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Interstitial Fibrosis of Lungs

Q: I am suffering from Diffuse Interstitial Fibrosis of Lungs since 1985 and the disease was diagnosed and treatment started, from August 1986, when the Vital capacity of my lungs was just 750 ml. The treatment started with a dose of 40mg Prednisolone for about three months and then there was a reduction of the dose @ 2.5 mg per week. The Vital capacity improved to about 1.8 Litres. The maintenence dose even touched as low as 2.5 mg for about 3 to 4 months. Then there have been variations in the lung capacity and the dose is being modulated on the basis of the lung capacity measured. The present maintenence dose is 12.5 mg. Also over a period of the past 16 years there have been side effects like Osteoporosis, Acidity and, nowadays, breathing problem. I have been prescribed 2 puffs BD of Seretide evohaler with which I get relief. I feel physically weak. Apart from Prednisolone, I take Seretide Evohaler, LAN 30, Ditide, Rocaltrol, Sandocal 500. The Vital capacity now is around 1.3 Litres. But off late, I have started feeling the acuteness of the problem; Also I have developed problem in my eyes. Under the circumstances I have started loosing heart. I have been able to comprehend the above based on my memory.

A:The response of Diffuse Interstitial Fibrosis to treatment is very variable, but all too often is minimal. Thus, a very good result with prednisolone treatment is an exceptional outcome. However, there is often a heavy price to pay, with osteoporosis and eye problems as common complications. Other drugs such as cyclophosphamide and azathioprine are unreliable therapies which also have severe side effects. The most interesting new drug is Interferon-b, but its true value cannot yet be assessed. Colchicine and penicillamine are older drugs that sometimes may help. <.br>There is some evidence that a natural agent cysteine, or its better tolerated derivative, N-acetylcysteine may be useful; moreover, these agents have no serious side effects when given by mouth. General meaures include an anti-oxidant diet of fruits and vegetables, and both general and breathing exercises to maximize oxygen usage and to conserve energy. Some stimulating or tonic herbs, such as ginseng or ashwagandha, can help. Oxygen supplementation (with a tank and mask delivery system) may eventually be needed. Finally, lung transplantation is a possible option in some countries.

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