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I'm Aware That I'm Rare: the phaware® podcast

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Kori Ascher, DO - phaware® interview 263

Jul 12, 2019

Dr. Kori Ascher was born and raised in upstate NY then relocated to South Florida for medical school, residency, and fellowship. Dr. Ascher founded Just Breathe Miami, a non-profit which raises awareness and supports those with chronic lung disease. The 2nd annual fundraising event, Just Breathe for Pulmonary Hypertension will be held July 25, 2019 in Miami, Florida. Tickets and info: www.justbreathemiami.com. In this episode, Dr. Ascher discusses what motivates her to raise funds and awareness for pulmonary hypertension. 

Hi, my name is Kori Ascher. I am a pulmonary and critical care physician coming from Miami, Florida.

I'm originally from upstate New York, and I moved down to south Florida for medical school residency fellowship, and I've grown roots in here. I've been here ever since. I have started an organization called Just Breathe, and I want you to bring awareness to all chronic lung diseases, because I'm pulmonary, so a lot of my patients have these.

Every year, I want to do a fundraiser for a different chronic lung disease. The last year I did it with the Pulmonary Fibrosis Foundation. This year, I'm focusing on pulmonary hypertension to help raise awareness, because it is so prominent. I see it so often in all of my patients. It really is analogous to having a cancer in regards to the amount of support that's required from financial to emotional to medical. I just want everyone to come together and support these people that deserve to have the support that they need.

So, I have a somewhat unusual story. When I was in medical school, I had no interest in pulmonology at all. I went into internal medicine residency, but in residency they make you go and do a little bit of this, a little bit of that to get a flavor of everything. Once I experienced pulmonary medicine, I couldn't go back to doing internal medicine. I was just immediately hooked and everything was about the lungs, the physiology of it, the patients, the diseases. I just found it very fascinating and interesting, and I couldn't turn around after I was introduced to it.

The role of the pulmonologist is paramount when it comes to diagnosing and recognizing early symptoms of pulmonary hypertension and officially diagnosing it. Initial symptoms can be so ambiguous and be so vague. Pulmonary hypertension, because it's not really discussed a lot and it's not really out there in the forefront of people's minds, it's often not diagnosed as quickly as we want it to be diagnosed. Meaning, the earlier we diagnose it, the more we can start treating it and trying to help the symptoms. For example, seeing a physician that isn't familiar with pulmonary hypertension, which is very common to not have pulmonary hypertension as your first thought of what's causing something such as shortness of breath. That could lead to misdiagnosis and delayed diagnosis.

So, that's where going to a pulmonologist and having a pulmonologist involved is actually really important. If the shortness of breath, or whatever the symptom is, does not go away because a pulmonologist will think of pulmonary hypertension as a potential cause. When a patient comes to me, very frequently what I'll have is a patient who comes to me and say, "I've been short of breath for X amount of time. I've been going to so many doctors and no one can figure it out, and they just keep me telling me it's in my head. It's not getting better. They gave me inhalers, such as albuterol or a rescue inhaler as it's called, and nothing is helping.”

So, when they come to me, symptoms that I look for are shortness of breath with walking or with exerting yourself that seems to be progressively getting worse over time slowly. There could be lower extremity edema, which is swelling of the lower extremities. The first thing I would look for in a diagnostic test would be an echocardiogram, which is an ultrasound of the heart, which is a noninvasive test so it's very easy to do on people, and also a breathing test [a pulmonary function tests], which measures the volume of how much air is going in and out of your lungs with your breathing.

I started this organization Just Breathe after I had an encounter with a patient that really left a mark on me. She was newly diagnosed with pulmonary hypertension by myself within the last couple months or so, and she very quickly deteriorated. She was in my ICU, because she had deteriorated so much. She unfortunately expired. In the time that she was diagnosed to the time that she expired, she was struggling to get the medicine that I was trying to get for her that would help treat her pulmonary hypertension, because they're vastly expensive. You need insurance approval, and all those things take a lot of time and documentation, and unfortunately that was time and documentation that she didn't necessarily have. So, it was really this one particular patient that inspired me to fight for the patients and to get people talking about these diseases to realize how important it is to know about them and that they exist.

The event that I'm having for Just Breathe is an annual fundraiser. Last year, it was the same as this year, the same setup. It's a happy hour with appetizers, food, music. Patients come and give their testimonials about what it is to live with the disease and how their perspective is on living with the disease, and a bunch of the health care providers from the south Florida area come and network and talk, and we just sort of celebrate the pulmonary hypertension [community]. All of the money that is raised from the fundraiser is donated to support those with pulmonary hypertension.

I think that awareness is extremely important because, unfortunately, even in doing this promotion for this event, when I have said pulmonary hypertension to people, people look at me like, "I don't know what you're talking about. Oh, that's just high blood pressure." It's really not. It's a much more convoluted disease with much more serious consequences if gone untreated. I think that it's just very important that the person walking the dog down the street knows that pulmonary hypertension exists and this is something that is prominent in the medical community, and that people are actually living with this and this is what people are battling on a daily basis.

I have a confession that I am not particularly into social media, but I will say that the power of social media is quite strong and you can't deny it. I did start this Instagram account and started to post things on lung disease and on myself and being a doctor to raise awareness, and to get people interested. It seems like it is working, because this is how you found me and how we were able to connect, so it seems to be doing the job I want it to do. The account is @DrKoriAscher, and then there's also the Just Breathe account which is @JustBreatheMiami.

My parting advice is if you are a patient experiencing symptoms, and you're not satisfied with your treatment or your diagnosis, or you just have a bad feeling, you think something is off, something is wrong, I really would encourage you to seek another opinion. You might be wrong, you might be right, but you should be comfortable with your medical management, so I would really encourage you to continue to seek until you feel comfortable with your diagnosis. Because, there's many times that patients are misdiagnosed with something else, and then when they come to see me, they say, "Oh, I knew something was wrong. This didn't feel right. I knew I didn't have this disease that this doctor said I had." So, if you don't feel something's right, chances are something is possibly not right.

My name is Kori Ascher and I'm aware that I'm rare.

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