Get Your Questions Answered

A pulmonologist can diagnose, treat, and manage illnesses that primarily affect the lungs. The doctor may perform testing and/or prescribe medications.

You may need to see a pulmonologist if you have a cough that lasts for a long time or trouble breathing.

Dr. Pamer offers evaluation and treatment of allergy, asthma, bronchiectasis, COPD, cough, gastroesophageal reflux, interstitial lung disease, laryngopharyngeal reflux, lung cancer, lung nodules, primary immunodeficiency, pulmonary fibrosis, pulmonary hypertension, shortness of breath, sleep medicine, and vocal cord dysfunction.

Allergy testing, cardiac and pulmonary rehabilitation, comprehensive pulmonary function testing (PFT), echocardiogram/ultrasound, electrocardiogram, exercise challenge testing, exhaled nitric oxide (FeNO), infusion suite for IV medications, methacholine challenge testing, microscopy, nasal eosinophil smear testing, osteopathic manipulation, speech therapy for voice disorders, upper airway pH probe testing, and vaccines.

We offer free smoking cessation classes once per month.

Pre-registration is required. Call (561) 640-3620.

Intensive Cardiac Rehabilitation is more than just exercise; it is a medically designed program that includes educational videos, live workshops, cooking classes, and 1:1 clinical consults. ICR offers a longer support program than typical cardiac rehab and can include up to 72 sessions. This increased service promotes a healthy overall lifestyle rather than a temporary fix. Dr. Pamer uses the Pritikin ICR program, one of only three programs approved for Medicare patients. This program helps patients reduce their risk of another heart event through three key pillars: regular exercise, a balanced eating plan, and a healthy mindset.

Heart disease can be a terrifying diagnosis, but it does not have to control your life. Dr. Mark J. Pamer, an expert in cardiac rehabilitation, offers a unique perspective on managing heart disease. He emphasizes that cardiac rehabilitation, often overlooked in conventional treatments, can be a powerful tool in the fight against heart disease.

Cardiac rehabilitation is more than just physical exercise. It is an in-depth program incorporating education on diet, heart disease prevention, and practical skills such as cooking. Traditional cardiac rehabilitation is common. It is usually done two to three times a week and may last about 90 minutes, including exercise and education.

However, Dr. Pamer advocates for a more intensive cardiac rehab program. This program is longer and more focused on education. It must be a Medicare-certified program based on one of three evidence-based, peer-reviewed programs shown to help reverse coronary artery disease.

The intensive cardiac rehab program focuses on diet, particularly vegetables and a low-fat Mediterranean-style diet. It includes cooking classes, providing hands-on training on how to prepare meals that help slow the progression of atherosclerosis.

The program also provides extensive education on heart disease prevention, exercise, and rehabilitation. This helps patients better understand their condition and actively participate in their care.

In addition to education, the program includes exercise such as treadmill use, cycling (if appropriate), light weight training, and isometric training to improve strength and cardiovascular health. The goal is not just to manage symptoms but to address underlying causes such as cholesterol levels and plaque buildup.

Living with heart disease does not mean living with limitations. With intensive cardiac rehabilitation, patients can improve their health and quality of life. Listen to the podcast episode to learn more about how cardiac rehabilitation can help you or your loved ones.

EP5: Combatting Heart Disease: A Deep Dive into Cardiac Rehabilitation

Will my Medication Affect the Results of my Skin test?

Medications that Interfere with Allergy Testing.

Thoracentesis is a procedure used to remove fluid or air from around the lungs. A needle is inserted through the chest wall into the space between the pleura of the lung and the inner chest wall. This test helps identify conditions such as congestive heart failure, viral, fungal, or bacterial infections, cancer, lupus or autoimmune disease, pancreatitis, blood clots, empyema, liver failure, tuberculosis, pneumonia, and reactions to medications.

Click the link for video: Facebook video

As a new patient, there will be some initial paperwork, which can be found in the forms section. Additionally, you will be asked to bring your ID and insurance card(s).

Because Dr. Pamer takes time with each patient, there is no set duration for an office visit. When you are in the office, you have the doctor’s full attention. He is highly regarded for his quality patient care.

Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. These tests measure lung volume, capacity, airflow, and gas exchange. This information helps healthcare providers diagnose and determine treatment for lung disorders such as allergies, respiratory infections, chronic lung conditions, restrictive airway problems, injury, sarcoidosis, asthma, and more.

There are two main testing methods, both performed in our office using state-of-the-art, hospital-grade machines: spirometry and plethysmography. These tests measure and interpret the volume, quantity, and force of air.

Chronic cough has become a major concern, accounting for roughly 40% of primary care visits. A persistent cough that does not go away can leave both patients and healthcare providers searching for answers.

Coughs can be productive or non-productive and are categorized by duration. An infectious cough lasts less than three weeks, while a cough lasting three to eight weeks is often due to postnasal drip after an infection. A cough lasting longer than eight weeks is considered chronic.

Dr. Pamer explains that common causes of chronic cough include postnasal drip, reflux, and lung disease. However, some causes may not show clear symptoms. For example, reflux may not always cause heartburn but can still lead to coughing.

Other causes may include untreated sleep apnea, hypersensitivity, or nerve-related conditions in the neck. Sensory neuropathic cough, caused by nerve irritation, is another possible reason.

Treatment requires identifying and addressing triggers such as smoking or certain medications like ACE inhibitors. It also involves treating underlying conditions such as reflux, asthma, or postnasal drip.

If your cough has lasted eight weeks or more or is affecting your quality of life, it is important to consult a healthcare provider trained in diagnosing and treating chronic cough.

Yes, several medications can affect skin testing responses. An allergist will always do a positive and a negative skin test control, which helps to determine if a medication that would interfere with the allergic response has inadvertently been taken.

Antihistamines are the drugs most commonly associated with suppression of the skin test (https://acaai.org/allergies/treatment/allergy-testing/skin-test) response. Any medication that suppresses histamine (https://acaai.org/resources/information/allergy-glossary#section-17) will reduce or prevent the swelling and redness at the skin testing site. Swelling and redness at the skin test site indicate that a patient is allergic to the allergen being tested.

For best results from your skin test, you should avoid most antihistamines for at least 7 days prior to skin testing. Many guidelines only recommend 3 to 4 days of avoidance prior to skin testing, but a significant number of patients will still have some reduced skin test response for up to 7 days.

Exceptions to the 7 day rule include hydroxyzine (Atarax), which should be stopped 10 days prior to allergy testing, and diphenhydramine (Benadryl), which can be taken until 48 hours prior to allergy testing.

Patients who are taking psychiatric medications such as amitriptyline, quetiapine, doxepin, and imipramine can also have skin test suppression. However, no patient should stop these medications without discussing this decision with their psychiatrist or primary care physician. The allergist can help the patient decide if they need to stop the psychiatric medication, or if an alternative method of allergy testing should be considered.

Another group of medications, called beta blockers, are often prescribed for high blood pressure. While these medications will not interfere with the skin test response, they can introduce more risks for allergy testing in the case of a serious reaction. Beta blockers can slow the patient’s response to epinephrine (https://acaai.org/news/IfYouAreHavingaSevereAllergicReaction), which is used for treatment in the event of an allergic emergency. This is a very rare event, but most allergists prefer for patients to be off beta blockers for allergy testing. This decision should be made with an individual patient, and only after the allergist (https://acaai.org/locate-an-allergist) discusses the matter with the patient’s cardiologist or primary care physician to determine which course of action holds the least risk for the patient. As with antihistamines, ideally the beta blockers should be stopped at least 5 to 7 days prior to allergy testing.

Allergy Testing (https://acaai.org/topics/allergy-testing)