FAQS

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 comprehensive 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 561-640-3620

Intensive Cardiac Rehabilitation is more than just exercise, it is a medically designed program which includes educational videos, live workshops, cooking classes, and 1:1 clinical consults. ICR offers a lengthier support program than the 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 the only 3 programs approved for Medicare patients. This is a comprehensive cardiac rehab solution that helps patients reduce their risk of having another heart event through three key pillars: regular exercise, a balanced eating plan, and a healthy mind-set.

Heart disease can be a terrifying diagnosis, but it doesn't 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, could be the secret weapon 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 pretty common. It is usually twice a week, sometimes three times a week and might last 90 minutes. It includes some education on diet, exercise, and heart disease, along with time on a treadmill, bicycle, etc.

However, Dr. Pamer advocates for a more intensive cardiac rehab program. Twice as long and more intense, this program is about doing a lot of education. It has to be a Medicare certified program because it's based on one of three programs that have been published in evidence-based peer-reviewed literature which has actually been shown to reverse coronary artery disease.

The intensive cardiac rehab focuses more on diet, particularly the role of vegetables and a low-fat, Mediterranean style diet. It includes cooking classes, providing hands-on training on what to do, how to cook, and what to use in your diet to help stop the progression of atherosclerosis.

Moreover, the program provides extensive education on heart disease prevention, exercise, and rehabilitation. With this level of education, the patient gets to understand their condition better and actively participate in their treatment process.

In addition to the educational aspect, the intensive cardiac rehab program includes time on the treadmill, bicycle if appropriate, light weight training, all kinds of stuff, isometric training to get a person stronger, get their heart going and to get them in much better cardiovascular shape. The goal of cardiac rehabilitation is not just to manage the symptoms of heart disease, but to potentially reverse its effects. The program works to deal with the underlying physiology, cholesterol levels, and plaque formation to help reverse that.

Living with heart disease does not mean living a life of limitations. With programs like intensive cardiac rehabilitation, patients can reclaim

their health and live fulfilling lives. Listen to the podcast episode to learn more about how cardiac rehabilitation can help you or your loved ones in the battle against heart disease

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

Thoracentesis is a procedure to remove fluid or air from around the lungs. A needle is put through the chest wall into the space of a thin gap between the pleura of the lung and of the inner chest wall. This test is helpful in identifying 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.
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As a new patient there will be some initial paperwork which can all be found in the forms section. Additionally, you will be asked to bring your ID and insurance card(s).

Because Dr. Pamer takes his time with each and every patient, there is no set time for an office visit. When you are in the office you have the doctor’s undivided 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. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders or health problems such as allergies, respiratory infections, chronic lung conditions, restrictive airway problems, injury, sarcoidosis, asthma, and more. There are two main testing methods, both of which are done in our office with the most state of the art, hospital grade machines. These are spirometry and plethysmography. Volume, quantity, and force of air are measured and interpreted.

Chronic coughs have become a major concern for many, accounting for roughly 40% of primary care visits. The persistent, nagging cough that just won't go away often leaves patients and even some healthcare providers puzzled. This was the main topic of discussion in a recent enlightening conversation between seasoned pulmonologist, Dr. Mark J Pamer, and co-host Garfield Bowen. Understanding the different types of coughs and their possible causes is crucial in the quest to demystify this common health concern. Coughs can be productive or non-productive and are typically categorized based on their duration. An infectious cough typically lasts less than three weeks, while a cough that persists between three to eight weeks usually results from postnasal drip following an infection. Anything beyond eight weeks falls into the category of chronic cough. Dr. Pamer emphasized that the leading causes of chronic cough are postnasal drip, reflux from the stomach, and lung disease. However, it's important to note that some of these triggers may not always be apparent on examination or may not produce any symptoms that the patient can feel. For instance, gastric reflux may not necessarily give rise to a bitter taste or heartburn, yet it could be the cause of the persistent cough. A particularly fascinating aspect of the discussion was the revelation that chronic cough could be a symptom of conditions often overlooked or undiagnosed by primary care providers or even pulmonologists. For instance, untreated sleep apnea, hypersensitivity, or a stimulated nerve in the neck could trigger a chronic cough. In the case of sleep apnea, the constant snoring and attempts to breathe against a closed upper airway result in a drop in chest pressure, potentially leading to acid reflux. The chronic cough could also result from hypersensitivity, akin to a peripheral neuropathy—an excited nerve in the neck that stimulates the throat. This condition, referred to as sensory neuropathic cough or hypersensitivity cough, is often the culprit behind many chronic cough cases that walk into Dr. Pamer's office. Treating chronic cough requires an aggressive approach, including considering the use of neuropathy drugs. The discussion highlighted the importance of eliminating possible triggers like ACE inhibitors (a class of blood pressure medications notorious for causing cough) and smoking. Once these triggers are addressed, attention should be turned towards aggressive treatment for postnasal drip, reflux, and asthma. In the end, the journey to conquering chronic cough hinges on equipping oneself with the right knowledge and seeking the right medical help. As Dr. Pamer aptly put it, if your cough has persisted for eight weeks or more, or if it's affecting your quality of life, then it's time to consult a healthcare provider trained in cough.