Pneumologist Pablo Bombá Rua has joined the Fundació Salut Empordà (FSE), with specialised consultations at the Santa Creu Clinic and Figueres Hospital. Trained in Argentina and with a medical degree recognised in Spain since 2004, he started coming to Catalonia in 2021 to work as a doctor. He says that he liked the Catalan health system and, therefore, decided to join the Pneumology Unit of the FSE.

It is important to visit him because he is in a sense the internist of the chest. Pulmonology is not only associated with asthma or COPD (Chronic Obstructive Pulmonary Disease), but encompasses all respiratory pathologies in general, including obstructive sleep apnoea.

At the same time, it is important that there is good coordination between the internal medicine physician and the pulmonologist in order to increase treatment effectiveness rates. In fact, good pneumology should be transversal and should interact with internal medicine, cardiology, otorhinolaryngology and allergology.

The list is enormous. When a person feels short of breath, pulmonary function tests should be performed; also when, after a change of weather or a viral infection, which may be Covid or another disease, wheezing is noticed in the chest; when a person who is smoking and, when trying to quit, notices that they are short of breath; when they notice or have been told that they stop breathing when they sleep; when an anomaly or doubt arises in a chest image observed in Primary Care, or when they think they may have repeated respiratory infections without an explanation.

Basically, it is for these reasons that you need to see a pulmonologist, but there are more.

The pulmonologist goes a step beyond general medicine because he or she looks for very specific things in complex patients.

Spring itself is a sensitive time for people’s airways whether they have allergies or not. It is a trigger for increased airway responsiveness. We cough more and produce more mucus, but people with allergies do it in a more exaggerated way, because they have more symptoms. In these cases, pulmonologists must intervene, together with allergists, to find the most appropriate treatment.

The pulmonologist goes a step beyond general medicine because he is looking for very specific things in complex patients. Mainly, it would be obstructive diseases, which would be asthma and MPOC, and sometimes one is combined with the other; also repeated lung infections, such as sleep apnoeas and the whole management of home ventilation equipment, or the use of home oxygen; we also see fibrosis of the lung.

If the apnoea is very severe, the person notices it himself, because he perceives the drowning during sleep, although sometimes he mistakes it for a waste. But more often it is a third party who notices it. In addition, their sleep is very fragmented, it is not continuous.

Therefore, people with sleep apnoea will basically be very sleepy during the day and have changes in blood pressure. They also have other symptoms, they get up several times during the night to urinate, or they have a dry mouth or a bad headache due to the breathing effort made during the night.

Not all of them. For example, there is a small group of asthmatics who are occupational and their asthma is related to their profession, because they are exposed to solvents, volatile compounds or industrial poles. But most asthmatics have a genetic basis, with an environmental trigger or a viral infection triggering their asthma. These cases are not predictable, but they can be treated.

What is preventable, for example, is COPD. Although we have pollution and other factors that favour the appearance of this chronic obstructive pulmonary disease, the main cause is smoking, and therefore it can be prevented. Tobacco, in all cases, always far away.