If they say
Who cares if one more light goes out?
In the sky of a million stars
It flickers, flickers
Who cares when someone’s time runs out?
If a moment is all we are
Or quicker, quicker
Who cares if one more light goes out?
Well I do

One More Light – Linkin Park

‘Together’ – Photos By Farzad

September 10th 2017 was the World Suicide Prevention Day.   While I have never had suicidal thoughts nor know someone close to me who has struggled with this issue, I will not ignore this topic.  I can recall one of my undergrad instructors discussing in a psychology lecture that suicide is a permanent solution to a temporary problem.
As health care professionals we have to deal with many obstacles, stressors and frustrations.  Just as we put importance on our dietary intake, exercise and quality of sleep, we need to be aware of our mental health.

Don’t ignore the problem.  Talk to trusted friends, family members and colleagues.  Seek professional help.

For more information visit Canadian Association for Suicide Prevention

-Farzad ‘Raffi’ Refahi  September 19, 2017

Dedicated to Chester Bennington (Mar 20 1976 – Jul 20, 2017)


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A Sunny Saturday

Today is Saturday Sep 16, 2017 around noon.  It is a beautiful sunny day with temperatures around 24 C ( 75 F).  Great day to be out, and to make most of it.  I would like to send a quick thank you to all the hard working Respiratory Therapists, Nurses, Healthcare Professionals, Police Officers, Firefighters and other essential personnel who are at work right now.


Farzad Raffi Refahi


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Larry King and Lung Health

Larry King is an ex-smoker who had an early detection because of his routine check up.
H was “diagnosed with stage 1 Adenocarcinoma, the most common type of lung cancer, through a routine chest examination.” – Reported byCNN (Lisa R France Sep14, 2017)

This is a good reminder to motivate your patients to attend their annual checks ups and appointments.  

Let’s aim :To monitor, to have an early detection, to offer more treatment options, and to provided have a better patient care.

For more details check out CNN’s article at

Farzad ‘Raffi’ Refahi

Sep 15, 2017


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Independent PFT lab

Lessons learned from Universal Pulmonary Function Lab.

I began working at Universal Pulmonary Function Lab slightly more than 2 years ago.  The lab was without a technician or RT for weeks before I was hired (to work as once a week [sole] operator.  The learning came from the challenges of working without having a prior training to their equipment, protocols and patient flow.  Here are my top learnings from that experience:

1.    Becoming resourceful.
Regardless of the amount of training you receive at the beginning of your job, the RT/Technician/Operator has no option than to quickly seek and utilize resources.  I stayed in touch with the amazing lead respirologists, Dr. A. Born.  I sought the advice of my PFT mentor Mr. Bernie Ho.  I discussed my issues with colleagues at the other PFT lab I was working at the time (Ms. Sylvia).  I accessed printed manual for the equipment and the online guidelines at ATS/CTC/ERS websites.   When put in situations like this, we have our school notes, textbook, previous instructors/preceptors, online guidelines, conferences and forums.   I am proud to say that under the supervision of Dr. A. Born, this lab holds and operates at a very high standard.

2.    The power of Body Language
Toronto is a great city painted with multiculturalism.  On regular basis, I would have elder individuals who could not understand English.  The ability to simplify and summarize instructions and to deliver it verbally, vocally and through body language is a useful skill I had to develop.   While PFT involves many small steps with many technical aspects, learn to simplify it for your patients.  It will require more attention and care but your patients will notice your effort and will appreciate it! It is all about patient-focused care after all.

3.    Independence
As a sole operator of a lab, there is only the RT/Tech, the patient and the secretary.  Doing PFTs in hospitals includes a variety of healthcare providers who you rely on or call on, if needed.   Monitor your patients throughout the test.  Some patient are not good evaluators of their symptoms.  Identify early signs of fatigue, dyspnea and vertigo.  Be aware and be prepared.

I leave this independent lab knowing that my replacement is also a dedicated and driven individual who will look at the lab and the patients.

Farzad Raffi Refahi RRT


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Marijuana sale in Ontario

“The Ontario government has announced a framework to manage the sale and use of marijuana…”- CBC News

I am posting this not to support nor to oppose this topic but to simply share the latest developments. Soon, it may be easier or more acceptaple to ask about patients’ cannabis use along with the [tobacco] smoking history.  

For the full news article please visit:



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Presenting At CSRT

In 2016, I gave a talk at the annual Canadian Society of Respiratory Therapists, CSRT, Conference.   At that time I was working six days a week, running a blog, and was trying my best to prepare for the presentation.  I was excited, nervous and driven.  My presentation was far from perfect, however, I learned a lot in the process and from the self-reflection after it was completed.

Here are my top three pieces of advice for first time presenters at CSRT:

  1. Quality.
    Know more about the topic than most people in the room. Do your research but don’t invest all your time on the research component.  There will always be individuals who would know more about the topic than you would, however gather enough information so your talk would be beneficial to most people in the room.  Presenting at CSRT requires quality and professionalism.  Do your research, deliver the quality, but don’t spend the whole time sharing your research.
  2. Keep It Simple.
    Collect all the relevant information, process it and present it in few key points.  A 45 minutes long talk is a short time to discuss all your findings.  It is best to summarize or select only 3 to 5 key ideas/points, and then focus on the delivery of those points.  Keep it simple.  Present the key points without relying too much on technology.  There seems to be always some technical issue during talks (happened during mine).
  3. Practice… Practice… Practice.
    Get to know your material. I would encourage practicing enough to memorize. Practice in front of friends and individuals in the field.   Use the feedback from the practice runs and modify your presentation until it is smooth and simple while delivering the main ideas.  I videotaped my practice runs so I would identify areas that required more attention.  Don’t be afraid to connect with your audience. Get to the room that your will be presenting early or during breaks. Stand where you will be presenting, look around and get to know the room.  During your presentation don’t forget to breathe.

  Here is the link to CSRT’s  Call For Presenter’s page:

Good luck!

Farzad ‘Raffi’ Refahi HBSc RRT CRE


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Pulmonary Function Testing Symposium

Back in 2016, I was working as the Lead Respiratory Therapist, or Chief Technologist, at a Toronto based respirology clinic.  I was responsible for diagnostic testing, training and supervision of staff, quality assurance and technical operation of the clinic (PFTs, MCTs, 6 MWTs, CPETs and Cap. Gas and ABGs).  One of our suppliers, Novus Medical Inc, informed me of an upcoming conference that focused on pulmonary function testing by Canadian Association of Cardio-Pulmonary Technologists (CACPT).  The 2016 Pulmonary Function Testing Symposium was a two-day event of talks, workshops and networking opportunities by experienced technologists, respiratory therapists, respirologists and other healthcare professionals.  Attendees were like minded individuals who were driven and dedicated to the field.  This conference allowed me to expand my knowledge, to learn from the wisdom of technologists, and to connect with individuals from across Canada (some whom I am still in touch with).

This year’s Symposium is on September 22nd and 23rd.  I am looking forward to talks by Laura Seed RCPT, Dr. Gottschalk, Lori Davis RCPT, Dr. Stanbrook, Angela Thomas RN, Dr. Allan Coates, Andrea White-Markham RRT, Dr. Myrna Dolovich, Tony Kajnar RRT, and workshops by Ontario Lung Association, Susan Blonshine RRT, Jane Schneiderman PhD, Susan Lori RKin and Tony Kajnar RRT!

This conference is organized by Laura Seed, Murray Beaton and Tony Kajnar.  To find out more about the conference I got in touch with CACPT.   I was lucky enough to have a conversation with Ms. Laura Seed, the VP of CACPT.   This is what she had to share.

The Canadian Association of Cardio-Pulmonary Technologists (CACPT) has always provided an education forum for its members.  For years the Pulmonary and Cardiovascular members of the CACPT across Canada came together at the annual Canadian Cardiovascular Conference (CCC).  Respiratory Sessions were included at this cardiovascular venue.  Attendance to the CCC unfortunately decreased dramatically in the last 5-7 years.  The Canadian Respiratory Conference (CRC) was then considered by the CACPT to provide an alternative education forum for the Pulmonary members.  The Pulmonary members did not attend this conference due high registration fees and not enough content on Pulmonary Function topics. 

In 2015, I as Education Chair, organized a 1 day PFT Symposium in Toronto at the Hospital for Sick Children.  This was very successful.  With feedback from the delegates pointing to the need of this type of symposium it was expanded to 2 days, to include not just lectures but also workshops.   At this time Murray Beaton of Novus Medical expressed interest in promoting this education forum.  This partnership has resulted in workshops that provide hands on experience in PFT testing. 

The PFT Symposium is unique as all topics for lectures and workshops pertain directly to aspects of a Pulmonary Function Lab.  It allows CACPT members, Respiratory Therapists and anyone else who work in the PFT lab to come together and learn from each other’s experiences.  What is particularly challenging is providing topics for the “diverse” experienced technologists that attend.  Basic topics such as learning to perform quality Spirometry to the more challenging topic of Methacholine Challenges are included in the program.  All employers of Pulmonary Function Labs, independent or hospital based, would greatly benefit in supporting their PFT technologists to attend the Symposium.  It speaks to the quality of care and patient safety that is provided when diagnosing, treating, and monitoring  patients with respiratory disease

The 2017 PFT Symposium will be on September 22 and 23 in Toronto at the International Living Learning  Center, Ryerson University.  Registration Link is available on the CACPT website (  The program can be viewed on the link as well.  There are plans underway to organize the 2018 PFT Symposium in Alberta (Edmonton or Calgary).

I also got in touch with Mr. Bernard Ho.  He was my PFT clinical preceptor at Women’s College.  I consider him as my mentor and, to this day, I seek his opinion, advice and suggestions.  I asked Bernie about his thoughts on this symposium, and this is what he had to share:

PFT Symposium by the CACPT (Canadian Association of Cardiopulmonary Technologists) is the only comprehensive annual educational seminar in Pulmonary Function Testing in Canada.  It provides up-to-date standards and recommendations of the American Thoracic and European Respiratory Societies.  More importantly, there is opportunity of networking among the colleagues and discussing test procedures and policies from various PF Laboratories.  PFT Symposium is accredited for 13 hours of continuing education (CE) /professional development (PD) credits by the CSRT and CACPT.    It is a great opportunity for PF Lab from the Independent Health Facility in Ontario to earn the required PFT professional development credits.


I am really excited to attend this year’s conference.  Hope to see you there!

Farzad ‘Raffi’ Refahi HBSc RRT CRE
September 01, 2017

-Image :
-Thank you to Laura Seed, Murray Beaton, Tony Kajnar and Bernard Ho.



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