DEAR DR. GOTT: According to the Pulmonary Fibrosis Coalition, there are just as many people who die each year from the disorder as do from breast cancer. This disease has no cure and no treatment. I have it and it is extensive. Mine was possibly (no one will say for sure) from a prescription given to me for the antibiotic Macrobid (nitrofurantoin). My doctor didn’t know that it causes scar tissue in the lungs.
I spent more than a year trying to discover why I had so much trouble breathing. I had breath tests, X-rays, overnight monitor, oxygen, an endoscopy, allergy testing, stress tests, etc., along with doctor visits and co-pays. I think all people should be warned and that much more attention should be given to this serious but sneaky life-ending disease.
Thank you for the opportunity to express my thoughts on this.
DEAR READER: There are approximately 140,000 known Americans diagnosed with pulmonary fibrosis. It commonly affects people between the ages of 50 and 75, although anyone can acquire the disorder. It occurs when lung tissue becomes damaged and scarred, making it more difficult for the lungs to function properly. There are a number of reasons for this to occur, to include specific lung diseases, medical treatment, and environmental airborne toxin exposure such as from bird and animal droppings, asbestos fiber/ silica dust/grain dust exposure at home or in the workplace. For example, lung damage may occur months or even years following initial radiation therapy for lung or breast cancer. Chemotherapy drugs, to include methotrexate and cyclophosphamide, are known to damage lung tissue. Some medications such as propranolol or amiodarone prescribed for heart irregularities can harm those same, delicate tissues. Not all, but some antibiotics to include Macrobid, Macrodantin, azulfidine and others can potentially cause harm to the lungs, as well. Then there are several medical conditions such as rheumatoid arthritis, sarcoidosis, scleroderma, pneumonia, tuberculosis, and more linked to causing pulmonary fibrosis.
Symptoms include fatigue, dry cough, occasional chest pain, shortness of breath, fatigue, weight loss without apparent cause, and muscle and joint pain.
Risk factors that enter the picture include occupational exposure to known toxins, having had chemotherapy or radiation treatments for cancer, the habit of smoking, and age. A genetic component is also linked as suspect.
Your physician can learn a lot by simply listening to your breath sounds with a stethoscope. Idiopathic pulmonary fibrosis patients will likely have abnormal crackling lung sounds. Diagnosis is often made with the assistance of a chest X-ray, CT scan, or echocardiogram. Beyond this, pulse oximetry to measure oxygen saturation in the blood, an exercise stress test performed on a stationery bicycle or treadmill, and through spirometry that helps determine how quickly air can circulate through the lungs may be ordered. There are instances when a biopsy may be called for, with samples obtained in a number of different ways.
While treatment cannot reverse any damage already done from pulmonary fibrosis, oxygen therapy can ease difficult breathing, reduce blood pressure in the right side of the heart, and reduce or prevent low blood-oxygen level complications. On the home front, remove yourself from known contaminants such as second-hand cigarette smoke or known toxins, maintain a nutritional, well-balanced diet, and keep your pneumonia and flu vaccines up to date.
The prognosis of this disorder can vary from person to person. Some individuals may experience exacerbation of symptoms rather quickly, while others may continue for years with minimal concerns or lifestyle changes. If you aren’t already tapped in, make an appointment with a top-notch pulmonologist in your area who can monitor your progress and offer the best treatment options available. Join a support group in your area or online.
For additional information, contact the American Lung Association at info@lung.org or the Pulmonary Fibrosis Foundation at www.pulmonaryfibrosis.org.
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