Brazilian Jiujitsu


What do my respiratory therapy blog and Innisfil Brazilian Jiujitsu have to do with each other? Do I practice Jiu-jitsu?

The fact that I had to look up the spelling of this sport should give you a clue. I am sure it is a great sport and can help people destress. I yet to try it, but hopefully one day. This blog post is a reflection than an informative respiratory therapy piece.
With the start of the pandemic, I was deployed to the acute care side of respiratory care. I had to push through personal and mental barriers, step out of the comfort zone, and help out where my presence was required. While uncomfortable, I was fortunate to have a job. I was lucky to rely on a steady paycheque. Not everyone has had the peace of mind when it comes to income. Many small businesses have suffered. To answer the question I asked at the beginning of this blog post, the common denominator of my blog and IBJJ is people. This is NOT a paid promotion. I have purchased a few of my friend’s merchandise and now I am shamelessly promoting his business. My friend PK opened his business in 2019 ( 1035 Cole Street. Innisfil, Ontario). I am looking forward to the day that he re-opens his gym, and does what he enjoys.

Since the start of the pandemic, I have seen many acts of kindness. Many people donated masks and food to hospitals. Something I benefited and very thankful for. I have also observed front line workers giving back.
Respiratory Therapy Society of Ontario (RTSO) recently shared these photos of RTs and organizations on social media (July 6th, 2020):

RTs and other healthcare workers joined to raise money and give back to their communities. #HCWS4FOOD.

Take a step back and evaluate your situation. Is there any way you can give back? Any way you can help out someone in need? Our experience has been different and we may be in different stages and financial situations so this is not put to push pressure on anyone. Giving back could even be volunteering and offering your knowledge and skills. If you don’t have the time or the money to give back, take a moment and appreciate what and who you do have (give gratitude).


This is also a perfect opportunity for me to thank John Meloche from Melotel Inc. for offering his expertise and services to me so I could offer my respiratory therapy blog to those who could benefit from it!

Farzad Refahi
July 8th, 2020

Let’s read an article a month– June 2020

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

This month I found a great article on June 20th, 2020. I spent a few days with it, and now I share it with you.

Predictors of progression in systemic sclerosis patients with interstitial lung disease

  Oliver Distler, Shervin Assassi, Vincent Cottin, Maurizio Cutolo, Sonye

  K. Danoff, Christopher P. Denton, Jörg H.W. Distler, Anna-Maria

  Hoffmann-Vold, Sindhu R. Johnson, Ulf Müller Ladner, Vanessa Smith,

  Elizabeth R. Volkmann and Toby M. Maher

  Eur Respir J 2020 55:1902026; published ahead of print 2020,

  doi:10.1183/13993003.02026-2019 OPEN ACCESS

Top 3 reasons why I enjoyed reading this article:

-A well-written review of key pathways implicated in systemic sclerosis-associated interstitial lung disease (pp2-4 ). Inflammatory pathways are complex and while I enjoy reviewing them, I never tend to be able to memorize them. There is also a nice diagram that goes along with the description (i.e. Figure 1 on page 3).  

-An insider and expert view of the challenges involved with the disease diagnosis. When it comes to interstitial lung disease, there is so much for me to read and learn about. I am involved with the Pulmonary Diagnostic side of respiratory care, and mostly I see patients with confirmed diagnosis of interstitial lung disease (usually in the later stages). Occasionally I do see patients who have some indications in an imaging test, CXR or Chest-CT, and are visiting the PFT lab for additional information. “One potential barrier to diagnosis a lack of awareness within primary care of SSc, which can lead to late referrals” (p.5). 

-If you are involved with pulmonary diagnostics, you will enjoy this article as there are references to lung function values (with some references to 6MWTs) (found on pp 7-8).

Happy Learning!

Farzad Refahi
June 25, 2020’s-read-an-article-a-month–june-2020/

CRE Renewal

Today I recalled a conversation with Dilshad Moosa about her Certified Respiratory Educator (CRE) recertification last year.  Then I realized that a year has passed by and this year is my renewal date!!  If you received your CRE from the Canadian Network for Respiratory Care (CNRC) in June of 2015, the due date is at the end of this month!  Visit CNRC’s website for additional information:

Farzad Refahi
June 17, 2020

Unsure? Get Tested!

A nasopharyngeal swab this past Friday followed the end of my deployment in acute care. A phone call from Markham-Stouffville Hospital confirmed a negative COVID-19 result. I endured 15 seconds of discomfort for a comfortable return to the PFT lab. It was a happy ending to being upfront.

Almost 4 months ago we stopped our pulmonary function testing. I was deployed to the acute care side of the respiratory therapy department. Helping in ICU, Emerg and wards. It was a quick refresher and a dive back to a side of respiratory care that I had not been involved with for almost 6 years.

While my exposure to COVID-19 patients and equipment were with proper PPE utilization, one could never be too sure. At the end of my rotations, and before seeing vulnerable patients in the PFT lab, I decided to get tested.
This is not the first time I have been tested over the last 3 months. With the start of spring, my seasonal allergies became evident. Mornings with red eyes and a runny nose were becoming the new norm for me. At the start of all this, and with these new symptoms, screeners and the occupational health department sent me for testing.

While I was relaxed, comfortable and calm about my recent, second test, the feeling about my first test was not the same. With my first test, I felt almost embarrassed and annoyed. Calling my manager and wondering what my colleagues would think about me being off due to COVID-19 was at the back of my mind. I didn’t want to be known as the person who didn’t use his PPE correctly or be known as the person who got deployed to be helping but now has become a vector. The only reason I am sharing my past false perception and beliefs is to share two points with you. Firstly, of course, you should do your best to follow proper hand hygiene, PPE, social distancing and other recommendations. Even if you have done all of the above correctly, it doesn’t mean that you are 100% protected. Secondly, there is no shame in getting COVID-19. Testing is becoming more readily available, so if you have any concerns that you might have contracted COVID-19, please get tested. It is important not only to look after yourself but also to protect others.

While I work in the healthcare field in Canada, this recommendation extends to all the frontline workers in the world. Thank you for your dedication and service. To those who have followed the recommendations and remained at home, thank you for your team effort. To those who have lost their jobs, became ill with this disease, or lost someone because of it, my heart goes out to you. 2019 and 2020 have been difficult but has shown me that we do great things when we come together. #StrongerTogether.

Farzad Refahi
June 13, 2020!/

Right After Getting The Swab

Thank you Carolyn

Image by Carolyn Greer on Instagram (Cardio-Respiratory Team)

Today one of my good colleagues retired from her part-time job at our hospital. The PFT department is thankful for her 20 years of service. While she held various roles over the years, I have known her for the past three years at Markham-Stouffville Hospital’s PFT lab. Her journey in becoming a respiratory therapist is truly inspiring, which you can read in this interview: .

Without hesitation, I can recognize her as our most patient-care focused clinician who also highly valued team effort in operating a quality lab. While I will miss working with her, I’ll stay in touch with her. When I was considering to join the board of directors at Respiratory Therapy Society of Ontario, she was one of the supporters who encouraged my involvement.  Many more words of wisdom that were shared on our way to Tim Horton’s.

Carolyn, thank you for your years of service. Glad to call you a friend.

Farzad Refahi

June 4 2020