to take the shoes off.


Another thing is in your home, don’t assume that people are going to come prepared. So have a box of gloves, have a box of, you know, a box of masks that when somebody comes in and say, listen, I don’t want you to take this personally, but please put on my gloves, put on my mask. Why? Because that person’s gloves coming in are only as clean as every other thing. That person touched that day. So protect your home masks, make my asthma worse. And I cough like a big dog. Mmm. There’s different kinds of masks. And there are strategies that you could probably you know, I, I’m guessing that your mask is making your asthma worse because it’s making it tougher for you to breathe and making it more effort. Therefore, you’re getting more. Broncospasm, here’s a suggestion. Ask your doctor. If you, if you know, you have to go somewhere where you have to wear a mask, ask your doctor.


If you could take your rescue inhaler 15 minutes ahead of time, you know, because that’s going to open you up a little bit. One of the ironies of, of asthma or obstructive pulmonary diseases that the harder you blow, the more air trapping and the more broncospasm we get. So the harder you work to breathe, the harder it becomes to breathe. So anything you can do to minimize that effort ahead of time is going to be a plus. And other things about one third of the people had no mask visible. Mmm. Other than, okay. About one third of the people had no mass visible or the mass was down around the next, other than Zabar’s. It seemed that a Mister Softee truck was doing. Yeah. That I don’t get. I know, I know Dave also said this ice cream truck. What? I don’t know.


I don’t, I don’t get it. One old timer, like myself said he couldn’t wear his mask because he was drinking coffee. Hmm. Your life or your coffee, your coffee, or your life. The similarity fell apart after that hate to be a killjoy, but maybe same Cuomo should suggest no eating or drinking on the sidewalks of pot. Wait till you get home to eat or drink. Okay. can the virus enter through an uncovered cut? I would say, I don’t know. If anybody knows, please, please say it. I’d say it’s probably not impossible, but it’s probably not probable, but if you have a cut, cover it again, minimize your risk, any type of exchange of blood and body fluid or anything like that, I suppose it’s possible. I’d rather not be close to someone sneezing. I don’t think you’re alone in that. How much does that blue mask protect us?


So is it, is it absolutely foolproof? No. Is it better than nothing? A lot better than nothing. It’s going to protect you from something big. It’s going to protect you from something that’s going to hit you. But that means as soon as you get hit with something, or as soon as you think this mask is suspect, you have to get rid of it. What type of mask do you recommend for someone with COPD that has trouble breathing? Again? I think the best mass, you know, again, most people, even if you have an end 95 mask like this, okay, it’s still not foolproof. Okay. When people on hazmat teams or firefighters wear masks like this they’re specifically fit for their face because we all have slightly different face and even a tiny bit think of it like a space suit, right? So if you have a space suit, it doesn’t matter.


If you have a pinhole in that space suit, it’s still a potential source of exposure. So, you know, I think you do the best you can. I think if you wear the most protection that you can, as long as you can breathe, if you can’t breathe, you need to breathe. Right? So I’d say protect yourself. If you really can’t mask, or you can only wear a mask that’s less protective than you need to be super careful and you need to extra socially distance, you need to make sure that you really don’t come in contact with people. How comfortable was I staying in a hotel when I was in California? Where precautions did I take? I was, I wasn’t like a hundred percent comfortable. I wasn’t as comfortable as being in my home, the precautions I took anything I had from the plane, any clothes I wore, I put in a corner where I didn’t touch them for 14 days.


I wiped down every single thing in the hotel. I only got I mean I had to obviously order food. And I wiped everything down. I mean, it’s, it’s, it’s not that I was a hundred percent comfortable. But I, you know, other things I do, and one thing I recommend to people is to keep a log or keep a journal of your vital signs. So especially if you’re at risk, take your temperature once in the morning and once in the afternoon or once or once in the morning. And once in the afternoon. And once in the evening look at trends because a lot of times somebody will say, okay, my normal blood, my normal temperature is usually you know, 97. So you may come in at 99.0, and that may seem like a low grade temp, but that may be super high for you.


So keep a record of this, keep a record of your heart rate, keep a record of your oxygen. Saturation, keep a record of your blood pressure so that when you, you know, when you go and when somebody you go to a health professional, they can look at the trends and they can see what’s normal for you because we all can be different from each other, not each one of us, but you get the idea of what I’m saying. I have an IPA H and Mayo appointment in July moved a few times. Should you consider going? I think, yeah. I think, you know, look, pulmonary artery, hypertension you know, it’s, it’s not something that has no risk to it either, so you have to get treatment. Okay. But I would ask your doctor, if you can have a telehealth appointment they say eyes, if you can’t have a telehealth appointment and you have to go in, I bet that Mayo.


And I would bet that the, the, the pH clinic there is tuned up for this and ready for people like you. So I, but I would ask them, what precautions are you taking? And then you take your own precautions going in eyes are also a potential opening. I’m going to stop this right this moment, because there’s 44 questions after this. I want to go to rehab and I want to go to recovery. Okay. because that’s important. We’ve all spoken about prevention, a million different times. And I talk about this almost every day in Facebook, live recovery. Okay. Couple of things. Health is like a bank account. Okay. So I call it health. Well, so there are things that you can do to increase your wellness and increase your chances of preventing you from getting the virus. If you come in contact with it, but also increasing your chances of doing well, surviving and thriving.


If you do get the virus. Okay. in my book, ultimate pulmonary wellness, I talk about five things that in my experience I’ve found to be the most beneficial and you know, there’s like big ticket items. Okay. So it’s like, everybody wants to ask, what about this tea tree oil? Should I put a drop on my tongue? Okay. You know, like this, I say, if you win a contest and you win a shopping spree, go to the electronics aisle. First, if you get a minute to take anything, you can go to the big ticket items. First, don’t go to the gum aisle. And it’s the same thing with your health. So you can drive yourself crazy reading, every magazine, reading every article, listening to every expert. But there are five things. And it doesn’t matter if you have heart disease, lung disease, general population, diabetes.


These are the five things that I think by the most beneficial and the biggest ticket items, number one, medical, okay. Medical is having the right doctor, taking the right medications, taking the medications properly. Okay. And to me, that’s part of the picture. It’s 20%. We live in a society where medicine is very often a 90 to a hundred percent of it, right. We live in a very medication testing and procedure based society, but lifestyle is everything. My friends, okay. Having the right doctor, right medical team take the right medications, take them properly. 20% exercise, huge, the single best thing you can do for yourself. And if you don’t have to take notes on this, it’s all in my book. And my book is available to read for free on our website. Okay. Number three, nutrition, crucial. And for pulmonary disease, there are certain types of nutrition that may be different for somebody who’s a diabetic or for somebody who has heart disease.


And it’s based upon, you know, minimizing carbohydrate, making sure you’re getting enough protein to build muscle and eating healthy fats. And especially if you’re trying to gain weight, or you’re trying to keep weight on eating healthy fats, which are, are very calorie and produce the least carbon dioxide. So carbohydrate, it produces the most carbon dioxide when it’s metabolized and carbon dioxide is what’s going to make you, you know, breathe more difficultly. It’s going to send a message to your brain that says, breathe, breathe, breathe, breathe, breathe. So a lot of people say, well, I don’t understand this. I went to the restaurant, I walked 10 blocks. I was fine. I had some bread. I had the fried calamari as an appetizer. I had the chicken parm. I had the tiramisu and I had two glasses of wine. I had to call a taxi. I had to take a taxi after I walked one block.


So in addition to having your stomach being full, pushing up on the diaphragm, you’re also producing a lot of carbon dioxide because that’s a high carb meal. This is all in the book. Okay. We could talk about this for hours, but it’s in the book, medical 20% exercise, nutrition, managing stress, anxiety, and depression. Okay. Managing your stress, anxiety and depression. It is super stressful. Having a chronic illness, especially one where the number one symptom is not being able to breathe, right? So the idea is a fight or flight, right? So our nervous system is broken up into voluntary and involuntary or autonomic. So voluntary is, I want to lift this up. I can lift this up. Involuntary is I don’t have to sit here and say to my heart, [inaudible] B, B beep beep. It’s automatic, right? Because if it wasn’t automatic, then I would die.


Every time I went to sleep at night, because as soon as I fell asleep, my heart would stop. Now, breathing is one of the few functions. That’s both automatic and voluntary, meaning that your, your body is going to make you breathe in order to, to regulate your carbon dioxide and your oxygen and the pH in your blood. But you can also control it yourself, which is what our breathing techniques are about. But if you’re stressed out all the time, you’re constantly having this fight or flight. You’re constantly having sympathetic so that the autonomic nervous system is divided into sympathetic and parasympathetic. Sympathetic is fight or flight. Okay? Parasympathetic is rest and digest. One is stimulating, puts out adrenaline in your system. And this developed automatically in our body because it happened a long time ago when a caveman was walking around. If he was picking berries and a saber tooth tiger jumps on him, he needs to either fight or run away.


Right? And so your body puts out a ton of adrenaline. That’s going to make you ready to fight or run. But today in today’s times, you know, we, we, we get that. If somebody cuts us off the road or somebody writing a check in front of us in the supermarket, Oh. Or somebody not wearing a mask. Oh. Or we watch politics. Oh, that’s probably the worst thing for you. But the idea is we over sympathize, we, we have this sympathetic nervous system that’s overactive. Okay. It’s anxiety provoking causes our blood vessels and our airways to constrict. So you have to manage your stress anxiety, and it could be depressing. Okay. But these are the things that we talk about, where we talk about attending support groups. We talk about, you know, doing things to take care of yourself. And then finally, the fifth component is prevention of infection.


So prevention of infection is crucial. Okay. And again, for once our community has an advantage over the general population, which is that we’ve been training for this for decades, right? Because not only don’t we want co Colvin, we don’t want the flu. We don’t want the common cold. We don’t want, you know, pneumonia, et cetera, et cetera, et cetera. So all the things that you do every time you do something good for yourself, that’s like putting money in the bank. Every time you don’t do something good for yourself, where you do something harmful to yourself, that’s like making the withdrawal. And the more money you go in with when that boiler breaks and you have to make a withdrawal to pay the plumber. Well, guess what? The more you have to start with the better chance you have of coming through on the other side, same thing with COVID.


So everybody at this moment has the opportunity to prepare themselves better if they do get COVID. So of course, first line of defense is prevention. We don’t want it, but if we get it, we want to come through in good shape. And that’s where those things in ultimate, pulmonary wellness come in handy. Now, for those of you that don’t know, we made our online pulmonary rehab program free, okay. Through the pulmonary wellness foundation, it’s called bootcamp. And it’s a 42 day program, six weeks. It’s on our website, pulmonary And guess what? You don’t have the excuse of not having time now. Right? So we can, you know, think of this. You know, people say, well, I’m stuck at home. I like to say we’re safe at home, but also think about hibernation, right? I think about the bear that goes and hibernates and protect himself and rests for a spring time, or think about the Caterpillar that goes into, we’ve been home for a long time.


This is a great opportunity for us to exercise for us, to meditate for us, to learn, to take our medications properly for us to really take care of ourselves in a way that we all know we should, but maybe we didn’t have time for it. So bootcamp is free in 42 days, you will feel better. We just, you know, we just had something accepting where we have almost 500 patients and we know it works. So feel free to join that. If you have questions about it, by all means, get to me now what to do, if you do have COVID okay. COVID comes in many different forums. And at this point I’ve seen probably 30 patients for telehealth. Who’ve had COVID okay. Some were very, very sick. Some were on ventilators, somewhere in the ICU for a very long time. Never were sick before now are oxygen dependent.


Okay. Some had very mild symptoms. Some are used to being very athletic. And so even mild symptoms make a big difference for them. But there’s a lot of variability here. Okay. There’s a lot of variability. And initially we thought it was a respiratory problem and respiratory is definitely involved. So we could see things like shortness of breath. We could see things like lower oxygen saturations. We could see things like decreased activity tolerance. I’ve seen a mixed bag when it comes to secretions. So some people report a very dry cough with no secretions. Some people report copious secretions, but the idea of proning okay, so we’ve heard this term proning which means putting somebody on their stomach. And they found that very useful in helping people, you know, to oxygenate and to breathe better and to clear secretions as rehab specialists and there’s people who do chest physical therapy.


We’ve been doing this for years and this has to do with the fact that there’s something, number one, it has to do with positioning. Okay. So positioning of the lungs and the airways. So think of it like this. So if we have a ketchup bottle, right, this is not up, but imagine we have a ketchup bottle and I want to get catch about right. And this is how it looks. I could shake and shake and shake and shake that catch-up is not going to come out until I put it in the right position. So same thing with, with our lungs and secretions. So especially if you have a respiratory condition that affects your body’s natural ability to clear secretions and bring things up, it’s even more important. But look, what happens now, when we put you in the position, and this has to do with the position of the trachea, the position of the bronchioles, which are the, the airways and the position of the bronchials.


So we put you in a position for gravity to assist with that. So one thing I recommend people do, and this is the same, whether you have COVID or whether you have COPD or any other condition where secretions might be an issue or where decreased aeration might be an issue is to spend some time lying on your left side. Because when you lie on your left side, guess what the right lower lobe is getting the most air. Okay. There’s something called ventilation and perfusion. Okay. Gravity is very powerful. So when we talk about ventilation, we’re talking about air and air will typically rise and blood is a liquid. And that has to do with perfusion and perfusion will always go to the gravity dependent position. So in other words, if I stand on my head, blood’s going to go down. Air is going to go up.


And what we want, ideally is we want ventilation and perfusion to be matched very well. So we want blood to come and take air from the area where we have good airation and where we have oxygen moving. So even if you don’t have COVID, but especially if you do have COVID and are trying to recover from Kobe, spend some time each day lying on your left side arm, overhead, do deep breathing exercises, spend some time lying on your back, spend some time lying on your right side, spend some time lying on your stomach because each one of these positions will be most beneficial for a different part of your lungs and will affect ventilation and profusion. I will post in the group, the postural drainage positions from my friend, Donna frown felt there’s book so that you see what they are. And so that you understand that there are specific positions for specific parts of your lungs.


So breathing exercises are really important. Okay? Aerobic exercise very important in bootcamp. We do this as what we call walkabouts virtual walks, where you can walk in place. We show you beautiful videos that we shot all over the world. We play beautiful music for you. And in six weeks you can go from walking four minutes to walking, 30 minutes, and most people do we need balance exercise. We need strength training. We need flexibility exercises. Now that sounds like a lot, right? Here’s the good news. Okay. People like to classify things. So people like to say, that’s not an aerobic exercise. That’s a strength exercise. That’s not a strength exercise. That’s a flexibility exercise. That’s a breathing exercise. You don’t do seven different exercises. The overwhelming majority of us, unless you’re a finely tuned trained athlete will get some aerobic benefits. Some strength benefit, some flexibility benefits, some respiratory benefit, and some B, B F S breathing balance, flexibility, strength, and aerobic benefit from all of these things.


And guess what I told you before about fight or flight exercise also uses up adrenaline and exercise also releases endorphins. So it also affects your mental state and your mood and your emotions. Okay? So it helps to reduce anxiety, reduce depression, et cetera, et cetera, et cetera, et cetera. Okay. So ultimately what I’m trying to say to you is that ultimate pulmonary wellness, okay. Everybody comes to us. A lot of times patients come to us and a doctor will say, you know what? We’ve tried everything. This is the last resort, but what a lot of people call the end of the line, we call the starting line because unless you’re doing everything right right now, then we know we can make you better. And that includes getting better at taking your medicine, exercising every day managing your nutrition, better, managing your stress and anxiety prevention of infection.


And with COVID again, the things are variable. The symptoms are variable. The results are variable. So some people need oxygen with oxygen use. Okay. People ask, should I turn off my oxygen? Okay. I ask people to rely on their instruments. And I, I tell people a lot of times people get a standard oxygen prescription. They’ll say two liters at rest, four liters with exercise. No. I want people to rely on their instruments. If your saturation goes down, bump your oxygen again. Talk about this with your doctor, but it doesn’t do you any good to keep yourself at a low oxygen setting and do a lower level of exercise because your body gets good at doing what you ask it to do. So if you ask it to exercise, if you ask it to be, if you ask it to be active, it gets good at that.


If you ask it to sit on the couch, eating potato chips, watching 63 episodes of sex in the city in a row, it gets good at that too. Not that it’s not an important skill, but if you want to get fit, you have to ask your body to move. There are neurologic symptoms for some people, okay? Some people have other systemic issues. Some people have a lot of inflammation related to COVID. There’s a saying by James, Carville a democratic strategist from the bill Clinton era that says keep the main thing, the main thing. Okay. So if you come out a lot of people just by nature of the fact that they were sick for four weeks and haven’t been active and have been lying in bed are going to naturally feel worse. They’re going to naturally feel more short of breath. They’re going to naturally feel deconditioned.


They may feel weak, or they have met may have less endurance that may or may not be because their lung function got better or worse. It may just be that they’re, that they’re inactive. They have to get active again. Okay. And they have to get moving again. That’s the number one thing. If you need oxygen, okay. Use the oxygen and turn it up as much as you need to remain saturated. The reason why I say that is because a lot of programs, like if you read the classic literature on pulmonary rehab, they’ll say patients feel better. They could do more, no change in lung function. Okay. We have a lot of improvement in lung function. And I think the key for that is that we push people much more vigorously than other programs. And we give people much more oxygen than other programs. So if your life requires this, if I exercise you down here, that you could do that until the cows come home.


But that doesn’t mean your life gets better. If your life requires this and by hook or by crook, if I give you 15 liters of oxygen by mask, and I can exercise you up here, number one, your body gets better at using oxygen. Your heart gets more efficient, your muscles get more efficient. And yes, I think you can, you can improve lung function. So for people coming out of it, I think the main things are going to be respiratory. I recommend everybody gets an aerobic and an, or an acapella, some type of positive expository pressure device to help you do breathing exercises every day. I think you need to get going on exercise early. Okay. A lot of times people say, I’ll start exercising when I feel better, right. Or I’ll start exercising when this happens, or I will change my diet when this listen.


One thing I believe is that with this particular illness, so we know some of the short term impact. We don’t know the longterm impact impact, but similarly to what we saw in nine 11 from what I’ve seen myself and what I, I have heard from talking to a lot of my friends who are physicians, we’re seeing scarring and people okay. Whether that’s going to be permanent or not. We don’t know. We’ve seen people with decreased lung function, whether that’s going to be permanent or not. We don’t know will this degree disease continue to progress over time. I bet in some people it will. I bet in some people it won’t, but my personal opinion is that the sooner we get going on, something like this, the sooner you get moving, it’s, it’s more important. I think even to do this early on than to wait and do it later, because I think early on is when we have the greatest chance of affecting how our lungs heal.


And that’s not the time you want to be resting things and taking shallow breaths. That’s the time we want to be pushing it so that, you know, it’s almost like a clay or wax. The wax is warm and flexible. We can shape it once it hardens it hardens. And I see the lungs in a very similar way. So I think that for anyone who’s had COVID, and it’s the same thing. If you’ve had pneumonia, it’s the same thing. If you’ve had an exacerbation of your existing lung disease, the sooner you get back on it, as long as it’s safe for you, I think the better longterm effect you’re going to have. All right, questions, comments, feedback, and then I’m going to go you know, we obviously went over time. I’m famous for that. And I do want to try to hit this list as best I can. Don’t feel pressure to stay, but you’re welcome to stay. Anyone want to ask a question out loud or make a comment out loud before I go to the list?


Yes, I, Betsy


Betsy, Hey, Betsy.


I find myself just declining, terribly, and I really need to help. I need someone to help me. I don’t know you, you guys, when I was able to come to pulmonary rehab was very helpful, but I can’t come anymore. And I, I don’t see any to be able to do this on my own. I keep getting more and more shorter breath just as you describe I’m I’m just going downhill and I’m desperate. I can’t do it on my own.


What are you doing now? That’s the, are you doing any exercise?


I’ve been trying to walk every day, but now I see my brother has gotten so short. I can’t even do that.


So are you, have you tried bootcamp?




Okay. I’m going to have Barry call you tomorrow. Okay. And we will talk about either bootcamp and or telemedicine and we will have one of our therapists work with you.


Thank you.


Just do me one favor. Shoot me an And I will forward it. We’ll get someone to call you tomorrow. We’ll get it going. Yeah. And, and, you know, again, you know, we closed the pulmonary wellness center on March 10th. You know, to me it’s like New York city is like, you know, it’s like a moat full of alligators. And you know, to me, it’s like, if I don’t want to ask you to Pross that moat to get to rehab. So we closed early, we’re still not open. I don’t even know if we will open. And the reason for that is because if the risk is so great for you, okay. And we don’t have a treatment and we don’t have a vaccine and you have an underlying condition or you’re immunocompromised, then I don’t feel comfortable asking you to do this, but that’s why we’re tuning up.


You know, we do have therapists doing telehealth at this point and listen, it’s not perfect. Okay. And certainly we can’t push you in the same way that if you were in the center, if I had you on an EKG right in front of me, if I was checking your blood pressure every five minutes, if you were checking your oxygen every five minutes and if we had the ability to help you immediately, if you had a problem, but the way that we’ve. So, so let me tell you this I’ve put off online rehab for a long time. Okay. I know some people have been doing it to me. The things I worried about were twofold. Number one, I was worried about patient safety. Number two, I wasn’t sure that it could be effective. Okay. Why? Because you know, Betsy that we push people pretty vigorously at the center, right?


Only because we’re monitoring you, but here’s how we get around it. Okay. Instead of two or three days a week, boot camp is every day. So even though we’re not pushing you as vigorously, we increase the volume by having you do something daily. And it’s a 42 day straight pro day straight day program. And it works, but here’s what I would suggest shoot me an email. And anyone else is also welcome to do the same thing. If they want information on bootcamp and or tele-health, the majority of people can do bootcamp. Okay. So what bootcamp is is every day we send you, there are four different activities for you. We lead you through it. Okay. It’s a self-directed program. You can do it whenever you want. And certainly I’m happy to discuss your condition with you to make sure that safe with you. You have to discuss it with your doctor. But we also have tele-health. Some people want somebody there watching them. I don’t think most people do once they get it done a couple of times, but sometimes you need a little push and I’m happy to do that with you. And I’m happy to get someone from my team to work with you. So again, other questions


I have, I have something I’d like to say.


Sure, yeah, who’s talking.


Oh yeah. And all yet this is obviously not directly connected to most of the people here, if not all of them, but I think everybody could get inspired by the love of the family. That’s reflected in this story, which I will tell you very, my nephew lives in Brooklyn. He’s 39 years old. My sister lives in New Jersey. He wanted to see his mother, but he did not want to expose her to who knows what, even though he seems fine. So he rode his bike for six hours, 43 miles without stopping to pee because he didn’t want to get infected by anything in the gas station. And


So no pants,


He is now with his mother and I just find it so amazingly inspiring. I just wanted to share it.


Awesome story. Thank you. Yeah. Yeah. There’s ways to do it. There’s ways to do. I also just got a bike too, because I want to ride uptown and see my parents outside, outside. But yeah, it, it, yeah. There’s ways to do it other questions. And then I’m going to go to the list again, guys. It’s been almost two hours. I’m still fresh. Okay. So I’m good to keep going. I’d like to get all this stuff on record. We did record this. It will be available, but I’m gonna go down this list. Okay. But I’m also going to turn off I’m going to turn off chat so that you can’t keep piling on questions. Cause right now they’re 64 64 64 waiting question. I heard someone’s voice. Yes. Hey Brad.


Tomorrow’s my last day. Okay. I’ve done it. And it’s fantastic. Can I say something where I’m wait, this is good, Betsy. Oh, are you okay? Betsy? I’ve been here for a couple of years and I have not started bootcamp. I would be more than happy to start with you because I need to push.


All right. So you have an offer right there. Okay. Today is Wednesday. Okay. Let’s say this. Anyone who wants to, I’m going to give you Thursday, Friday, Saturday, and Sunday to enjoy yourself. Okay. Monday we all start bootcamp together. Day one. Anyone, none of you could go on. You could do it at any time you want, you could do it at any time you want. So use the next four days to sign up. Okay. For bootcamp and to join the ultimate pulmonary wellness Facebook group. And we’ll go through 42 days together. And even if you’ve done bootcamp before and you’ve fallen off the wagon there’s strength in numbers, people. Okay. And I will do it with you. Okay. So Monday bootcamp now


This is it, Noah at pulmonary wellness.


Yeah. It’s or But here’s the thing. You can go on our website, pulmonary And I’ll, I’ll put this in an email to everybody tonight. Not tonight, tomorrow. I will do it. But sign up for bootcamp and then go day by day. All this stuff is right there for you. So other things they’re saying eyes, let me just get to where I am. So I have family that are essential workers. I’m around them every day. How can you really protect yourself? I think my chances are high. All I can do is make sure we wash your hands. They get tested all the time. I don’t like to worry about it. So great question. So here’s the thing. So family are essential workers, so essential workers could be healthcare professionals. Essential workers could be people on the checkout line who are coming in contact with a lot of people.


So yes, if people are going in and out of your house and they are exposed to a lot of people, there, there is a potential exposure. What? That’s fun. All right. Listen guys, if you’ve never seen my standup comedy routine, trust me. I’m good at suppressing hecklers. Okay. So don’t try me. Don’t try me. But here’s the thing. Here’s some ways to prevent it. Okay. So somebody has just been out working all day, your home alone, or your home, and they want to protect you. First thing, get out of the clothes that they’ve worn all day, right? So if you have the ability to go to the washroom, get all, get out of your clothes. As soon as you come in the house. No, I’m not giving marital advice right now. Although it could be either beneficial or detrimental, depending upon the current state of your marriage, but immediately get out of your clothes, get them in the wash, take a shower.


Okay. Get into fresh clothes. Have inside clothes. Did you only wear inside, have outside clothes? Did you only wear outside once? Make sure you’re changing your clothes every day. You’re washing your clothes every day and keep your shoes outside. That’s about the best you could do. Okay. That’s about the best. It’s a risk. I’m not going to lie at Catherine. It’s a, it’s a, it’s a, it’s a delicate situation there. Okay. But yeah, getting tested also, incidentally testing is another situation, right? So that’s another situation there. Why? Because there’s false positives because there’s false negatives, right? So people can test negative who have Kobe people could test. I haven’t heard of any, I don’t know anyone personally, who’s had a false positive. In other words, I don’t know anyone who tested positive that didn’t have grown a virus. I do know people who’ve tested negative who then wound up having Corona virus. So testing is great, but you’re only as good as your last exposure. Right. it would be great if we could test and then that test inoculated you from getting the virus. Alright, so, yup. Yup.


Hi, my name’s Katrina. I have severe pulmonary arterial hypertension.


My question is every time I go outside or if I have to go to the hospital, I always wear a mask. I, then if I go to the hospital, I then quarantine my mask, you know, for at least 72 hours without touching it. Is it say that again? When you go to the hospital you want so I have an N 95 for the hospital and then I leave it in my car for 72 hours. Is it okay to reuse that mask? Okay. So it’s okay to re keep reusing masks. Yes. So yes and no. Yeah,


I get you. I totally got it. So let me tell you how I would, I would address that. Okay. And 95 is a hard to come by, right? These things are much easier to come by. I’ll tell you what I did on the plane and in the airport. I had this, and then I had my not a, not an in 95, but I had a, I have a vog mask. And I also have this I don’t love this one as much as the bog mask, but I just bought it because one of my favorite animals is the mandrill. And this way, you know, people are always surprised because in this part of town, in New York city, it’s, you almost never see a mandrill in the wild, in New York city. So I love to surprise people. And the people like, Oh my God, it’s a mandrill. And then I’m like, no, it’s just me. But here’s the thing to protect your [inaudible] right? This is like gold, right? Even healthcare workers sometimes have a hard time to my friends that work EMS. This is what they do this mask, which is light anyway, this mask. Okay.


So I’m going to great question. I’m going to tell you, I’m going to tell you what ha this is what it means. This is going to protect your mask from the inside, right? So this is going to protect the inside of your end 95. This is going to protect the outside of your end 95. So I’m not saying you make an N 95 masks sandwich with two of these. Okay. But what I’m saying is that it depends where the risks. So for this, you know, I’m more concerned. Like if you think you’re not going to be in a situation where you’re going to have people potentially projectiling onto you or something like that, then I’d want to protect the inside of the mask from getting wet, from getting your own slobber all over it. For lack of a better word, you know, I bet I’m the only person who said slobber today in all of the world.


But anyway, but the idea is I would want to protect it like this. And this is what I did when I was on a plane. Now let’s say I’m an EMT. I might come in contact with splashes. I might come in contact with spurts or squirts. Then I might, well, then I’m not going to be wearing this and 95 anyway, that I’m going to wear a fit test and mass. But I think if I had to make one single recommendation, if you’re walking around the hospital, you’re probably not going to be subjected to, especially if you socially distance, I would put this here, put the N 95 above protector and 95. It’s more valuable.


Okay. Thank you. And then two more, really quick things. When you talked about the airplane and talking about going through TSA was very helpful. As far as being in the plane, you said that you had both masks. Do you think that’s sufficient? Given the fact that air is cycling?


No. Okay. But it’s better than no mask and it’s better than one mask. Right? So understand this. I knew when I got on a plane, it was a potential risk. Okay. now I look, here’s something else you could do. Okay. Because no, one’s flying. Tickets. Tickets are cheaper, right? That’s one benefit. Okay. If you’re, if you have the balls to fly, okay. Let me tell you this. I, I, I bought a first class ticket. Okay. I made sure I was in the front seat of the plane. Look at the map that they give you when you buy your tickets. Right? Cause you could see no one’s sitting there. Hmm. Someone’s in the window. I know if I take this, but American airlines and Alaska air both only had you, either sitting with the people that you’re with or your own row, both of them.


So I give them both credit for that. Okay. That’s a great thing. I had the front seat on the plane. I got on the plane last. Right? Because by that time, everybody else has already on the plane. If I would got on the plane, first, everybody walks by me. Right. I got off the plane first. Now not everybody can do that. I recognize that. Okay. But even with that, is it, is it a definite no, it’s not a definite, but I could tell you this, even before COVID, when I, I don’t know why I’m susceptible on a plane. So every time I would fly and take my precautions, I would not get sick. Every time I would fly in. And let’s say I was running late. I didn’t have my wipes with me. I would get sick. I would get sick. But if I wipe down the seat, if I wear a mask, if I, every time I get up, I wiped down this, I wiped down and I over, I overdo it.


And I also take these this is just hand sanitizer that we made at the pulmonary center. And it’s a spray. Right? So there are certain things. Here’s one thing I didn’t like when they, when they when they took my driver’s license, they took it out of my hand. Right. So now he’s holding my driver’s license. Great. So what could I do about that? Spray it, right. So spray it. I don’t care if I get this stuff on my bed, but the idea is, is it foolproof? No. Is it a guarantee? No. Okay. But do you want to stack the odds in your favor and the, the other beauty is that now I can teach you based on what I actually saw. I don’t know too many other people that have flown in the last three months. So I took the risk for you, my friends.


Okay. To keep you safe. Okay. So think of us, the pulmonary wellness foundation, bus safe. One more question, Katrina. And then you’re out. What about ordering over three months? Do you think it’s now safe? If you wear a mask and gloves to get it? Okay. So a mask and gloves to pick it up. So you’re talking about takeout or delivery. It’s about the same. It’s about the same either one. Okay. So I’ve, I’ve ordered food in Manhattan. Okay. I’ve, I’ve gotten food delivered. Is it foolproof? No. Is it as safe as making your own food where you know where it’s been? No. So in other words, if the cook cooking, it has COVID and he’s been touching all your food. I don’t want to gross you out, but I’m being realistic, but I think it’s, I think it’s not that likely, I think.


And I think that you don’t my gut feeling no pun intended is I don’t think you get COVID by eating it. Okay. I think if you eat something it’s probably going to be killed by your stomach acid. Probably. I don’t know for sure. But, you know, I think that if you, so again, I get food delivered here sometimes. Okay. So what do I worry about? I worry that the person delivering it hasn’t has been wearing the same mask for, you know, the whole week or two weeks or three weeks. I worry that they’d been wearing the same gloves for two weeks or three weeks. I worry that somebody in the restaurant who prepared the food could have been transmitted this. So what do I do? And is it not, is it foolproof? No. Does it make me feel a little better? Yes. so they come in, I first wiped down, out.


I first wiped down my counter, right. So I wiped down my counter sterile field. Think of it like a sterile field. Right. If we were going to do a little procedure I’d take the food out. I first of all, put my own plates on that sterile field. Right. So I put a bowl here. I know it’s mine. As I’m unpacking, I take the food, put it into my own plate. Right. So that means at this point, and then I get rid of everything here. So everything that came, any bags, anything like that, any containers that somebody else could have touched? I get it outta here. Now everything’s in my sterile field and I I have my food in there, but think where’s my risk now, my own hands. Right? Because I just touched all this bag that could be exploded. Wash my hands right now.


I have a sterile field, not really sterile. It’s not really sterile, but you get the idea. I’m using that as an example. But now I have my clean field. I have my clean dishes. I have my clean food and I have my clean hands. And then I think you’re okay. Again. I think if you, if you were to swallow it, I think it’s going to get destroyed by your stomach acid. I think it’s an okay risk. It’s not foolproof, but I think it’s relatively low risk. If there is something that’s low risk. All right. Other questions. Sure. The cat is adorable. Who’s that? Terry Lynn. Where are you right here? I see you. You’re in the forest.


Yeah. Okay. So I have a cleaning lady that comes to the house every two weeks. In your personal opinion, you know, she’s wearing her shoes and I can get I’ve got covers here and I can have her wear on her feet. So I’m going to ask her to do that. She doesn’t wear a mask when she’s here. I bug out for four hours while she’s here because I have 30% of my lung function. I’m also,


He has to wear a mask when she’s there. It’s a rule. What do you mean?


I leave? I leave the house and she figures she’s here alone. She doesn’t need to wear a mask and that’s okay. Okay.


And set up one of those Teddy cams to make sure that she really is wearing a mask. No, listen, you know, let me tell you something last night in our support group, we talked about setting boundaries, right? So whatever she thinks is, okay, what she just said. She figures that I’m like, who gives a shit? What she figures. It’s not a doctor. She’s a cleaning lady, no disrespect to a cleaning lady, but she’s trained in cleaning, right? I’m not going to ask my doctor to clean my tub. Don’t ask the cleaning lady if she has to wear a mask. So the idea is you have to say this, listen, I don’t want you to take this personally, but I have a lung disease and I am at a higher risk than the average person. And even though I don’t think you have COVID, even though I trust that you’re taking care of yourself as Ronald Reagan says trust, but verify, right?


And the way you verify wear a mask, okay? I need you to wear a mask. When you’re here, I need you to wear gloves. When you’re here, I need you to take your shoes off, put on these things. If you can’t do that, then I will find somebody who will. And the majority of cleaning companies these days are tuning up to this. You know, I have patients who I have to go in their home. Okay. Not now I’m not doing it. But if I did, I’m confident that I could go in safely, but I would follow, you know, and what I’m advising to my patients at your front door. This is why I say have the mask for her. Right? Because let’s say your cleaning lady, and I know you live in the forest, but let’s say your cleaning lady takes the subway to you.


And she’s wearing the same mass that she wore on the subway. You don’t know, maybe someone sneezed on that mask. So to me, I trust myself, right? It’s like scuba diving or parachuting. I pack my own equipment. I set up my own tank. I pack my own parachute. Okay. Metaphorically speaking, because I would never parachute, but I do scuba dive and I set up, I set up my own thing because guess what? I don’t know who this person is. I don’t know what she did. I don’t know if she values safety as much as I do. I don’t know if she values my life as much as she values her own life. I don’t know what her level of education is. So I’m going to have this stuff here. It’s like serving order. It’s like, would you like a hot towel? You know, it’s like this serve, you know, come there, have the Butler, have a mask, have some wash, have some wipes put on these things.


And then as soon as she’s gone, she throws them away. Or you put them in a bag for her and she uses them only in your house. Okay, great. But there’s benefits to having someone clean your house and disinfect your house, right. Because you know, for obvious reasons, other questions, I’m going to alternate a question from the chat and a question from the group. If anyone has one. So basically we should just stay in the house. I go to the grocery store every two weeks yesterday, I went to a gym within our community. I was the only one there wiped down the machines I used with Clorox wipes, wore a mask and gloves. My husband works out doors twice a week, comes home showers. Right. Right. How can we keep safe? If the world keeps turning Lorene, Lorene, Lorene, I’m going to, I’m going to answer you in your own voice.


So basically, no, I’m just kidding. But the idea is you’re right. There’s a lot of things that are out of our control. Okay? But the way that you deal with this is you educate yourself. You listen to people who you trust and you follow those instructions. And you know, to me, I trust me more than I trust the governor. I trust me more than I trust the president. I trust me more than I trust my cleaning lady. I trust my cleaning lady. I trust her not to steal more than I trust myself. But but when it comes to things like this, I have a lot of experience with this. I’ve been doing it for a long time. So, you know, you have to you’re right. Nothing is foolproof. There’s no guarantees. We have to stack the odds in our favor. We have more at stake. We got to stack the odds in our favor. That’s a good question. That is a question. Deborah could have another one. All right, go ahead. Yeah.


So there’s two things you could do. One is this something called longevity, which is bootcamp plus it’s graduate boot camp, which you should have gotten some information for, or, you know, bootcamp is like a, it’s like a buffet, right? It’s like a sampler menu. So it’s like, we want to show you all the things that are available to you and then you can, you can continue to exercise, but you’re right. You have to do something. Right. So exercise, it’s like pushing a car uphill. As soon as you stop pushing, you start rolling back downhill. So do longevity. There’s a few actors, I think there’s three, six extra weeks in there. But also, yeah, you could do any of it. Make sure you’re doing something every day or go back to the ones you like, if you like Bollywood do Bollywood, if you like, you know armor size to armor size, but yeah, you gotta stay active.


Is it bad to go to the doctor’s office to do the PFT? Here’s a good question. Okay. What I would ask is this is it a visit and is it going to change anything? Right. So if it’s just that, Hey, my doctor likes to get a PFT every six months just to track how I’m doing. I mean, a PFT is a potentially risky situation because we have to trust that this has been super cleaned, right? And not doubting everybody. I think most of them do, but you know, what if, what if the tech didn’t have coffee that day and they’re still sleep from the night before, you know, who knows? I’m saying, if you need the test, get the test. If you don’t need the test and it’s not going to change your treatment, ask your doctor if you could have a telehealth visit.


And the other thing is that when it comes to PFT, is there are Bluetooth devices now that you could get at home, or you could use a peak flow meter to track trends. There are other things you can do besides just going in and having a full PFT again, risk versus benefits. So what is the risk of going to the doctor’s office and getting a PFT versus what is the benefit? What are you going to find out and what is going to change based upon that is two weeks. The maximum one should count on for no symptoms. I mean, I’ve heard is as long as 17 days, I mean, there’s probably going to be at some point, somebody who comes out on the 18th day with symptoms or the 19th day there are outliers to everything, but 14 days, no symptoms and no potential exposures.


I think you’re probably good. But keep in mind that you’re only good. You’re only as good as your last exposure. So if you go 300 days and you haven’t seen another person and then you’d go out to the grocery store to pick up some pop tarts. Well guess what you have 300 days is, is, is in the books. Okay. You’ve just used your last pack, man. You’re starting again at day one. So it’s day one from your last exposure. We live in New Jersey and the hair salons will be opening at the end of June. What can I say to my husband to convince him not to get a haircut? He thinks if he wears a mask and the haircutter does too, then it’s okay. We’re in total disagreement. So again, both of them wearing the mask is better than one of them wearing a mask.


And one of them were an investor better than neither one of them. Men. Is it foolproof? No. Are they wiping down the whole seat in between each use with an antibacterial antivirus, idol, wipe or spray? Because guess what? It’s not just the sitting there in the mask face to face, but I sit here and I have this. Are they giving me a new gown? That’s been washed since the last person’s using, because guess what if the gown of the last person has coronavirus on it or has COVID on it and I’m now wearing that gown. And not that I’m going to, I’m going to lick the gas like that, but guess what? Maybe now that’s on my shirt and maybe later I got an itch on shirt and then I got it. It’s on my face. Right? Okay. Here’s a F. Okay. So you asked me, what can you say to your husband?


Don’t say anything. Tell him you want to give them a nice head massage. Everybody loves to have the hip hair massage, right? You tell them you want to give them a nice head massage, except instead of using massage oil, you use Nair. He’s not going to need a haircut after that. Thank you, ladies and gentlemen, I’ll be here. I’ll wait. No, I’m kidding. I’m kidding. But, but the idea is, listen, if it’s not foolproof and it’s not even that, I don’t think it’s that good to go to a barbershop. Okay. It’s close contact. Even a mask like this, right? So this is not airtight. So can something get over one person’s mask and under another person’s mask? Yes. But even more than the mask, because if they don’t speak, if they cough and the other drug, I worry about the contact because it’s less obvious.


Right? So I worry about touching something. That’s less obvious because then we don’t know. And then I think that’s a potential source, but it’s not the best I know people are doing it. But what I would say is this New York city opened on Monday, right? I would say, don’t do anything for six weeks. Well, don’t do anything for four weeks. Watch what happens in two weeks. Watch what happens in four weeks and watch what happens in six weeks. Because what I think I already see spikes, right? So this morning when I woke up, they said 14 States on the rise. Now they’re saying 19 States on the rise, probably by the end of the week or the, you know, the end of next week or the beginning of next week, it’s going to be every state on the rise. So I think now is not the time to run out and do anything.


I think now the time is, is let somebody else be the Guinea pig. And I’m speaking only selfishly right now. And I’m speaking selfishly for you guys, my community, because you know what, I, can’t not everybody listens to me. I’m lucky if anybody listens to me. Okay. So I can’t control other people, but the idea is, at least for us, let’s watch and see what happens, right? So it’s like, is this door hot? Woo. Yes. Better someone else’s hair because people are going to run out and do anything. I’ve seen people out drinking. I’ve seen, I’ve seen people doing crazy things. Okay. So I think we have to watch it. I think a lot’s going to be learned over the next several weeks about how do you get it? How do you not get it? And who’s at highest risk because I think more people are going to get it.


How far away should a person be from the person trying to take your temperature with the touchless thermometer? It just spends like how much wood could a Woodchuck Chuck, if a Woodchuck pitcher, how far away should a person be from the person trying to take your temperature? You know, I think you should be as far away as you can. I mean, I think you should be an arm’s. I think you should both be masking. I think they should be wearing gloves. I think you should make sure that they’re wiping the thermometer in between each use. It sounds funny, but not everybody does it. You know at our pulmonary center, we wipe every machine in between every single patient use. Because the last thing I want is for somebody to get sick at the pulmonary wellness center, my sister is a nurse and we just got together recently.


Hopefully all goes well for her and myself. That’s a tough one, but thank God for your sister. You know, I give these people so much credit. You know, yes, for me, the mask is a big deal. I cannot breathe. Yeah. And a lot of people do, but here’s one thing. Okay, let me tell you about this. Okay. Everything is uncomfortable when you first do it, right? Like walking is uncomfortable until you get better at it. Don’t put the mask on for the first time when you’re about to go out and do 26 different things, sit at home in a comfortable position. If you have a rescue inhaler, take it first, just hold it. Like one of the toughest things. When you’re learning how to scuba dive, especially as, as a rescue scuba diver is when somebody pulls your mask off underwater, right? And you know, it’s very disconcerting because your nose is now exposed and your eyes are now exposed and you can’t see, but you don’t start off at a hundred feet deep in the ocean.


You start off in the pool. And what I would say is sit here. I had a dentist when I was a child and he used to give every kid a pair of sunglasses and a mirror. And he would say, if you raise that mirror up, then that stops the equipment. So if you need a break, he stops the drill. Right? That gives you a sense of control. I would say, take the mass. Don’t even put it on right for now. Just cover your mouth with a brief one breath. Take the mask away. Hey, I’m okay. Let me try to breath.


Hey, I’m still okay. Let me put one side on and hold this side. Oh, wait, I’m getting, let me drop this side. Now I can breathe again, practice this stuff. And in the same way that I teach you about recovery positions from shortness of breath, practice these things in a controlled position, in a controlled environment. Don’t wait till you have to jump out of the plane to try to remember how the parachute works. Okay. Practice, practice, practice. All of these things you can get better at they’re all skills are the new valves only good for people with long lung? The answer is no. The answer is they’re good for, for many people with COPD and hyperinflation. So you don’t necessarily have to have a long, long, you could just have a hyperinflated lung, but each person is evaluated individually. And we have a bunch of talks that we did about that there in our website under lecture series 2020, and have a bunch more coming up about these valves.


To me, the valves are the most exciting thing to happen to CLPD in my entire career. Because up until now, they’ve been adding a medication change, you know, making a combination medication, switching the classes that are in the combination. If the valves work for you, you’re back in business. I’m having a challenging recovery from COVID would be getting great to get your thoughts on rehab. So this is from freedom Baird. I, I think that again, bootcamp is a plus. Okay. And, and freedom. If you’re still on and you want to talk about this by all means I think bootcamp is a great place to start. I’d say bootcamp is gonna work for 80% of the people. Like this is how it is eight, like 80% of the program works for 80% of the people. And then we have to tinker with individual stuff.


So what I would say is start boot camp. It’s a great start. If there’s variations, contact me and we can troubleshoot shoot individual issues. But yeah, I think a lot of people are having a difficult recovery. Some people, it takes longer than others, but I think we have to do breathing exercises every day. I think we have to do the drainage positions, do the breathing exercises left sideline, right sideline on your back preowned start aerobic exercise in bootcamp. They’re called walkabouts start becoming more and more active, increasing the time and intensity of exercise. I hear someone sneaking up on me. Who’s who wants to say something.




Correct. I will mute you then. Tracy, I have the valves and the answer is no it’s for people with emphysema. So Barbara, some people with emphysema can have with a call long, long. Okay. And due to the hyperinflation, some people’s lungs will actually expand downward toward the diaphragm and flatten out the diaphragm. But, but you don’t have to have long, long to benefit from. And, and actually long, long, I don’t think there’s a really medical term. I know what you mean by it. But but the idea is that it, there are people who don’t have long lungs that still benefit from the valves. When out of the house is using a personal oxygen concentrator using an oxygen tank. I would say slightly, I would say slightly. And the reason why is because when you’re using a portable oxygen concentrator, you’re getting air and oxygen, that’s being filtered through the regular air.


Okay. When it’s coming from a tank it’s a hundred percent closed medical grade oxygen. And then your risk is still at the note. You have the risk at the, at the nose, at the nasal cannula anyway, but it’s not more from a tank. It is a little bit more from because even if you’re masking when you’re using the POC, the portable oxygen concentrator, you’re still getting air from the outside. And it is filtered, but it’s not virus side. One thing I’ve recommended that people do is you could take a little bit of this, this mask you know, material and just tape it over the filter. Don’t leave it there. You know, if it’s super hot, I mean, it could make your machine a little bit harder, but to answer the question, very simply a personal oxygen concentrator is riskier than a tank pediatrician told my 18 year old daughter not to use a nebulizer.


And your other college students went in door, it went in the dorm because it aerosolizes COVID that’s right. So if you have COVID and you use a nebulizer, so initially we heard this and we weren’t sure if that was the reason, because it potentially spreads it to other people. Or if it’s that it opens up your airways increasing the chance that it’s going to get deeper in the lumps, but you’re right. I mean, and in all fairness, you shouldn’t really be nebulizing around other people. Anyway, you know, for the simple reason that anything you’re breathing in and out is being aerosolized into the air, but in particular it, it can aerosolize Kobe, but only if you have COVID, if you don’t have COVID it can’t aerosolize COVID when I switched from tanks to personal concentrator, it left me feeling vulnerable. You know, the thing is that the portable oxygen concentrators don’t give you nearly nearly as much oxygen.


And a lot of times people get confused and they think the numbers that are actually settings, they’re not leader flows on the portable oxygen concentrators. And the other thing is that any time you’re getting a pulse system, it’s not going to be in liters per minute. Okay. Only the tanks on continuous we’ll give you actual liters per minute. So I do understand that. And again, you know, the thing is, rely on your instruments, meaning your, your oxygen, your pulse oximeter, right? Because when you’re a pilot, when you fly a plane, you can’t tell if you’re at 10,000 feet or 50,000 feet, because air looks like air. That’s why they use an altimeter when you’re scuba diving. You can’t tell if you’re at 30 feet or 130 feet, because water looks like water. That’s why you use a depth gauge. Okay. Same thing with oxygen saturation.


And if you want to learn more about oxygen, I have a webinar that I did. It’s, it’s a short one. It’s only two hours. But the thing is that I tell you everything you could possibly need to know about how to best use your oxygen. I also have some articles that I wrote called oxygen manifesto where I tell you everything and clear up a lot of the misconceptions about oxygen, because there are many, my mother is in a nursing home. The nursing homes have been getting hit pretty big. Yes. Well, the nursing home has made an appointment for me to do a window, visit the home she’s in, hasn’t affected as it, would it be better if I hold off on the visit? No. If it’s going to be a window visit. Nope, absolutely. No reason to hold off, go for it. But I assume it, let me just clarify that.


I assume you mean you’ll be outside of the actual nursing home. So if the answer is, yes, you’ll be outside of the nursing home, your mom, you’ll be looking at your mom through the glass, do it. If it means like prison you know, like you’re visiting your mom in prison and you’re using that phone and your mom’s like, and your mom’s like, listen, can you put some money in the commissary? I need some cigarettes and some, some pantyhose then no, don’t do it. Okay. if you can’t do the time, don’t do the prime. But the idea is if it’s going to be outside then yeah, I think there’s value in that. And I think there’s low risk. Are we still to disinfect food? I mean, I can’t, you know, how could you disinfect food? You know what I mean? You can’t put something on your food.


That’s going to disinfect it. That may not kill you. So if the answer is, if it’s going to kill you to disinfect your food, well, I’d take my chances again. I don’t have a, I don’t have any proof, you know, bill Maher does this good. He says, I don’t have any proof. I just know it’s true. I don’t think, I think most things, I think our, our GI system is pretty tuned up to destroy. Okay. Like if you think of some of the garbage and street meat and hotdogs and some of the crap you’ve eaten over the course of your life, I think the stomach acid is pretty lethal against COVID. So I don’t think worrying about, you know, that food itself, eating it is going to give you COVID. I worry more about how did it get to you and the packaging it comes in and the utensils that it comes in and who touched it?


After a while, Barbara, I got used to carrying the electrical plugs with me so I can recharge my battery anywhere I go, even if I get stuck. Yeah. Now I know the concentrator is preferable and safer. It’s not safer. I don’t know if we’re still talking about I dunno if we’re still talking about a concentrator versus a tank, but a concentrator is not safer than a tank. A concentrator is taking air from the atmosphere and running it through your concentrator, which is, is filtered. So it’s filtered for things like dust and particles. It’s not a guarantee against COVID. It’s not, I’m sorry. A tank, nothing is coming up. COVID is not coming out of an oxygen tank. It’s a closed system. I have a perforated eardrum. Can the virus enter there? That’s a great question. I don’t know the answer, but I, I, you know, somebody made a joke about this because I said before eyes and nose and mouth, I thought about this.


When I saw that, that old man get pushed down and started bleeding from his ear because that’s a direct route. That means you had a brain injury. So I think any open area where there’s an opportunity for blood and or body fluids to mix, I’d say can’t definitely be ruled. So I would, I would ask your doctor about that. If you have an ENT, that’s who I would ask about it. And I would say, is there anything I could put in my ear to just minimize the risk? I don’t know. What is the title of Jane Martin’s upcoming book? I do not know. Jane, are you still here? If you’re here, I’ll give you a free plug. I don’t know, but she’s got a lot of books out there that are great. She’s super experienced. I believe she’s, I don’t know if she’s an RN or a respiratory therapist, but I do know she’s super smart and super experienced.


So we will make that available to you. We’ll make the title available. When, when we know the link for pulmonary wellness, Thanks, James. What about letting my cleaning lady in the house? We talked about it. Noah, you seem great, Nicole. So good to see here. You even just virtually, I don’t know how this happened, but you’re even better looking than I remember you from that stop, stop. Not surprised at all, but really happy to see how many people are. All right. This is personal. I’m not going to read this. I will be flying next week to Europe. I have three good work and dance opportunities and Slovenia is COVID free. It’s still, I wanted to hear what you would suggest them. Someone who use call me, Nicole, let’s talk about this. Actually. I see you’re gone. I will call you pulmonary Jane’s title is 2019.


Live your life. I wrote a blurb for her book. Great read. Is it 2019? Then it might be out already. My daughter who lives with me will be staying with a friend in Manhattan for a few days, and then coming home. Both of them have been quarantined at their house until now. So good question. So both of them are quarantined in their house, so they’re good for now. Okay. My daughter’s going to stay in Manhattan. So if they both stay in the house the entire time and they stay in the house for 14 days or more 17 days and come home, they would be okay if there was, you know, but then it’s the question of what is she coming in contact with on the, on the, to and from, right? So if the question is is she driving herself there? That’s great.


That’s better than public transport obviously, but if she’s putting it in a garage, right? And that, that garage attendance has COVID, it’s a potential exposure. So the idea it’s not perfect, but I would say if you want to minimize exposure or daughters, or, you know, her friend is quarantining, she’s quarantined at home. She drives to Manhattan. She’s wearing a mask, she’s wearing gloves. She gives it to the attendant. She comes into the building, she’s masking and gloved. While she’s in the elevator. Another source of exposure comes into the house, takes off her gloves, throws them away, throws away the mask changes are closed. They stay home. Then the only real risk is going back to pick up her car from the, in which case, I would say mask gloves, wipes, get in the car, wipe, wipe, wipe, wipe the seat, wipe the steering wheel, wipe the console, wipe anything that that guy could or woman could have touched.


May I add, can you hear me? There was a second part. I accidentally sent that, but you anticipated the confession here comes a confession. There’s one more thing. I forgot to tell you the questions that I had the background was first of all, if, if they have both been separately quarantining, then is there really any need for them to check out their virus status before they get together? Just to make sure they are healthy or there’s not much left


Quarantined for more than 14 days?


No. They’re only going to be together for say about four days or so.


Right. So you’re asking before they come together, do they have to check their virus status?


Yeah. Is there any reason if they both been, if they’re both healthy and


Both been not healthy, healthy is tricky. Right? So the question is, if they’re both asymptomatic, here’s the question? Have they had zero potential exposures for 14 days. So in other words, if they’ve been home in their house for three weeks, then by all means you don’t have COVID. If you don’t have any symptoms, right. If it’s been three weeks, you don’t have COVID.


How about a walk to trader Joe’s and I was shocked


To trader Joe’s. No, I walk in trader Joe’s. Yes. So then yeah. So that’s a potential exposure, absolutely


Tests, probably.


So the testing is a tough, tough question, right? Why? Well, only just the tests are not a hundred percent accurate, right. The tests we don’t know for sure. And, and just because let’s say today I get a test. Okay. So today I go to trader Joe’s, right? I’m home for seven days, I get a test, I test negative. I could still become positive. I can convert to positive for another seven days after that. So I, is there a potential risk? Yeah. Is there a probable risk? We don’t know.


And, and, and is that, is there a risk of going in and getting a test with other people who are online or to,


So, yeah, so here’s the thing I went to get tested recently because I, again, I told you, I thought I was sick in December and January. I wanted to find out if I have antibodies. Right. I got sick right after I got the test. I’ve been quarantining the whole time I wanted to get, I wanted to get tested before I flew. Okay. So what I did, I went, I got tested the next day. I was sick as a dog. So I had to put off my trip for another three weeks because I had to be asymptomatic and I had to be asymptomatic. And I tested negative for antibodies means that I wasn’t sick in, but now I might’ve been sick again. Now I might’ve had COVID so I have to go test again. But if I’m not going to come in contact with anybody else, I’m not going to take the risk.


Here’s the crazy thing. Right. So I told you about when they took my temperature, they asked me to pull my mask down right? When they took my blood or when they took my not blood. Cause I didn’t get blood. Did I get blood? I did get blood. But when I took my blood and my blood pressure, they didn’t have a table for you to put your arm on. So the person taking my blood, put my arm on her lap that she was wearing PBE on. I was like, I might have, I might’ve had Colvin now again, but I’m not going to go get testing. Cause if I didn’t have it, I don’t want it. So the test to tricky, it’s tricky. It’s a very tricky thing. And it sounds funny. It sounds funny, but it’s not funny.


Yeah, it is. By the way, with the viral test. Just do you get the results in 15 minutes at any place to get it?


No. No. Unless there’s something I don’t know about. Where did you hear that?


Well, I, for some reason, when, when what’s his name, when our governor had his, you know, public nasal swab, didn’t they know the results very soon. I, I, it’s not true. I guess I’m wrong. But how, how long does it take to get results?


48 hours. For sure. I don’t know. I, I’m going to be honest with you. I’m not super studying these tests yet and I’ll tell you why I don’t trust them anyway. So I, I’m not, it’s not something I’m I’m for testing, but again, if you have something where there’s a lot of, a lot of, if the results can’t be counted on, I’m going to wait until there’s a better test again, before I get tested again. So, but again, is it better than knowing nothing? Yeah, it’s probably better than knowing nothing.


And, and when my daughter comes home from being with her friends and then at that time, should she be self corn Cheney? Hardly. Yeah. So we should stay apart. Yeah, I have I have and it’s just being separate rooms. That’s the best we can do. It’s a one bedroom.


Yeah. So it’s be in separate rooms. Yeah. I mean, ideally, yeah, you really shouldn’t come in contact with each other. You should have different chairs. Right? You should use different parts of the couch. You know, I have a lot of stuff that I wrote about this. It’s on the website, but yeah. I mean, you know, when everybody’s asking everybody asks questions like this, right. And they’re like, well, you know you know, we’re, we have a small pocket. That’ll probably be okay. Right. And it might be okay, you know, but if you really, if you really want to do it, you don’t, you’re never in the same room. Right? Any time one of you is in a room you’re, you’re disinfecting anytime. You’re, you know, it’s, it’s hard and it, and this is the argument for not running out and doing all these different things.


That’s the argument. Okay. No, I hear you. Listen again. I hear you. I told you I just flew. I just flew to LA. So I took a risk. Would I advise any of you to do that? No. Did I do it? Having confidence that with my hazmat experience and my EMS experience that I could stay safe, I feel like I could say safer than most people, but I also knew I was taking a risk. So everything is risk and benefit. So this is what happens. Like Carolyn, no offense, but I’m not even going to say, I never say no offense. Cause usually no offense has followed by something offensive, but this is what happens. People say, well, what if, and there they keep asking me questions until I say, you know what? That sounds safe.


Listen, you know, you’re a grown woman, you’re a smart woman. You know that you’re taking some risks. Your daughter knows that you’re taking some risks. I hope she really likes this friend. You know, I hope they don’t have a fight while she’s there. And then she comes home and says, I knew I shouldn’t have visited her, but you know, but the idea is there’s risk involved, but should you wear masks? Yeah, it would be great if she wore a mask around the house. Well, I should feel it. Yeah. How do you stay safe in a plane with the air cycling? Same thing. It’s not, there’s no way to do it. A hundred percent. You try to minimize risk. If you have to fly and have to fly is really relative. I don’t think most people have to fly these days. I really don’t even recommend I fly again.


You know? I’m I’m in the bumper now and I’m not leaving. So the idea is it’s, it’s hard and a plane is a risk. I saw something from one of the airline executives last week that said, Oh, you know, we filter it and we do this and we do that. You’re actually safe in a plane. It’s not that risky. Well, of course, what do you expect? You know, heroin dealer is not going to be like, well, you know, you’re actually safer taking my heroin with a, no, it doesn’t work that they’ve got an agenda. So a plane is a risky business. Okay. It’s higher risk than average, but I will say one good thing. I had extensive talks with the personnel at every single step of the way. And I asked them questions and I probed and particularly with Alaska air and American, those are the only two I flew.


But, but the Alaska airline pilots, not pilots, the flight attendants were telling me how happy they were with the steps that Alaska was taking and like American one flight per day. So one flight to New York in the morning, then they disinfect the whole plane. Not just clean, not just tidy up, they do something, some kind of miss, which they’ve never done before. And then there’s not a flight for until eight hours later. So again, but plain is risky question to go with previous message. Is there any reason for them to have virus test? We just did that. She had my daughter self quarantine. Just did that. Yes. Your story about going through TSA was helpful, but what about on the plane? Again? Plane is risky. It is a risk. If you don’t have to fly, don’t fly. Have you started back your outpatient, pulmonary rehab?


If you have one and how safe is it to return? We don’t, we’re still closed. Okay. Now we’re in New York city. Okay. New York city is much, much higher a risk than let’s say where I was in California. You know, like if, if you have a freestanding clinic where, you know, somebody, you know, the people drive to it and you can socially distance or you see one patient at a time and you also have to think about the waiting area and things like that. But the idea is you know, for me, very honestly, I don’t know if we’re going to reopen the pulmonary in the center. I don’t know a lot of it depends upon what happens with the virus. Is there an effect of treatment? Is there an effective vaccine? Is there a super flattening of the curve? Meaning does it go away?


You know, for me, I’m not a money person at all and if I can’t keep you safe, then I’m not bringing you in. It’s that simple. It’s not worth it to me. I don’t want to be in a situation where listen, we w in what I do, there’s an average in, in cardiopulmonary exercise, testing and exercise, there’s an average of three deaths in every 10,000 exercise sessions, we’ve done 110,000 exercise sessions over the past 20 years, I have never lost a single patient. Not one. We could have had 30 and been on the average. I’ve never lost a patient. Knock on wood. Thank God, spit throw some salt over your shoulder. But I really think it has to do with the closeness of the monitoring because we control what we do. We’re super careful. My team is super experienced, but you know what I worry about.


I worry about the elevator ride up. I worry about the bus in. I worry about the train in. I worry about the Uber. I worry about the elevator at your house. That’s the uncontrollables. I’m confident we can control the space in the pulmonary wellness center. I’m confident we could keep you safe there, but I’m not confident asking you to cross that mode with the alligators, just to get exercise. And again, exercise is crucial. Okay. It’s super important. I told you, it’s one of the best things you could do for yourself. But there’s other ways to get the exercise if there’s no way to get it any other way. But I think boot camp is good. I think telemedicine is it as good? No, but is there less risk? Yes. The bore. I know you want to say something that quickly, when you say, if you’re going to open it right now.


I mean ever, I’m being honest. I mean ever if, if, if Corona virus never goes away, right? In other words, if that’s something that we always have to deal with and there’s no vaccine and there’s no treatment, I’ll treat you. Bye, bye. I’ll treat you remotely. I’m not going to ask you to come in two times a week. I’m not going to ask you to come in. It’s like rolling the dice. You know what I mean? It’s like rolling. I don’t want to have a practice where, you know, every, every month I find out I lost three or four patients because they came to the pulmonary wellness center. It’s not worth it to me. I’ll figure out another way to do it. Tele-Health bootcamp you know, the first rule of medicine premium. No, no, Sarah, anyone know what that means. First do no harm. And that’s it. You know, I take your health and wellbeing very seriously. And you know, I could find another job. I could find other things to do. You know it, and it’s not even a question I can help people in other ways I can do other things, but even if I couldn’t okay, I’m not going to put you at risk again, the stakes are too high. My opinion.


Maybe you can do house visits. Yeah. But again, same risk. Okay. So, so yeah, we’re working. I mean, trust me, we’ll do the maximum, whatever we can do. My team is already starting to do telehealth. We’ll we’re going to do some stuff, but again, the idea is now if we come to your house, okay. And I go to five other people’s house or 10 other people’s house, there is potential for exposure. So again, we’re not looking to be typhoid Mary of pulmonary rehab. You know, we’re looking to keep you safe. And the everything we do is about lowest risk possible, maximum benefit possible. And we’re working on it and we’ll get something going on. Do I think it’s safe to get takeout. We talked about that book is free to read at the foundation site. Yes. You mentioned protein for building muscles. What are the best choices for protein?


Lean meats dairy products. A lot of this stuff is in the book. Okay. So we could talk for, I could go another three hours talking about nutrition for pulmonary disease. It’s in the book, read the nutrition chapter. Today I went to do labs and get a pap and they both wanted me to pull my mass down to take my temp. I said, no, they walked me to the next office and took my temp with a forehead thermometer. I couldn’t believe that I’m okay being, yeah, I don’t understand why anyone’s taking oral temps. I don’t understand it at all. Yeah. I’ll dress in there. I don’t have underlying conditions while I had COVID-19. I didn’t feel short of breath that came as I am healing, but I had difficulty exhaling fully. So what does that mean? Okay. So this is important. So we don’t know what the kind of progress or progression of COVID is over my gut feeling is that there are some people who have it, they get rid of it.


They never hear from COVID. Again, I know some people who seem to be you know, they have it, they get hit hard, they come back and then they’re probably never going to hear from it again, once they recover. I think there are some people who we’re going to see, because this is an inflammatory process. And for some people it’s more inflammatory than others. I wouldn’t be surprised if there are some people who we see a similar type of sequella as we did after nine 11, which is that, you know, over time, like if you think about it like an, like a, a clam or rather an oyster, when a oyster gets a piece of sand in it, and it becomes irritated and irritated and irritated, except in this case, you don’t get a Pearl at the end, you get, you know, maybe scarring, maybe inflammation, but this is why I think it’s so important to jump on the rehab right off the bat.


So as soon as you’re safe to start exercising and you could still have COVID, you could still be, you know, even infectious to others and you could still start bootcamp at home. But I think that we don’t know what it means yet. Okay. So maybe over time the inflammation will get better. It’s also possible that over time the inflammation will get worse. There’s a lot of unknowns at this time. So I don’t, I don’t want to say what I think will happen, but the thing is that all the things we talked about before related to ultimate pulmonary wellness, which is taking the right medications, exercise, nutrition stress and anxiety management prevention of infection, all those things. It’s the same formula for overall health and wellness. And it works. So you have to do as much as you can. Yeah. Which is safe reportable to, or tank.


Again, we talked about that tank got to go. Any supplements you recommend? I don’t personally recommend any supplements, but one of my one of the people that I have tremendous respect for is dr. Richard Brown. He’s a psychiatrist. And he also specializes in respiratory conditions. We did a webinar a few weeks ago, and he recommended a number of supplements that he swears by. And even if it’s not a supplement thing, the webinar is truly worth watching. And if you don’t watch that one, I will say that we got into a bit of a political discussion at the beginning, which I’m not thrilled with. So if you don’t like that kind of stuff, just skip ahead to like 20 minutes in. But we also did a webinar several, several years ago. That was also good in which he recommended the supplements. But one in particular that he loves is called respire guard.


Respire guard R I think it’s R E S P I R G a R D. And I trust this guy implicitly guy’s real deal. So dr. Richard Brown MD, he also has a great book called healing power of the breath. And this guy is phenomenal. Mmm. I am going through a flare of pure pleurisy at the moment. Are there any other lung movement moments I can do to get more oxygen in my lungs? The answer is yes, it’s deep breathing. It’s positive expository pressure devices, like the iRobot or the acapella and doing them in the different drainage positions have to go. Everyone have a great night. What did you say people should get to foster expiration? I don’t know. To foster exploration, I don’t know, are eucalyptus oil installations, beneficial. You know, I have mixed feelings about essential oils. We did a webinar on that a while back, and that’s also in the files.


The one thing I’ll say is that there’s a tremendous variability in quality. So if you are going to use any type of oils like this, make sure it’s from a company that does their own external testing. So somebody is making sure the quality and the safety is good. What is my email address? Noah@Pulmonarywellness.Org. Do you have to be on Oh two to get one to cover pulmonary rehab? Absolutely not. Absolutely not. And like I said, bootcamp is free. That is the end of the questions. Yes. Two hours and 51 minutes later, this might be, this is not the record. Cause when I did a talk at Baylor a few years ago, I think it was three hours and 15 minutes on pulmonary fibrosis. Before we go, nine more minutes, nine more minutes. I’m going to sit here till 10 o’clock if anyone has any other questions.


Good? Yes. Can I have the name of the doctor again? I saw Brown MD. Okay. I’ve been taking the tack that he suggested.


That’s a good question. I don’t know. Yeah. I don’t know. And with supplements, it’s hard to know.


Yeah. Because I don’t know anything yet.


Yeah. It’s hard to know. I mean, the supplement industry is very unregulated. So it’s hard to know. I trust Richard Brown very much. He’s a physician, he’s a psychiatrist. He responds to like responded to the world trade center, responded to the tsunami respondents. I mean, he’s a super bad ass and he’s real deal and he’s super healthy and he’s super strong. And he’s a hell of a nice guy and I trust them. So the only thing is


I just touch base with them or, yeah. I mean, if you send me an email, I’ll forward it to him. Okay. Yep. I’ll forward it to him. Okay. What did he do? What did he do? Supplements for one, he doesn’t, he doesn’t do supplement, but he like he recommends certain things. He had COVID himself. So he and he had a pretty, he was not a ventilator and he wasn’t hospitalized, but you had a pretty big dose of Colbert. He said, he’s still recovering from it. And this is a guy that’s super fit. But Beth, I’m sure we made that list somewhere, but we, there’s probably a transcript all under on each of the webinars. We now have the transcripts. So you can also read through the transcripts and all the, all the supplements will be listed. There will like respire guard lungs for lung specific. So I’m taking antibiotics.


So I asked dr. Brown that I asked him about interactions. He said, there’s no interactions, but I would, I would check it with your doctor to be safe. Okay. I have a question. Yup. And back to the oxygen, when you’re talking about some traders, as you can tell him on one of these things too. Yep. 24 seven. I use the concentrator in the house when I’m sitting and I’m very happy with it being at three. Yeah. When I stand up to walk across the room, it drops and would go down into the sixties without your oxygen saturation. Yep. So what is it when you’re sitting it’s 96 with a three 96 and you get up and it drops to 60%. It depends. If I’ve walked 5%, Tim 12 steps. Yeah. What’s your diagnosis. You have pulmonary fibrosis. Yeah. Along with CLPD and asthma, everything bad.


I have bad lungs and I had lung cancer that I took the radiation induced pulmonary. Okay. Okay. Got it. So couple of things so my question would be is that reading accurate? Okay. Because sometimes the readings are accurate in a certain range and then they decrease. Do you have any other type of either systemic or circulatory issues that might be affecting your reading things like Sjogrens things like a cold year to Caria things like Ray nodes, things like scleroderma, anything like that? When my fingers are cold rhinos just gotten beaten up last year, then it won’t take at all. Okay. So my art at 93 or 94, and they sit there real nice. And then all of a sudden go dumb, dumb, dumb as it goes down down.


So first order of business is to find out is that accurate or not?


Okay. Cause I’ve gone in, I’ve walked around my pulmonologist office area and had to start going down. Okay. Then you have to turn your oxygen up. Well, I keep, I keep the regular one. Poof. When I’m going outside to get into my scooter, I put it on five and that’s not, I’m going a little further on five. There are nothing nothing’s bigger than five, four H you know, that carry and take with me.


Okay. So let me say this. We talked about this before, so you’re talking about a portable oxygen concentrator. Okay. So what device do you have your plugin outdoors? So the bore, I told you not to call me sugar in front of other people. So so, so here’s the thing. First order of business, we need to know if that’s an accurate reading or not. Okay. So you need to get a test. I would try to get a test with a forehead sensor. Okay. Once and for all, whatever you have to do to get that test, we have to know if that’s accurate and that now you had radiation. Okay. You have pulmonary fibrosis. So if, if pulmonary fibrosis or if you have, you know, radiation, pneumonitis, it’s very possible that you are dropping. I would question whether you really dropping to 60% or if we’re not getting an accurate reading, that’s why you need a far sensor.


If you are dropping, okay. Everything with oxygen is about supply and demand, right? So what I mean by that is that sitting and doing nothing, the demand is very low. So you can get by with a low oxygen delivery when you get up and start walking and the demand is greater. So you have to increase your supply somehow. And it’s very possible that that device is not going to be adequate for you. You may need much more oxygen and you may need to use a tank and you may need to use a mask. That’s very, that’s not impossible.


I have a big tank at home for the emergencies of electricity went off, but that was pry your, I talked to my pulmonologist about trying one of, you know, something to help me. And she said, well, if you can do it fine, you know, talking about bootcamp, I was talking about your bootcamp for this. But yeah,


I mean, you could try it. It’s going to help you. But if you’re going to 60 or 70, it’s not going to, don’t expect it. You know, it’s going to bring you back into the nineties. Okay. That’s telling you, like, if that’s accurate, that’s telling you, you have significant respiratory disease and a significant diffusion problem. Which means that the way we get around that is we have to increase your leader flow. And you know, you may not be able to get adequate leader flow off of a concentrator when you exercise. And if you can’t even use it


That I can, I think


I can push it up higher. If not, I’ll talk to the respiratory therapist about coming out and getting me something. Okay. But hang on one second. Okay. Just listen for one second. You, you’re saying that you have the big tank at home, right? Right. So we’re talking about when you’re active, because when you’re home and you’re sitting, the demand is very low. So then you probably could get by with a pulse system, but it’s when you’re active that your saturation is going to drop, because then there’s a big demand, low supply. That’s when you would need a tank. And because the tank is a hundred percent oxygen, right? The tank is pure oxygen. And if you can’t get enough with a cannula and you really shouldn’t be using a cannula with more than six liters per minute, max eight liters per minute, but then you could get a much higher saturation if you were to get a non rebreather mass. And that’s what we do with our pulmonary fibrosis patients. I started seeing pulmonary fibrosis patients in 1995. And you know, at that time there were no medications for pulmonary fibrosis and, you know, essentially people would come in and describe what you just,


Yeah, there’s no medication. At least I don’t think that’s a medication for put for the radiation induced.


There might not be, that’s true that there, but there might be a, is your doc, is your pulmonologist a specialist in interstitial lung disease? No. Okay. So you got to see someone, you got to go to interstitial.


Well, doctor she’s, she’s been my respiratory therapist. I have my pulmonary doctor for probably 20 years because I was an asthma CLPD before this happened.


Is she a specialist in interstitial lung disease? So like pulmonary fibrosis, hypersensitivity, pneumonitis, you should find out because if she’s not, then you know, that’s a very specialized field. So, and official lung diseases, very specialized CLPD. Everyone could do it as, not everyone could do it. Okay. Interstitial lung disease. So what I would suggest for you is watch the webinar with dr. Robert Kaner that we did. Okay. He’s my go to interstitial lung disease guy. And he’ll give you a better understanding of what you need to do, but you have to see somebody who specialized K a N E R it’s on our website. But the thing is that you have to make sure that, you know, because again, a general pulmonologist is not going to be an expert in interstitial lung disease, and there’s a lot to interstitial lung disease.


And you don’t know one right off the tip of your tongue in Baltimore, Washington area. No, thank you. I’m going to try with that big old tank and I’ll see if I can get a mask and somebody to turn it to the right speed. So I maybe can do a one and a two and a half when I go to the swimming pool, when it’s open the therapy pools, and I need you to reward her, I can walk up and down floating my little oxygen tank with me. And I just, I walk up and down the pool or kick my legs out and stuff.


Do you ever check your saturation? I do. I do. And what is it? I can keep it unless I start going really fast. I can keep it up above 90. Okay, great. Yeah. Use your accelerator as your guide because once you start going, but the buoyancy of the water takes a hundred pounds off of something. It makes it much easier to move around. Yeah, definitely more reliable. Yeah. So the ones we use at the office are why am I drawing a blank Massimo? But I’ll tell you which ones are actually pretty good. Massimo makes a makes one that is an adapter for smartphones and they make it for the iPhone and they make it for the Android. And I think that one is actually pretty good because the key to any oximeter is the sensor. And I think Massimo was very good and they do make a portable one. Now I think it’s called the I forgot the name of it, but they do make it, it email me Betsy. I’ll help you find it. Yeah. Alright. You guys tricked me into going over my nine minute. My nine minute cutoff. I will give you two more minutes cause I don’t like to end on anything other than an even number. I have a disorder and it’s why my bonds high look, it looks so good. But any other last minute questions, comments, feedback.


You’ve been great. Glutosiome anything in NAC and the Seattle sustain for the lungs? Nothing


NAC. Yes. A glutathione. I don’t know. Okay. One more thing. This loves NAC. So if he loves it, I love it. I’m going once going twice, going three times, ladies and gentlemen. Thank you so much for showing up. If you like what we do, if you’ve gained benefit from it, please go to [inaudible] dot org. Any gifts you might like to give us, go right back to you in terms of programming, for those of you that have donated this month, this week, this year, this decade, this lifetime. Thank you so much. Greatly appreciated. We don’t get paid. It’s all goes right back to you. Have a great night. Everybody stay safe.


Okay, thanks. Have a great night everybody. Bye. Bye.