Interstitial Lung Disease

WHAT YOU SHOULD KNOW

In this disorder, the tissue between the air sacs in the lungs becomes inflamed, thick, and stiff, making it difficult to breathe. The disease often progresses to a chronic stage called by a variety of names, including interstitial pulmonary fibrosis, pulmonary alveolar fibrosis, and idiopathic pulmonary fibrosis. The chronic phase is marked by permanent scarring, or inflammation, of the lung tissues and an irreversible loss of the tissues' ability to transport oxygen.

Causes

The cause of interstitial lung disease is unknown. However, according to the American Lung Association, some researchers believe that viral illnesses and exposure to irritants such as tobacco smoke may play a role in its development. Although a tendency to the disease may be hereditary, it's thought that the condition can be aggravated and made chronic by certain occupational hazards such as chemical vapors and dust, certain drugs, and connective tissue diseases such as rheumatoid arthritis and systemic sclerosis.

Signs/Symptoms

Early warnings include shortness of breath during exercise, a dry cough, and sometimes chest pain. If left untreated long enough, these symptoms will gradually get worse---possibly to the point that you will experience shortness of breath without any exertion and even while resting.

Care

The type of care depends largely on the extent of damage to the lungs. The doctor is likely to prescribe steroid medications to reduce inflammation. Influenza vaccines and pneumococcal pneumonia vaccine may also be recommended to prevent infection, and antibiotics may be needed if a bacterial infection develops in the lungs. Oxygen may be required to assist breathing.

In some cases, interstitial lung disease responds very well to medication and the disease eventually runs its course. If the disease becomes chronic, a lung transplant may have to be considered.

To determine the extent of the disease, your doctor will first order a series of tests, including a chest x-ray, blood tests, and pulmonary function tests. The doctor may conduct a bronchoalveolar lavage (BAL) test in which cells from the lower respiratory tract are removed and examined. Another possibility is a lung biopsy, in which a sample of lung tissue is surgically removed for examination.

Risks

Interstitial lung disease is a very serious problem. Left untreated, it can lead to heart or respiratory failure.

WHAT YOU SHOULD DO

• Take your medications precisely as prescribed. Carefully following your treatment plan will speed your improvement and make breathing easier. Do not stop taking the medication until it is all gone, even if you feel better.
• Try to avoid occupational irritants as much as possible.
• If you smoke, it's very important to stop. Smoking can make the condition much worse. Your doctor can prescribe a variety of aids.
• Limit exercise until your condition is under control and your doctor advises that it is all right for you to resume such routines.

Call Your Doctor If...

• You find that you are becoming breathless during exercise.
• You develop a fever.

Seek Care Immediately If...

• You begin coughing up blood.
• You begin experiencing intense chest pain.
• You cannot breathe, despite taking your medication and following all of your doctor's advice. Call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself!

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay:

• Oxygen: You will be given extra oxygen either by a mask or nasal prongs.
• Taking Vital Signs: These include your temperature, pulse, blood pressure, and respiration. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm. These tests may be performed hourly.
• Pulse Oximeter: This is a clip placed on your ear, finger, or toe and connected to a machine that measures the oxygen in your blood.
• IV: A tube placed in your vein for giving medications or liquids. It will either be capped or have tubing connected to it.
• Medicines: The following drugs will help you breathe easier. They may be administered by mouth or given in your IV.
• • Antibiotics: If you have an infection in your lungs, the antibiotics will help to clear it up.
  • Bronchodilators: These medications help to open up your airways. They are typically either inhaled or given in tablet form. For long-term management of the disorder, you may need to continue taking this type of medication after you are discharged.
  • Steroids: This type of medication reduces the swelling and inflammation of the tissue in your lungs.
• Breathing Treatments: At the start of your hospital stay, a machine may be used to help you inhale medicine. A healthcare worker will help you with these treatments.
• Chest X-ray: This picture of your heart and lungs is used to monitor your condition.
• Blood Tests: Samples will be taken from a vein in your hand or the bend in your elbow. The amount of oxygen in your blood will also be evaluated, and samples for this test may need to be drawn from either the wrist, elbow, or groin.
• ECG: Also known as a heart monitor, an electrocardiograph or an EKG. Patches are placed on your chest and then hooked up to a TV-type screen which shows a trace of each heartbeat. Doctors use this tool to watch for signs of heart trouble prompted by your breathing problems.