Departments

At the Yale Chronic Obstructive Pulmonary Disease (COPD) program, our highly trained and skilled specialists provide comprehensive and multidisciplinary treatment to patients with COPD, an inflammatory lung disease that obstructs airflow from the lungs, making it increasingly difficult to breathe. We care for individuals: With emphysema With chronic bronchitis With COPD with associated bronchiectasis With asthma/COPD overlap With COPD/obstructive sleep apnea overlap With combined emphysema and pulmonary fibrosis (in conjunction with our interstitial lung disease team) Who experience frequent disease exacerbations and/or hospitalizations Under consideration for surgical therapies for emphysema (such as bullectomy, lung volume reduction surgery, and lung transplantation) Who need a pre-operative respiratory assessment for other forms of surgery With a suspected genetic basis for their disease (such as alpha-1-antitrypsin deficiency) With chronic respiratory failure related to COPD Patients suffering from COPD may experience flare-ups that require hospitalization, leaving them feeling weaker. Our physicians tailor treatment plans to help them manage their COPD so that they can live life to the fullest. Our physicians are also exploring therapies and medications that can help patients in the future. Whether patients have mild symptoms, need rehabilitation, or assisted ventilation, we can help. We also offer lung volume reduction surgery or lung transplantation to eligible patients. The Yale COPD program is staffed by two pulmonologists, a pulmonary specialist nurse practitioner, nurses, and respiratory therapists with special expertise in COPD. We arrange visits for patients with other specialist providers as needed, including cardiologists, thoracic surgeons, thoracic oncologists, palliative care specialists, otolaryngologists, allergists/immunologists, sleep medicine specialists, and health psychologists. The Yale COPD Program receives referrals for patients with difficult-to-control symptoms and/or frequent acute disease exacerbations, those who do not respond well to routine medical therapies, those with co-occurring complex medical conditions or overlap syndromes (as detailed above), those who may require surgical therapies, and those who have advanced disease with chronic respiratory failure. Providers in the COPD Program perform comprehensive evaluations and develop individualized care plans for all patients, with the goal of partnering closely with each patient’s primary care and other specialist providers. In addition, opportunities to participate in clinical research trials of new therapies in COPD are often available through our collaboration with the Yale Center for Asthma and Airways Disease (203-500-3808).

The Smilow Cancer Hospital Lung Cancer Screening Program is a multidisciplinary program that provides lung cancer screening to patients at risk for lung cancer. Our program has a coordinated approach that offers a complete and seamless screening process. Our team includes world-recognized pulmonologists (doctors who treat diseases of the respiratory system), specialized chest radiologists (doctors with advanced skills in reading CT scan images of the lung), thoracic surgeons and thoracic oncologists (doctors who treat lung cancer), tobacco/smoking cessation counselling specialists, and specialized nurse practitioners. Our goal is to provide lung cancer screening in the context of a care process that takes patients from risk assessment to screening to resulting and referral, if needed. Should an abnormal finding be identified, our team will guide and support our patients through next steps. Our program is comprehensive and coordinated, and provides the patient with access to a specialized, expert team of caregivers. Our processes are efficient and seamless. Additionally, our team has the knowledge, experience, and compassion to provide patients with the best lung cancer screening experience. Because of this, our team is available to guide patients throughout the screening process and beyond, if needed. Whether it’s an annual follow-up scan or further evaluation, we have the people and resources to care for each patient. Our team uses nationally established guidelines to care for our patients. Our tobacco treatment services are available in person or via telehealth visits. Read our list of frequently asked questions regarding lung cancer screening . National Cancer Institute: Lung Cancer Screening Lung Cancer Prevention National Lung Screening Trial National Lung Screening Trial - Questions and Answers Lung Cancer Screening (PDQ)- Patient Version Centers for Medicare and Medicaid Services (CMS.gov): NCA - Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) American Cancer Society: American Cancer Society Guidelines on Lung Cancer Screening Early Detection, Diagnosis, and Staging Causes, Risk Factors, and Prevention United States Preventive Services Task Force (USPSTF) A & B Recommendations

Obesity is a common problem that can cause fatigue, diabetes, fatty liver disease, and sleep problems, and raise the risk of many cancers. It reduces energy, and can take the pleasure out of many aspects of life. Extra weight also places stress on vital organs, including the heart, liver, and kidneys, as well as joints and the reproductive system. Although organs can work under this extra stress for a number of years, eventually they are likely to fail. Most organs lose about 80% of their capacity before symptoms are evident, and by that time, it is often too late to return them to normal function. The conditions associated with obesity are: Cancer Cardiovascular disease Diabetes Liver disease Obstructive sleep apnea Losing weight can help improve and sometimes cure many of these conditions, as well as fertility issues. Losing weight can also lead to a life with fewer medications, lower health expenses, and overall greater enjoyment. At the Yale Metabolic Health and Weight Loss Program, we offer all nonsurgical weight-loss interventions in one location. Our philosophy is to focus on health, rather than specific disease, and to tailor our care to each patient’s specific needs and goals. The first step in our care is to determine weight-loss goals. Patients may need to lose 5 to 10% of their body weight to help in the treatment of a disease. We will help patients choose from interventions that include intensive meal-replacement programs, a range of medications, or endoscopic (nonsurgical procedure) options. Sometimes, there are additional medical necessities, such as an upcoming surgery, that require a specific weight-loss goal. We will explain the advantages and disadvantages of the various options, but the choice will depend primarily on what feels right to the patient. We provide therapies under the medical supervision of obesity experts. Patients can choose from the full range of tested interventions: Lifestyle changes: Nutrition counseling goes hand-in-hand with medical management of metabolic health. Care will include a personal visit with a registered dietitian with advanced training in weight management. OPTIFAST® program: OPTIFAST® is a medically monitored weight management program that allows patients, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education. The OPTIFAST program provides full meal replacement for 12 weeks and transitions to self-prepared “everyday” meals in conjunction with comprehensive patient education and support, to help patients achieve long-term weight loss. Medications: All medications are used as part of a comprehensive program that includes proper nutrition and a healthy lifestyle. Contrave® is a single pill that contains two medications (naltrexone and bupropion) and is taken twice a day. It will reduce appetite and can produce weight loss in the 5 to 10% range. Phentermine is taken once in the morning, and is prescribed for a few weeks.

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

We are a multidisciplinary team focused on the diagnosis, treatment, and prevention of illnesses due to exposures and hazards in the workplace and environment. We provide comprehensive diagnostic and therapeutic services to patients with a broad range of occupational/environmental conditions, including asthma, cancer, dermatitis, and others. We combine a thorough medical evaluation of patients with a detailed assessment of occupational and/or environmental exposures that could be contributing to the patient’s medical condition. This may involve a visit to a worksite or home by a team led by our industrial hygienist. Often, this exposure assessment leads to identification of a hazard that can be eliminated or reduced, resulting in an improvement of the patient’s clinical condition and a reduction of risk for others. We also work with employees, unions, industry, government, and others to provide exposure assessments, consultations, and risk assessments to ultimately reduce and prevent occupational and environmental illnesses. Tests we offer: Beryllium blood testing Chest X-ray “B-reading” Cholinesterase testing Heavy metal analysis Isocyanate antibody testing Ototoxicity screening Hypersensitivity pneumonitis testing Other services: Industrial hygiene evaluation Independent medical examinations Outbreak investigations Health and safety policy development Risk assessment Workers' compensation

At Yale Medicine, our team of otolaryngology specialists care for ear, nose, and throat conditions that can affect your balance, breathing, hearing, and sleep, as well as your ability to speak, swallow, and maintain voice quality. Our physicians professionals also have advanced training in the diagnosis and treatment of conditions related to allergies and sinuses, which are often due to other respiratory issues. To address the broad spectrum of ear, nose, and throat conditions, we offer a full range of treatments that includes minimally invasive procedures alongside traditional therapies, both surgical and non-surgical, to ensure the most effective approach. Special care is offered in the following areas:•General and pediatric ear, nose, and throat care•Head and neck cancers•Hearing and balance testing and treatment•Pediatric otolaryngology•Sinus and allergy conditions•Skull-base disorders•Snoring and sleep apnea care•Speech and swallowing conditions

At Laboratory Medicine, we study the molecular and cellular components of blood and other body fluids. This work is crucial to diagnosing and managing illness and understanding the mechanisms and origins of disease.Our physicians, known as clinical pathologists, provide consultations to other doctors regarding optimal laboratory diagnostic approaches and the interpretation of complex laboratory tests. Our team includes pathologists, scientists, phlebotomists, medical technicians, technologists, and others who perform important support functions for our state-of-the-art laboratory. We are available every day, 24 hours a day, for physicians. We perform approximately 10 million tests each year, and also provide specialized high-tech testing to other hospitals in the Yale New Haven Health System and institutions throughout New England, and as far away as Puerto Rico. We also operate multiple satellite facilities and patient service centers located throughout the state. We ensure that every test we offer—at every location—is accurate and reliable. When physicians request to have patients’ blood drawn, here is what happens: Collection: A doctor, nurse, technician, or phlebotomist will draw the patient’s blood. Several tubes may be needed for different types of tests. Depending on what illness the patient might have, his or her doctor may want to obtain a urine sample, throat swab, or other sample. After the sample is collected, the container is labeled with the patient’s name and other information. The sample is received and processed by the Laboratory, and testing begins: Chemistry Testing Blood and other bodily fluids are tested for chemicals, drugs, and substances that indicate disease. We check cholesterol and other tests for risk of heart disease, glucose to monitor diabetes, or thyroxin to monitor the thyroid gland. Hematology Testing We analyze the amount and function of blood cells and plasma. Examples include the Complete Blood Count (CBC) that tells the doctor how many cells of each type are in the patient’s blood, and the prothrombin time (PT) to measure the time it takes for the blood to clot. Microbiology Testing We test a variety of specimen samples for infections caused by bacteria, fungi, or parasites. We often do urine cultures for urinary tract infections. Virology Testing We test for viral infections. This includes rapid tests for respiratory viruses such as influenza, molecular tests for noroviruses, and antibody tests for HIV. Immunology/Molecular Diagnostics Some tests are used to determine whether the immune system is functioning properly. State-of-the-art analysis of DNA and RNA is used to test for a variety of diseases and for the risk of developing certain diseases. Other specialized tests include the ANA, used to screen for autoimmune disease, and Factor V Leiden genotyping for patients with blood clots. Tumor Profiling Laboratory This lab analyzes tumor DNA to predict the sensitivity or resistance of tumors to a

We offer state-of-the-art evaluation and treatment for patients with a wide range of lung disorders, including asthma, chronic obstructive pulmonary disease (COPD), emphysema, lung cancer, and undiagnosed or general respiratory problems. Many patients come to us with work-related pulmonary disease or with sleep disorders. They might not have a diagnosis, but have symptoms such as persistent or nagging cough, or shortness of breath at rest or with exertion. Our skilled, experienced specialists can diagnose and take care of difficult or unusual problems. The history of our center dates back more than a century, when it was set up through a bequest from Sarah Winchester in memory of her husband, William Wirt Winchester, and their young daughter, both of whom succumbed to tuberculosis. This gift resulted in the establishment of the original Winchester Hospital in West Haven, dedicated to the care of patients with tuberculosis. Today, the Winchester Center for Lung Disease at Yale New Haven Hospital is committed to the integration of cutting-edge patient care, education, and research across the full spectrum of pulmonary disorders. Our specialists are faculty members of the Yale School of Medicine Section of Pulmonary, Critical Care and Sleep Medicine, with national and international expertise in treating even the most challenging lung conditions. The center is continually evolving to meet changing needs. Most recently, in response to COVID-19, the center developed a Post-COVID-19 Recovery Program , which offers pulmonary-focused, multidisciplinary evaluation and care for patients recovering from COVID-19. In addition to our comprehensive general pulmonary practice, we offer the specialty center programs listed below. For more information about any of these programs, call the Winchester Center for Lung Disease at 203-495-2410. Adult Cystic Fibrosis Center Cystic fibrosis (CF) was previously thought of as a childhood disease, but is now considered a chronic disease because more adults in the U.S. are living longer with CF and maintaining good quality of life. The Adult CF Program provides team-based care for adults with CF on both an inpatient and outpatient basis. Our comprehensive program includes diagnosis, treatment, and counseling for sinus, pulmonary, gastrointestinal, liver, nutritional, endocrine, mental health, and reproductive issues. Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that blocks airflow from the lungs and makes it difficult to breathe. The COPD Program (including emphysema, chronic bronchitis, and asthma/COPD overlap syndrome) provides a personalized treatment plan for each patient to help manage their COPD. Whether patients have mild symptoms, need rehabilitation, or require assisted ventilation, we can help. Chronic Pulmonary Infection Research and Treatment (CPIRT) This program is focused on the leading innovative care and research for acute

We care for patients with a broad spectrum of sleep disorders, including sleep apnea, insomnia, narcolepsy, and restless leg syndrome. We are accredited by the American Academy of Sleep Medicine, and evaluate, diagnose, and treat these disorders with a coordinated approach. We know that a good night of sleep matters. Other issues we treat include: Snoring Sleep apnea-related seizure disorders Circadian and shift work-related disorders Parasomnias, such as sleep walking and talking, and abnormal behavior during sleep Our internationally recognized physicians are board-certified in pulmonary critical care medicine or neurology. They also have additional certifications in sleep medicine. As an interdisciplinary program, we work closely with specialists in otolaryngology (ENT), neurology, cardiology, psychology, dentistry, and bariatric surgery. We offer a state-of-the art lab testing system to pinpoint patients’ sleep problems, as well as home sleep-testing systems. At the West Haven VA, we care for veterans, who frequently struggle with sleep issues related to posttraumatic stress disorder and traumatic brain injury. Our VA program includes six in-hospital monitoring beds and 30 home sleep-testing units. Through our Sleep Center in the Department of Pediatrics, we treat sleep disorders in children, and manage patients with congenital disorders that impact breathing during sleep. We have a three-bed testing unit in Yale New Haven Hospital specifically designed for children that includes dedicated staff who are experienced in dealing with children and their sleep disorders.

At Yale Medicine, our pulmonary, critical care, and sleep medicine physicians focus on your respiratory health. We have a team of specialists to diagnose, treat, and manage respiratory conditions that affect your lungs and breathing. From asthma to complex lung diseases, our goal is to help you breathe easier. Our doctors are board-certified in internal medicine, pulmonary medicine, critical care, and sleep medicine. These expert physicians work closely with specialists in cardiology, diagnostic radiology, and pathology to provide you with comprehensive care for your respiratory condition. Office visits take place at the Winchester Center for Lung Disease in North Haven, Connecticut. Our sleep specialists treat most types of sleep disorders and see patients at our sleep centers at 3 locations in New Haven County. Specialized care is offered in the following areas: Adult cystic fibrosis Asthma and airway diseases Bronchiectasis and chronic pulmonary infections Cardiorespiratory exercise testing Chronic obstructive pulmonary disease (COPD) Clinical research in a wide range of lung diseases Interstitial lung disease Lung cancer screening and pulmonary nodule evaluation Medical intensive care unit for pulmonary conditions Multidisciplinary sleep care Pulmonary embolism Pulmonary function laboratory Pulmonary vascular disease Sleep apnea and other sleep disorders Thoracic interventional pulmonary embolism Thoracic oncology Tuberculosis

Scleroderma (or systemic sclerosis) is a complex disease which results in chronic hardening and tightening of connective tissues, and patients can experience many different symptoms involving different organs. Our multidisciplinary team of doctors and nurses with expertise and an interest in scleroderma, including specialists in rheumatology, allergy and clinical immunology, pulmonary and critical care, cardiology, gastroenterology, nephrology, and dermatology, provide care for patients. The team provides coordinated, multidisciplinary, and compassionate care for patients and all the parts of the body scleroderma affects, including the skin, lung, heart, kidneys, and gastrointestinal system. We also address functional, nutritional, psychological, gynecological, urological, and/or sexual health challenges. The goal is improved quality of life for our patients. We strive to ease the burden on patients and their families. Support staff help patients gather outside medical records and coordinate appointments with different specialists at Yale so that patients can get all their relevant medical care in one place. Doctors readily communicate about the plan of care through the electronic health record. We also actively participate in clinical research, to bring the most innovative treatments for the disease to our patients. Yale has been designated as a Scleroderma Center by the Scleroderma Foundation.

Yale is the regional leader in diagnosing and treating a wide range of sleep problems in infants, toddlers, children, and teens. Sleep problems can be linked to respiratory issues, or may stem from other medical, behavioral, or developmental concerns. We are dedicated to working with each family to locate the source of the child’s sleep issues, and to find a way to better sleep. No matter the cause, we will deliver comprehensive, compassionate care for each child’s sleep challenges in a warm, child-friendly environment. Our staff includes physicians who are board-certified in pediatrics, pediatric pulmonology, and sleep medicine. We are the only center in the state staffed exclusively with board-certified specialists. In addition to diagnosis and treatment of sleep issues, we provide support for patients in need of oxygen and ventilators, and continuous positive airway pressure (CPAP) titration and management. Nonrespiratory sleep complaints we treat include: Insomnia, including difficulties falling asleep and nocturnal awakenings Excessive daytime sleepiness Restless leg syndrome Sleep disturbance, including parasomnias (sleep walking, night terrors, nightmares, and bed wetting) Narcolepsy Respiratory sleep problems include: Obstructive sleep apnea with snoring, noisy breathing, disrupted sleep, or daytime sleepiness and/or attention problems Life-threatening eventsin infancy Respiratory complications of neuromuscular disease, including muscular dystrophy Pre- and post-operative evaluation for scoliosis, spina bifida, cleft palate, and other neurosurgical and craniofacial disorders