SPEAKER_00: 0:01

Welcome to the Healthy Matters Podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, healthcare, and what matters to you. And now, here's our host, Dr. David Hilden.

SPEAKER_03: 0:19

Hey, everybody, and welcome to episode 23 of season four. I am David Hilden, your host of the podcast. And today I am joined by Jessica Oswald. She is an infectious disease doctor, and we are going to tackle a condition that affects nearly half a billion people worldwide every year and results in about four million deaths on Earth every year. We're talking about pneumonia. I know you've all heard of it. Many of you maybe have even had it, but it's one of those illnesses that isn't in Entirely understood. Is it like, is it a bad cold? Is it contagious? How come it lands some of us in the hospital? Well, today we're going to clear the air quite literally with Dr. Oswald. So thanks for being on the show.

SPEAKER_01: 1:01

Yeah, thanks for having me.

SPEAKER_03: 1:02

Great to have you, Jessica. So we've all heard the word pneumonia. Tell us really in simple terms, what is it?

SPEAKER_01: 1:07

Yeah, so pneumonia means infection in the lungs. That's really all pneumonia means is just in the lungs, there's infection there. Any kind of infection? It's most commonly when we're talking about pneumonia It's most commonly going to be caused by viruses and bacteria, but it can be caused by even a fungus. That's quite rare.

SPEAKER_03: 1:26

Loads and loads of people get this thing. And I think it has a, well, I know it has a variety of severity. Some people walk around, they've got something called pneumonia. Other people land in the hospital and a lot of people die in it, regardless of what's causing it. What's happening in the lungs in pneumonia?

SPEAKER_01: 1:42

So the way I like to think about it is that our lungs are made up of millions and millions just millions of these tiny little sacs. So we have, you know, our airway that goes down and all these tiny little sacs. And these little sacs, when we get infection in there, our immune system starts to react and it can fill up these sacs with fluid and inflammation. And then it makes it hard to breathe because you can imagine these sacs are what gets the air in it and they're all full. So it's like a balloon that's full and nothing else can pass through. And so it causes you to get shortness of breath. You can start coughing. You can get fever. I

SPEAKER_03: 2:14

like that explanation, actually. A lot of people think your lungs are just big, empty No, they're

SPEAKER_01: 2:21

these millions of little alveoli. And it's these alveoli that get filled.

SPEAKER_03: 2:26

What are they getting filled with? Are they filled with water or bacteria?

SPEAKER_01: 2:30

Yeah, both. And so we have immune system that lines the lining of these alveoli. And they send signals to our body that they're trying to fight a bacteria or a virus. And it sort of calls and recruits other parts of our body to help out. So fluid comes in from other parts of our body, sometimes pus forms, other fighter cells. cells and it fills up these sacs with fluid and pus. That sounds

SPEAKER_03: 2:52

lovely. Fluid and pus in your lungs. You know, infectious disease doctors, I'm not saying they're into the gross stuff, but this is the kind of stuff you have to deal with all the time. Absolutely. So you said it can be caused by many different things. Do they all result in the same end result? Like if I have COVID, that's a virus that leads to respiratory infection. Or if I have bacterial pneumonia, very different bugs or organisms cause it. Does it all kind of lead to the same

SPEAKER_01: 3:18

situation? Yeah, it can. So some viruses will stay mostly in what we call our upper airways. So things like our nose, our throat, or the bigger airways going down into our lungs. And that's more things like a cold. And so if you have a virus that just affects your nasal passages, your throat can be a common cold or the larger airways can cause bronchitis. But sometimes if that virus gets deeper into the lungs, into those sacs and cause problems, it can cause pneumonia. And that's the same with bacteria. Not all bacteria cause pneumonia, We have bacteria living in our mouth and in our throat, but sometimes if enough of it or the bad bacteria get into our lungs, it can cause these problems.

SPEAKER_03: 3:56

What is the difference between a cold, bronchitis, and pneumonia?

SPEAKER_01: 4:01

So I've already kind of talked about how pneumonia is really in those deep alveoli, those deep lung sacs. And so if it's not in the lungs and it stays higher up, if it's affecting the big airways, that's bronchitis. Generally, that can cause someone to have a fever or cough, but it really shouldn't cause them to need help breathing or problems with their breathing or their air that they're getting. And then a cold, again, is usually the upper. And even though it's, you might say, just a cold, people can feel really cruddy with a cold. So I don't want to minimize the symptoms and the days lost from work and how poor people can feel when they have

SPEAKER_03: 4:33

a cold. I've had people actually look visibly disappointed when I've told them they might have a cold and not pneumonia. They look, oh, they look deflated. And I have said that before. It doesn't mean you don't feel sick. I I know you feel miserable right now. It's just that they're a little bit different. The infection's in a different place.

SPEAKER_01: 4:54

And again, that cold won't cause you to be, it might be hard to get air through your nose, but it won't cause you to be short of breath or require oxygen or hospitalization from just the cold in the upper part.

SPEAKER_03: 5:05

Before we get into a little bit more detail of the various types of pneumonia, I did raise some kind of staggering statistics in my little comments at the beginning. I said nearly half a billion people. I think there is something like four or 500 million people in the world get pneumonia and several million die. Is that true in the United States as well? And in other words, how common is it here?

SPEAKER_01: 5:23

Yeah, so pneumonia is a very common condition here in the United States. It's estimated that maybe there's around 4.5 million outpatient and emergency room visits every year. And community acquired pneumonia is actually the second most common cause of hospitalizations. And it's the most common infectious cause of death in the United States.

SPEAKER_03: 5:44

So it is super common. Absolutely. Who's at risk of getting it?

SPEAKER_01: 5:48

So we We worry most about people who are 65 and older, so sometimes referred to as older individuals, but I just like to say- Late, middle age. People 65 and over. Individuals who have chronic medical problems, things like COPD or other chronic lung diseases, heart disease or heart failure, diabetes or other immunocompromising conditions, even if they're on medications that weaken their immune system, are at higher risk of severe pneumonia or getting pneumonia in general.

SPEAKER_03: 6:17

So before I get down into even more details. A lot of us have been told as we're growing up that, you know, it's cold outside. Put your hat on. You're going to catch your death of pneumonia. Is that true?

SPEAKER_01: 6:28

I've

SPEAKER_03: 6:28

also

SPEAKER_01: 6:29

heard

SPEAKER_03: 6:29

that. I mean, come on. Lots of people are getting pneumonia. It seems like we're probably encountering it all the time. So why aren't we all just coming down with it? And do you get it from cold weather or you go out with your hairs wet? You know, you're a kid and you just got out of the shower and then you went outside and it's cold out. Your mom says you're going to get pneumonia.

SPEAKER_01: 6:47

No, not exactly. It doesn't exactly work that way. We do know that pneumonia is more prevalent in the winter months in places like Minnesota, the fall and winter. That's probably from a combination of factors. Respiratory viral season is starting up, and that's more prevalent in the fall and winter. And we know that after someone has had a respiratory virus, they're at increased risk of having a bacterial pneumonia. Also, in the winter, people tend to be indoors more, in closer quarters, where things like viruses and bacteria can be spread from person to another more easily. And with cold outdoor weather, sometimes it can dry out what we call our mucous membrane, so the lining of our nose or our throat, that might make it more easy for bacteria to latch on. And then that bacteria can then go down into our lungs. And so the cold weather might make it slightly more easier for bacteria to set up shop and get into our lungs. But just going outside with wet hair doesn't cause

SPEAKER_03: 7:42

pneumonia. That's not how it quite works. Okay. Let's talk now about the various types of pneumonias. You said earlier, community acquired pneumonia. And then there's others. And listeners, we're going to talk a little bit about hospital acquired and aspiration and the like. Could you talk us through those? What do you mean by community acquired?

SPEAKER_01: 7:59

Yeah, really, that's just a fancy term for people who are out living wherever they stay getting pneumonia. And we distinguish that or we separate that from people who are in the hospital when they get infection in their lungs. The reason we do that is that when people are in the hospital, sometimes they're at risk for getting more resistant bacteria or other types of pneumonia. And so the bacteria that you get from just being at your house when you got sick or being around your kids and you got infection is oftentimes a little different. So it's just meaning that you're living in your home or your apartment or with your family and you get pneumonia. That's community-wide pneumonia. It can

SPEAKER_03: 8:35

still be serious, but is it a different bacteria than the kind in the hospital?

SPEAKER_01: 8:40

We worry that the types in the hospital are more resistant bacteria that might need different antibiotics to treat it.

SPEAKER_03: 8:46

Okay. So how common is that? Move on to hospital-acquired pneumonia. Is that a common thing?

SPEAKER_01: 8:51

Yeah, it is a common occurrence. It's more common if people are in the hospital and require intubation, so that tube that goes through their throat into their lungs to help them breathe. But it can happen in the hospital. People are more at risk when they are not able to protect their airways or what we call aspirating, where they swallow fluid from their stomach or from their nose into their lungs.

SPEAKER_03: 9:13

Many of our listeners have probably heard that term before, aspiration. I know that's been on my mind. I I had a patient in my primary care clinic who recently actually died of pneumonia from aspiration. What does that mean, aspiration?

SPEAKER_01: 9:26

Yeah, so aspiration is where something goes into the airway that's not supposed to go there. Oftentimes that's fluid from our mouth or maybe, again, stomach fluid or acid came up and then goes from our esophagus or our feeding tube into our lungs. And that can cause bacteria that live in those spaces to get into our lungs in a higher amount than our body able to cope with or able to deal with.

SPEAKER_03: 9:50

I've often found that a little amazing, actually. We have basically one opening into our bodies, your mouth and your nose, but they're connected, your mouth and your nose in the back, and you breathe and you eat through there. Why doesn't that happen more often that people aspirate?

SPEAKER_01: 10:05

So maybe surprisingly, most healthy people probably do have small bits of aspiration on a daily basis. We call those small bits microaspirations. But if you have healthy airways and you have a healthy immune system, your body can take care of those small amounts of fluid or bacteria that get into your lungs. It's when someone swallows a larger volume of that or they have irritated airways, maybe because they smoke or they have COPD or some other lung condition, it can cause infection more easily in those individuals.

SPEAKER_03: 10:39

Your immune system and your lines of defense in the body are just incredible. That's why you cough, you know, and you get crud out of your airways that's not supposed to be there. Let's talk about Symptoms. Talk us through symptoms, if you could, of pneumonia first and how that might differ then from, say, something more upper airway like bronchitis or a cold.

SPEAKER_01: 10:57

Yeah. When someone has pneumonia, they will commonly have a cough. So a cough would be one of the main symptoms. People can feel short of breath even with that cough. Sometimes people will get chest pain when they're taking deep breaths or coughing. And then oftentimes they'll also have fever and that's that body's inflammation or immune response and they'll get a fever. So those are some of the main symptoms of pneumonia.

SPEAKER_03: 11:20

That sounds like I could have those for a lot of things, doctor.

SPEAKER_01: 11:23

Yeah. Yes, Dr. Hilden, you are right. So it can be tricky to distinguish. And so with viral illnesses, sometimes I'll think about or ask about what I call upper respiratory symptoms. So do you also have a runny nose or sinus congestion? And is it mostly involving that area to make me think it's more commonly or more likely to be a cold? Like up in your head? A head cold. Yes. We'll call it head cold, but really in the sinuses. When it gets into the lower airways, that's when evaluation by a healthcare provider can be really helpful because we'll use our stethoscope and we'll listen to your lungs and see if there's good air movement. Your provider might actually want to even get imaging of your lungs, like a chest x-ray to see if there's what we call like an infiltrator, some of that fluid in the lungs.

SPEAKER_03: 12:07

If I'm having some of these symptoms and I'm feeling unwell, especially if I'm maybe an older adult or I have some other medical problems, I've got a fever, I've got a cough, talk us through what you would do or what what any doctor or other healthcare practitioner would do to diagnose it.

SPEAKER_01: 12:21

Yeah. So if you had a fever and cough and it wasn't going away quickly, and it's not that your neighbor just told you, I had influenza and you guys were together and you think it's influenza, but if you're really feeling unwell or if it's been a couple of days, I would say to get checked out by your provider because what they'll likely do is they'll check and make sure your oxygen level is good. They'll listen to your lungs and make sure that you're getting good air movement in your lungs. And again, they might recommend an x-ray. or some imaging of your lungs to make sure there's no pneumonia in there.

SPEAKER_03: 12:50

We often talk in medicine about early diagnosis. And in general, that's always a good idea. It's better to know earlier than later. But does it matter in pneumonia if you catch it a little bit earlier? I

SPEAKER_01: 12:59

would say it's important to catch it and not wait too long at home. If people wait too long, it can become more severe. There's a risk that their oxygen levels could drop lower. And if you have pneumonia, it's important to get started on the right treatment. So oftentimes that includes antibiotics.

SPEAKER_03: 13:16

So we've been talking with Dr. Jess Jessica Oswald about pneumonia, everything you need to know about what causes it and what it might feel like if you have it. We're going to take a short break. And when we come back, we're going to discuss when and why pneumonia can become dangerous, how it's treated, how you can prevent it and maybe even avoid it altogether. So stay with us. We'll be right back.

SPEAKER_02: 13:40

When Hennepin Healthcare says, we're here for life, they mean here for you, your life, and all that it brings. Hennepin Healthcare as a hospital, HCMC, a network of clinics in the metro area, and an integrative health clinic in downtown Minneapolis. They provide all of the primary and specialty care you'd expect to find, as well as services like acupuncture and chiropractic care. Learn more at hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life. Thank you very much.

SPEAKER_03: 14:16

And we're back talking with Dr. Jessica Oswald. She is an infectious disease doctor and a medical educator here at Hennepin Healthcare in downtown Minneapolis, a colleague of mine in the Department of Medicine. Before we get into complications and all the bad stuff about pneumonia, I want to talk about a term that people have often heard, walking pneumonia. Is that a thing?

SPEAKER_01: 14:37

Yeah, it is a common term people use. Really what that term walking pneumonia means is that it's not so severe that you can't continue to do the things in your life, like walk around, go to the grocery store. But it could still mean that you have true pneumonia or bacterial pneumonia. And so it can still be infection in the lungs. It can still require treatment. And so it's still something, if you're having persistent symptoms of cough or shortness of breath or chest pain when you cough, I would still get that checked out, even if you think it's quote unquote a walking pneumonia.

SPEAKER_03: 15:09

You know, I guess I know where it came from is, you know, somebody said, well, I'm still walking around and I have pneumonia, but it's not exactly a term we very specifically in medicine. You still have pneumonia. You're still ill, but you're just not in the hospital. Just not bedridden. You're not bedridden. Yeah, I guess that's what walking pneumonia means, folks. Okay, now I want to ask you to go to all of the stuff that can go wrong with pneumonia. So why can pneumonia get serious? In other words, what complications can happen?

SPEAKER_01: 15:36

So we talked a little bit earlier about the staggering statistics about how many people worldwide or even locally get pneumonia, and it's really high. And so a small percentage And so those complications can include sepsis, which is where the body is responding to a serious infection and other organs can become involved. Our lungs are all these little sacs like I've talked about, but then around our lungs is fluid. And that fluid around the lungs can also get infected and almost become an abscess or a pus pocket around the lungs. And we call that an empyema or an infected pleural effusion. So that can be really sick. Sometimes that can even require drainage of that fluid so that people can breathe easier. So those are some severe complications.

SPEAKER_03: 16:25

And those are usually landy in the hospital.

SPEAKER_01: 16:26

Yes. I would say that with those things, people should definitely be evaluated and oftentimes will get admitted to manage in the hospital.

SPEAKER_03: 16:33

So you talked about the fluid around your lungs can get infected. What's an abscess when it's in your lungs?

SPEAKER_01: 16:38

Yeah. So a lung abscess is in that tissue. It's a more contained pocket of infection or abscess. We don't usually have to put needles in those, but antibiotics are usually given for much longer. And that's more common after people have had a serious sort of aspiration event, but can happen with any type of pneumonia. And then again, antibiotics are generally needed for quite a bit longer, talking about weeks or months.

SPEAKER_03: 17:03

Let's talk about the various treatments. So you come in and let's say you have, first of all, a bacterial pneumonia caused by not a virus, but a bacteria. What's done?

SPEAKER_01: 17:13

We treat with antibiotics. So if it's not a virus, and we confirm or everything points towards a bacteria, we'll use antibiotics. And if you're seeing your outpatient provider, they'll oftentimes prescribe at least one antibiotic. Sometimes if people have more medical problems, so things like COPD or heart disease, sometimes we'll even do two antibiotics to make sure we're really covering all of the bacteria that might be involved.

SPEAKER_03: 17:39

So I do mostly primary care and I prescribe relatively few antibiotics. If I have a pneumonia I would. But far more common are things we covered earlier. Upper respiratory infections, viral stuff, bronchitis. Talk to us about bronchitis. Are antibiotics needed for that?

SPEAKER_01: 17:58

Yeah, that's a great question. Even though people might have a really severe cough and feeling well with those conditions like we've talked about, people can feel very sick from things like a cold or bronchitis. But those are generally caused by viruses and an antibiotic won't treat the virus or or make the condition better. And it's important to know that antibiotics can have risks associated with them. People can get nausea or diarrhea or sometimes even infectious diarrhea. And so we don't want to treat things like bronchitis or colds with antibiotics because it doesn't help and it poses a risk.

SPEAKER_03: 18:35

Yeah, listeners, I am guilty of about, I don't know, 20 years ago, 25 years ago when I was first starting, we gave too many antibiotics, plain and simple. We gave too many antibiotics. I wrote a lot of prescriptions for azithromycin, for what a lot of people know as a Z-Pak. This is an effective antibiotic. It has got its uses. It's a good antibiotic, but we missed, I say we, the medical community, we over-prescribed. It was often easier to write a prescription. That was back in paper. I wrote just four letters, Z-Pak, and signed it too many times. I'm so glad that we're talking in this fashion now. You usually don't need those antibiotics, and you certainly don't if it's of viral bronchitis, which most of them are. I don't know why we were so, I don't know, dumb back then.

SPEAKER_01: 19:21

Well, because you want to make people feel better, right? We want people to feel better. And it's important to know that, unfortunately, I wish that that would make them feel better, but it won't. Oftentimes things like Tylenol or ibuprofen, lots of hydration, resting up, those are the mainstays of managing. They

SPEAKER_03: 19:40

are. And time usually does make most of the folks, at least in an ambulatory clinic type setting, usually Okay, so that's bacterial pneumonia. Bacterial pneumonia does require antibiotics. What about viral pneumonia? Now, a lot of people know about a certain virus that's been around for exactly five or six years. They even named it after the year it was found, COVID-19. What about viral lung infections? How are they treated?

SPEAKER_01: 20:06

Viral lung infections, you're mentioning COVID-19. There's many, many viruses that can cause even viral pneumonia. So things like COVID-19, influenza, RSV, and then there's many others like metanumovirus and rhinovirus, etc., Many of the viral illnesses do not require treatment, but there are some that we do have treatment options. So for example, influenza or flu, if you're someone who has chronic medical problems or at risk of having severe flu infection, there is an antiviral medication that your provider can prescribe for you. Again, not for everybody, oftentimes not for what we call people with no comorbidities or healthy young individuals, but sometimes if people are older or have chronic medical problems.

SPEAKER_03: 20:54

Many are probably listening. If you're listening, maybe you took a medication for a few days after your COVID or after your influenza. And it's good to mention influenza when we're talking about viral pneumonias because a lot of people talk about the stomach flu, this, that, and the other thing. Influenza is a viral respiratory illness. And even that sometimes gets confusing to people. Absolutely. You mentioned earlier, and we're not going to focus on this much, but fungus. That sounds horrible.

SPEAKER_01: 21:21

Yeah. Here in Minnesota, we have a A lot less of... A

SPEAKER_03: 21:25

lot less

SPEAKER_01: 21:25

fungus? No, we have fungus, but we don't have as many people coming in with pneumonia from fungus. You know, if we lived in the Southwest United States, there's an organism called cocci or coccidioides, and that can cause a common pneumonia. And it's a common cause of pneumonia in places like Southern California and Arizona. But we don't have as much of that in our soil up here in Minnesota. See, it's pure

SPEAKER_03: 21:47

living up here. It is. Up here in God's country in Minnesota. So all of you listening in Phoenix You might get it a little bit more. We do have listeners in Phoenix. So if you get pneumonia, it could be something different. And isn't fungal pneumonia more with people whose immune systems aren't so hot?

SPEAKER_01: 22:04

It can be. The one type of fungal pneumonia that we get here, and it can affect really anybody, is something called blastomycosis. It's quite rare, but it does occur a handful of times in Minnesota a year. And it doesn't need to be someone who's immunocompromised, but it's from the soil, generally

SPEAKER_03: 22:21

speaking. So good. So lots of fungal pneumonia. things that can cause it. There are treatments for it. Let's talk about if you did get a more serious kind of pneumonia. You ended up in the hospital. What does a recovery look like for you?

SPEAKER_01: 22:32

It can really vary depending on how severe that infection was. If someone is admitted to the hospital, they'll be started on antibiotics. Sometimes people will require oxygen in the hospital or in severe cases even require intubation where that tube goes down in their throat into their lungs to help them breathe. And recovery can be, you for people. Not that the bacteria isn't gone, because with the antibiotics it will kill the bacteria, but it can take people time to recover their lung function and their physical activity, especially if going into the hospital they had maybe some other medical problems or depending on their baseline level of health, it can take a while to recover.

SPEAKER_03: 23:12

Do people need to get follow-up pictures, x-rays?

SPEAKER_01: 23:17

Historically, we would say yes, but I think that the data on that is sort of evolving, and I don't think in everybody we don't necessarily need to get follow-up pictures as long as they're improving and the pneumonia looked typical on imaging.

SPEAKER_03: 23:31

Yeah, and if you got better?

SPEAKER_01: 23:32

Yeah, you got completely better. We don't always need to do that.

SPEAKER_03: 23:35

You maybe don't need to do that. And most people don't need oxygen? You touched on oxygen already.

SPEAKER_01: 23:39

So most people do not. Many people are seen in their clinics, and a good portion of people can be managed— in what we call the outpatient setting, so not getting admitted into the hospital. And those people should not require oxygen. Now, if someone is in their clinic seeing their provider and their oxygen levels are low, they'll likely need to go into the hospital where oxygen therapy will be administered in addition to antibiotics.

SPEAKER_03: 24:04

So that's when you measure your oxygen with that little thing on your fingernail, right? Exactly. It's called a pulse oximeter, folks. Okay, I don't want to get this. How do I prevent getting pneumonia? Are there things I can do?

SPEAKER_01: 24:16

Yeah, there are things you can Thanks for asking. As we are entering this respiratory virus season, I would encourage people to get vaccinated against things like influenza or flu and COVID. And if you're eligible for the RSV vaccine, those are vaccines that can prevent respiratory viruses that can cause pneumonia. And then again, also make you more likely to get bacterial pneumonia after that. If you're someone who smokes, trying to cut back or quit smoking can be helpful as smoking irritates the protective linings of our airways, making sure that your chronic medical conditions are well managed so your diabetes is well controlled, helps your immune system function better and prevent these infections and then good hand hygiene and if you're around people who are sick making sure they're masking and you're masking or if you're in tight spaces especially in the winter and have immunocompromising conditions might want to consider masking during those times as well to prevent pneumonia.

SPEAKER_03: 25:09

Your vaccines are effective. They do what they've claimed to do. No one should claim they're perfect but they are in effect and often the most effective thing you can do. And so what is happening in our country today about vaccines just pains me. And so I'm glad you brought up vaccines. And I don't know too many of my colleagues who say, take this vaccine and everything will be perfect. You won't ever get it. You won't ever, you know, nobody ever says that. But they are effective at reducing incident of infectious diseases. They do reduce hospitalizations and they do reduce deaths. And so listeners, I would just, if you took a message home about vaccine, what you're hearing in the national discourse about vaccines is scary to me as a doctor. I don't know if it is to you, Dr. Oswald, but it is to me. Yes,

SPEAKER_01: 25:59

yes. And to remember that getting vaccinated and preventing many of these illnesses also protects some of the people who are weakest among us. So very young babies or older individuals who immune systems, you know, really might not protect themselves.

SPEAKER_03: 26:12

That's a great point. It's not always just for you. It's to protect your communities as well. And the So thank you for that point. Good ideas for trying to keep yourself healthy. Things that we can all do from vaccines to washing your hands and good hygiene habits. I like all that stuff. Before I let you go, Dr. Oswald, what tips would you leave people about pneumonia?

SPEAKER_01: 26:34

I would just say, again, we're entering a season where it's more common. So as we've already talked about, consider getting vaccinated. Make sure you're listening to your body. And if you have this persistent cough or struggling to breathe, please get evaluated by your provider if you have any concerns. And yeah.

SPEAKER_03: 26:51

Thanks for being on the show.

SPEAKER_01: 26:53

Thanks for having me.

SPEAKER_03: 26:54

We have been talking with Dr. Jessica Oswald. She is an infectious disease specialist at Hennepin Healthcare. We've been talking about pneumonia, what it is, what causes it, how you treat it, and importantly, some steps you can take to perhaps prevent it. I hope you picked up some good information, as have I, and I hope you'll join us in two weeks' time when we have another outstanding episode. And in the meantime, be healthy and be well.

UNKNOWN: 27:17

Bye.

SPEAKER_00: 27:19

Thanks for listening to the Healthy Matters Podcast with Dr. David Hilden. To find out more about the Healthy Matters Podcast or browse the archive, visit healthymatters.org. Got a question or a comment for the show? Email us at healthymatters at hcmed.org or call 612-873-TALK. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota and engineered and produced by John Lucas at Highball. Executive producers are Joe Jonathan Comito and Christine Hill. Please remember, we can only give general medical advice during this program and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.