Dr. on's Report

[Guest guest]

A short time ago I went to North Caroline for an evaluation by Dr. Lake on of Duke University. Yesterday I had a report from him. Because he is a preeminent, if not the preeminent, pulmonologist specializing in IPF, I want to share with you some of his comments. Also, my visit with him underscores Bruce and Beth's constant iteration that if you have IPF you should get an evaluation at one of the many centers of excellence. I received more info from Dr. on than I did in five years of seeing the local pulmo.

Not all of Dr. on's comments are necessarily medical, but I will include a few for your amusement.

"He us a very well appearing pleasant elderly gentleman in no acute distress, speaking in full sentences."

And that, my friends, is sometimes hard to do.

Vitals: blood pressure 122/69, pulse 68, respiratory rate 10, temperature 97.4, saturation is 96% on room aire.

Chest: He had bibasilar crackles approximately 1/3 of the way up, otherwise, his lungs are clear.

Cardiac: Normal without murmurs, gallops or rubs.

Tests results: Studies showed evidence of traction bronchiectasis as well as what I believe is honeycoming at the lung bases bilaterally.

Impression: I suspect Mr. Marshall suffers from idiopathic pulmonary fibrosis. We will wait full

connective tissue disease serologies to ensure that he is not having underlying connective tissue disease that what would explain his symptons. His remarkably well-preserved spirometry and lung volumes and a moderate impairment in DLCO seem out of proportion to his radiographic disease.

Treatment Options: I think his decision to use n-cetylcustube (NAC) was a reasonable one. Data from

the IFIGENIA trail in which the addition of NAC to a regimen of Prednisone/Azathioprine was beneficial

in slowing the decline of lung function. I think it is a reasonable medication to consider as its antiocident effects might be antifibrotic as well. I advised him that he could take three tablets a day.

He has an active exercise regimen, and I think that is contributing to his health. I think it worth repeating an echocardiogram.

Mr. Marshall is contemplating moving to North Caroline. If he does, we will be more than happy to follow him here at the Duke Interstitial Lumg Disease Clinic. (This is my favorite comment.)

Sorry to make this so long, but I hold it up as to what we all should get from our pulmonologists. And it is for that reason I want to share this with you. I have a totally different impression of my condition and some

excellent info that will help me to keep my IPF under some control or to at least modrate its effects upon my daily activities.

If you can, by all means arrange for an evaluation at your nearest center of excellent. My insurance paid for everything except $85.00. I broke my penny bank and paid it. Jack79/IPF - UIP/dx06/05 Maine