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Pulmonary medicine involves the evaluation of the lungs and its interaction with how you feel and breathe.  Our Pulmonologists are Board Certified physicians who are specialty-trained to identify and treat conditions of the lungs.  Common lung conditions include asthma, COPD (chronic obstructive pulmonary disease), emphysema, pneumonia, and lung cancer.

Sleep medicine involves the evaluation of sleep-related conditions which are a common cause of daytime sleepiness.  Common sleep conditions include obstructive sleep apnea, central sleep apnea, and parasomnias.  

Critical care medicine involves caring for our patients if they become severely ill and require treatment in the Intensive Care Unit.  Our physicians take pride in providing the best care in the office and in the hospital setting.

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HOURS

Here When You Need Us

Office Hours

Monday - Friday

8:30am - 5:30pm

Hospital Hours

Our physician network provdes coverage to our hospitalized patients 24 hours a day, 7 days a week, 365 days a year.

CONTACT US

We’re here for you when you need us. Call us to schedule an appointment or use the contact form below and we’ll get back to you as soon as possible.

2700 Ygnacio Valley Road, Suite 100

Walnut Creek CA 94598

Phone (925) 939-3050

Fax (925) 939-3057

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1️⃣ Before Your Procedure

 

Fasting: Nothing to eat or drink after midnight.

Take only approved morning medications with a small sip of water.

 

  • Medications:

    • Stop blood thinners before the procedure 

      • Clopidogrel/Plavix: 5-7 days

      • Apoxaban/Eliquis: 48-72 hrs

      • Rivaroxaban/Xarelto: 48-72 hrs

      • Dabigatran/Pradaxa: 3-5 days

      • Warfarin/Coumadin: 5 days, ensure INR < 1.5

    • Diabetes medications

      • Stop SGLT2 inhibitors 3 days before the procedure

        • Empagliflozin/Jardiance

        • Dapagliflozin/Farxiga

        • Canagliflozin/Invokana

        • Ertugliflozin/Steglatro

        • Sotagliflozin/Inpefa

      • Metformin: hold morning of procedure

      • Stop GLP-1 medications 1 week before the procedure 

        • Dulaglutide (Trulicity)

        • Semaglutide(Ozempic, Wegovy, Rybelsus)

        • Liraglutide (Victoza, Saxenda)

        • Exenatide (Byetta, Bydureon)

        • Lixisenatide (Adlyxin)

        • Tirzepatide (Mounjaro, Zepbound)

    • Antihypertensives

      • ACE inhibitors / ARBs (lisinopril, losartan): hold morning of



 

2️⃣ Day of Procedure

Arrival: Check-in 2 hours prior to scheduled

What to Bring: Photo ID, insurance card, and a responsible adult driver (you cannot drive after anesthesia).

Attire: Loose clothing, no jewelry or valuables.

You’ll meet your anesthesiologist and pulmonologist to review your plan and consent.
 

3️⃣ During the Procedure

Performed under general anesthesia in a fully monitored setting.

Typical duration: 60–90 minutes

The team uses Ion robotic navigation to guide biopsy tools to small peripheral lung nodules with CT-based accuracy.
 

4️⃣ After the Procedure

You’ll recover in the PACU for 1–2 hours under observation.

You need to have a ride home. You will not be permitted to drive yourself home after general anesthesia. 

Expect mild sore throat, hoarseness, or minor blood-streaked sputum for 24 hours.

Resume clear fluids once your gag reflex returns; advance diet as tolerated.

Do NOT drive, drink alcohol, or make major decisions for 24 hours.

Call immediately if you develop:

Shortness of breath or chest pain

Fever > 101 °F

Persistent or heavy bleeding
 

5️⃣ Follow-Up

Pathology results are usually available in 3–7 days.

Our office will contact you when the results are back to review them and to discuss the next steps.

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©2026 by Muir Pulmonary Critical Care and Sleep Medicine.

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