Re: Convenient doctors

August 3, 2009

Bruce, You are soo right on as usual. Just talked to my pulmodudette and told here I was going to get evaluated at National Jewish and she said "Right On! I'm so glad for you" I wish I could clone her because even though she is not a IPF expert and she knows that, she is one of the most supportive and loving doctors I've ever had and some people on this group have had such horror stories. After 7 years because of this group I will find out more and learn more about this craptaculer disease. Thanks for just putting it out there.Dyane Phoenix IPF 02>> Sometimes when you're seeking a convenient doctor with expertise,> depending on where you live, thats just not possible. Joyce Rudy> couldn't find one in her area of Arizona and in fact was being done much> harm by her pulmonologist's ignorance. Going to National Jewish was of> great trouble and expense but she'd tell you today its value. Many of> these means of finding expert pulmonologists will not give those expert> in Pulmonary Fibrosis. However, a good compromise might be finding one> of those for routine help while going to a major ILD center for> diagnosis and treatment. Ideally then they would coordinate with the> local doctor.> > I don't have or know of any lists of doctors with PF expertise. I would> ask any doctor how many PF patients does he currently treat and where> did he gather his knowledge of the disease. Those are very fair> questions. The Pulmonary Hypertension Association actually does have a> list of those expert in PH and since they often work closely with PF> doctors, one might look there and ask them for a cohort. I live in the> Dallas area and there are only two doctors here who make their list.> None of them are in the city I live in, Plano.> > I use PH as an example because its the information readily available and> a disease many of us may face. Here is their find a doctor tool:> > http://www.phassociation.org/Find_A_Doctor/> > Unfortunately, there is not an expert PH doctor in West Virginia or> South Dakota or North Dakota or Wyoming or New Mexico or Idaho and many> other states only have one. Regular Cardiologists are not qualified for> PH. Regular Pulmonologists aren't.> > The same situation exists with PF. I'm not pointing this out to be an> alarmist, but there are areas of the country you can't find the> expertise you need. If you live in Mississippi, you may have to drive to> Alabama or Louisiana. I drove 900 miles initially for a thorough second> opinion and work up because although there were those with experience in> Texas, they weren't yet a Center of Excellence. I suspect those same> states i listed above that don't have PH doctors may not have> pulmonologists I would trust to diagnose or recommend treatment plans on> PF. Which brings one to a personal decision of choosing a good doctor> not properly trained in PF or traveling. Traveling adds time and> certainly expense. I'd recommend the compromise of local maintenance> under remote expert supervision, but each must make their own choices.> We have a member who lives in GA but chose Duke because at the time> Emory wasn't at current levels. Jack Marshall is in Maine and travels to> Duke. We have those from Mississippi going to Alabama and Joyce Rudy> went from remote Arizona to Denver. MangoMan who keeps us entertained> would love to return to Mexico, but we've lost a member who made a trip> back to Mexico and he recognizes the facts of medical exposure and risks> enough to realize its not the best place to live with PF.> > Mostly, we don't choose where we live based on medical needs but other> factors led to it long ago. However, two years ago I was contemplating> where to live and my medical needs were an overriding part of that> decision and that was before the PF diagnosis. I feel for those who> can't move and can't get what they need locally. However, I don't want> us to overlook the fact that some locations just don't have doctors> expert in PF. As important as research may be and as national attention> may be, one thing that is sorely lacking is training within the> Pulmonology profession in Pulmonary Fibrosis. I'm sorry the answers> aren't as we wish when some look for medical expertise in their area. I> would personally do anything I could to get to the best I could find,> but that may not be possible for some nor the choice others feel is> right for them. I do suggest one thing though to those saying they can't> travel the distance. Reread Joyce Rudy's story. She sacrificed the birds> she loved, made the trips by herself at great expense, and had to beg> friends to take care of her dogs. She went against the recommendation of> her local pulmonologist and made the trip. I remember her lost and> frustrated. Now I see her upbeat and off to her exercise program. Likely> her life has been lengthened. No doubt the quality improved and not just> from a physical standpoint. Even more from a comfort and control> standpoint.>

August 3, 2009

bruce

although i didn't read every word, your points are well taken

i am one of the fortunate who lives in a city with 2 universities that have departments specializing in ILDs

the first doc that i had at Penn, actually left Penn to go into private practice in one of the suburbs

so it is possible to find a doc outside of a specialty hosptial who has an interest and experience in ild's

however, if i were looking now, i would not know about him and still take the first available at Penn or Temple

at that time, i certainly didn't know where else to look

i have a feeling that the above doc is a rare breed

i did think about following him, but he thought i would be better off staying with someone at Penn

especially since i was evaluated for transplant and if and when the time comes, it would be necessary for the two docs -- pulmonary and transplant -- to interact

it turns out that their offices happen to be near each other

Pink Joyce R (IPF 3/06) IFA 5/09 Pennsylvania

Donate Life Listed 1/09 Inactive 4/09

www.transplantfund.org---

Subject: Convenient doctorsTo: Breathe-Support Date: Monday, August 3, 2009, 1:57 PM

Sometimes when you're seeking a convenient doctor with expertise,depending on where you live, thats just not possible. Joyce Rudycouldn't find one in her area of Arizona and in fact was being done muchharm by her pulmonologist' s ignorance. Going to National Jewish was ofgreat trouble and expense but she'd tell you today its value. Many ofthese means of finding expert pulmonologists will not give those expertin Pulmonary Fibrosis. However, a good compromise might be finding oneof those for routine help while going to a major ILD center fordiagnosis and treatment. Ideally then they would coordinate with thelocal doctor.I don't have or know of any lists of doctors with PF expertise. I wouldask any doctor how many PF patients does he currently treat and wheredid he gather his knowledge of the disease. Those are very fairquestions. The Pulmonary Hypertension Association actually does have alist

of those expert in PH and since they often work closely with PFdoctors, one might look there and ask them for a cohort. I live in theDallas area and there are only two doctors here who make their list.None of them are in the city I live in, Plano.I use PH as an example because its the information readily available anda disease many of us may face. Here is their find a doctor tool:http://www.phassoci ation.org/ Find_A_Doctor/Unfortunately, there is not an expert PH doctor in West Virginia orSouth Dakota or North Dakota or Wyoming or New Mexico or Idaho and manyother states only have one. Regular Cardiologists are not qualified forPH. Regular Pulmonologists aren't.The same situation exists with PF. I'm not pointing this out to be analarmist, but there are areas of the country you can't find theexpertise

you need. If you live in Mississippi, you may have to drive toAlabama or Louisiana. I drove 900 miles initially for a thorough secondopinion and work up because although there were those with experience inTexas, they weren't yet a Center of Excellence. I suspect those samestates i listed above that don't have PH doctors may not havepulmonologists I would trust to diagnose or recommend treatment plans onPF. Which brings one to a personal decision of choosing a good doctornot properly trained in PF or traveling. Traveling adds time andcertainly expense. I'd recommend the compromise of local maintenanceunder remote expert supervision, but each must make their own choices.We have a member who lives in GA but chose Duke because at the timeEmory wasn't at current levels. Jack Marshall is in Maine and travels toDuke. We have those from Mississippi going to Alabama and Joyce Rudywent from remote Arizona to

Denver. MangoMan who keeps us entertainedwould love to return to Mexico, but we've lost a member who made a tripback to Mexico and he recognizes the facts of medical exposure and risksenough to realize its not the best place to live with PF.Mostly, we don't choose where we live based on medical needs but otherfactors led to it long ago. However, two years ago I was contemplatingwhere to live and my medical needs were an overriding part of thatdecision and that was before the PF diagnosis. I feel for those whocan't move and can't get what they need locally. However, I don't wantus to overlook the fact that some locations just don't have doctorsexpert in PF. As important as research may be and as national attentionmay be, one thing that is sorely lacking is training within thePulmonology profession in Pulmonary Fibrosis. I'm sorry the answersaren't as we wish when some look for medical expertise in

their area. Iwould personally do anything I could to get to the best I could find,but that may not be possible for some nor the choice others feel isright for them. I do suggest one thing though to those saying they can'ttravel the distance. Reread Joyce Rudy's story. She sacrificed the birdsshe loved, made the trips by herself at great expense, and had to begfriends to take care of her dogs. She went against the recommendation ofher local pulmonologist and made the trip. I remember her lost andfrustrated. Now I see her upbeat and off to her exercise program. Likelyher life has been lengthened. No doubt the quality improved and not justfrom a physical standpoint. Even more from a comfort and controlstandpoint.

August 3, 2009

Pink Joyce

Yes, its how to find those who branch and its that generally they're

still not too far away. There is one practice in Plano that has four

pulmonologists, all from UTSW. It is looking to add two more from this

year's group that completes their residency in Pulmonary Care there. So

the tie and relationship is strong and they've all got some degree of

knowledge and experience with PF. This is the practice I went to

initially but have switched as they only had two doctors and were 90%

critical care so not available when needed.

>

> From: Bruce Moreland brucemoreland@...

> Subject: Convenient doctors

> To: Breathe-Support

> Date: Monday, August 3, 2009, 1:57 PM

>

> Sometimes when you're seeking a convenient doctor with expertise,

> depending on where you live, thats just not possible. Joyce Rudy

> couldn't find one in her area of Arizona and in fact was being done

much

> harm by her pulmonologist' s ignorance. Going to National Jewish was

of

> great trouble and expense but she'd tell you today its value. Many of

> these means of finding expert pulmonologists will not give those

expert

> in Pulmonary Fibrosis. However, a good compromise might be finding one

> of those for routine help while going to a major ILD center for

> diagnosis and treatment. Ideally then they would coordinate with the

> local doctor.

>

> I don't have or know of any lists of doctors with PF expertise. I

would

> ask any doctor how many PF patients does he currently treat and where

> did he gather his knowledge of the disease. Those are very fair

> questions. The Pulmonary Hypertension Association actually does have a

> list of those expert in PH and since they often work closely with PF

> doctors, one might look there and ask them for a cohort. I live in the

> Dallas area and there are only two doctors here who make their list.

> None of them are in the city I live in, Plano.

>

> I use PH as an example because its the information readily available

and

> a disease many of us may face. Here is their find a doctor tool:

>

> http://www.phassoci ation.org/ Find_A_Doctor/

>

> Unfortunately, there is not an expert PH doctor in West Virginia or

> South Dakota or North Dakota or Wyoming or New Mexico or Idaho and

many

> other states only have one. Regular Cardiologists are not qualified

for

> PH. Regular Pulmonologists aren't.

>

> The same situation exists with PF. I'm not pointing this out to be an

> alarmist, but there are areas of the country you can't find the

> expertise you need. If you live in Mississippi, you may have to drive

to

> Alabama or Louisiana. I drove 900 miles initially for a thorough

second

> opinion and work up because although there were those with experience

in

> Texas, they weren't yet a Center of Excellence. I suspect those same

> states i listed above that don't have PH doctors may not have

> pulmonologists I would trust to diagnose or recommend treatment plans

on

> PF. Which brings one to a personal decision of choosing a good doctor

> not properly trained in PF or traveling. Traveling adds time and

> certainly expense. I'd recommend the compromise of local maintenance

> under remote expert supervision, but each must make their own choices.

> We have a member who lives in GA but chose Duke because at the time

> Emory wasn't at current levels. Jack Marshall is in Maine and travels

to

> Duke. We have those from Mississippi going to Alabama and Joyce Rudy

> went from remote Arizona to Denver. MangoMan who keeps us entertained

> would love to return to Mexico, but we've lost a member who made a

trip

> back to Mexico and he recognizes the facts of medical exposure and

risks

> enough to realize its not the best place to live with PF.

>

> Mostly, we don't choose where we live based on medical needs but other

> factors led to it long ago. However, two years ago I was contemplating

> where to live and my medical needs were an overriding part of that

> decision and that was before the PF diagnosis. I feel for those who

> can't move and can't get what they need locally. However, I don't want

> us to overlook the fact that some locations just don't have doctors

> expert in PF. As important as research may be and as national

attention

> may be, one thing that is sorely lacking is training within the

> Pulmonology profession in Pulmonary Fibrosis. I'm sorry the answers

> aren't as we wish when some look for medical expertise in their area.

I

> would personally do anything I could to get to the best I could find,

> but that may not be possible for some nor the choice others feel is

> right for them. I do suggest one thing though to those saying they

can't

> travel the distance. Reread Joyce Rudy's story. She sacrificed the

birds

> she loved, made the trips by herself at great expense, and had to beg

> friends to take care of her dogs. She went against the recommendation

of

> her local pulmonologist and made the trip. I remember her lost and

> frustrated. Now I see her upbeat and off to her exercise program.

Likely

> her life has been lengthened. No doubt the quality improved and not

just

> from a physical standpoint. Even more from a comfort and control

> standpoint.

>

August 3, 2009

Excellent commentary, Bruce. I second your recommendation that we each seek the best trained doctors

we can find and afford. I am blessed that I can afford to travel from Maine to NC to see a doctor, and sometime in the near future to actually move there so that I am near to Duke. As Beth would testify,

Dr. on is one of the best. I am grateful that he took me on as a patient when he probably had more that he needed. But privately, I think it was because I made him laugh. Jack79/IPF - UIP/dx06/05 Maine

To: Breathe-Support Sent: Monday, August 3, 2009 1:57:05 PMSubject: Convenient doctors

Sometimes when you're seeking a convenient doctor with expertise,depending on where you live, thats just not possible. Joyce Rudycouldn't find one in her area of Arizona and in fact was being done muchharm by her pulmonologist' s ignorance. Going to National Jewish was ofgreat trouble and expense but she'd tell you today its value. Many ofthese means of finding expert pulmonologists will not give those expertin Pulmonary Fibrosis. However, a good compromise might be finding oneof those for routine help while going to a major ILD center fordiagnosis and treatment. Ideally then they would coordinate with thelocal doctor.I don't have or know of any lists of doctors with PF expertise. I wouldask any doctor how many PF patients does he currently treat and wheredid he gather his knowledge of the disease. Those are very fairquestions. The Pulmonary Hypertension Association actually does have alist

of those expert in PH and since they often work closely with PFdoctors, one might look there and ask them for a cohort. I live in theDallas area and there are only two doctors here who make their list.None of them are in the city I live in, Plano.I use PH as an example because its the information readily available anda disease many of us may face. Here is their find a doctor tool:http://www.phassociation.org/Find_A_Doctor/Unfortunately, there is not an expert PH doctor in West Virginia orSouth Dakota or North Dakota or Wyoming or New Mexico or Idaho and manyother states only have one. Regular Cardiologists are not qualified forPH. Regular Pulmonologists aren't.The same situation exists with PF. I'm not pointing this out to be analarmist, but there are areas of the country you can't find theexpertise you need. If you live in Mississippi, you may have to drive toAlabama or Louisiana.

I drove 900 miles initially for a thorough secondopinion and work up because although there were those with experience inTexas, they weren't yet a Center of Excellence. I suspect those samestates i listed above that don't have PH doctors may not havepulmonologists I would trust to diagnose or recommend treatment plans onPF. Which brings one to a personal decision of choosing a good doctornot properly trained in PF or traveling. Traveling adds time andcertainly expense. I'd recommend the compromise of local maintenanceunder remote expert supervision, but each must make their own choices.We have a member who lives in GA but chose Duke because at the timeEmory wasn't at current levels. Jack Marshall is in Maine and travels toDuke. We have those from Mississippi going to Alabama and Joyce Rudywent from remote Arizona to Denver. MangoMan who keeps us entertainedwould love to return to Mexico, but we've lost

a member who made a tripback to Mexico and he recognizes the facts of medical exposure and risksenough to realize its not the best place to live with PF.Mostly, we don't choose where we live based on medical needs but otherfactors led to it long ago. However, two years ago I was contemplatingwhere to live and my medical needs were an overriding part of thatdecision and that was before the PF diagnosis. I feel for those whocan't move and can't get what they need locally. However, I don't wantus to overlook the fact that some locations just don't have doctorsexpert in PF. As important as research may be and as national attentionmay be, one thing that is sorely lacking is training within thePulmonology profession in Pulmonary Fibrosis. I'm sorry the answersaren't as we wish when some look for medical expertise in their area. Iwould personally do anything I could to get to the best I could find,but

that may not be possible for some nor the choice others feel isright for them. I do suggest one thing though to those saying they can'ttravel the distance. Reread Joyce Rudy's story. She sacrificed the birdsshe loved, made the trips by herself at great expense, and had to begfriends to take care of her dogs. She went against the recommendation ofher local pulmonologist and made the trip. I remember her lost andfrustrated. Now I see her upbeat and off to her exercise program. Likelyher life has been lengthened. No doubt the quality improved and not justfrom a physical standpoint. Even more from a comfort and controlstandpoint.

August 3, 2009

Thank you Bruce,Today i tried to call for an appointment to the UWMC. I couldn't get through. I'll try again tomorrow. I did join the Neptune Society and I got my urn and a book to fill out with information my children will need or want to have. Beverley Joy,71, UIP,NSIP 1-09,Diabetes,Sjogren's,Fibromyalgia IdahoSubject: Convenient doctorsTo: Breathe-Support Date: Monday, August 3, 2009, 10:57 AM

Sometimes when you're seeking a convenient doctor with expertise,

depending on where you live, thats just not possible. Joyce Rudy

couldn't find one in her area of Arizona and in fact was being done much

harm by her pulmonologist' s ignorance. Going to National Jewish was of

great trouble and expense but she'd tell you today its value. Many of

these means of finding expert pulmonologists will not give those expert

in Pulmonary Fibrosis. However, a good compromise might be finding one

of those for routine help while going to a major ILD center for

diagnosis and treatment. Ideally then they would coordinate with the

local doctor.

I don't have or know of any lists of doctors with PF expertise. I would

ask any doctor how many PF patients does he currently treat and where

did he gather his knowledge of the disease. Those are very fair

questions. The Pulmonary Hypertension Association actually does have a

list of those expert in PH and since they often work closely with PF

doctors, one might look there and ask them for a cohort. I live in the

Dallas area and there are only two doctors here who make their list.

None of them are in the city I live in, Plano.

I use PH as an example because its the information readily available and

a disease many of us may face. Here is their find a doctor tool:

http://www.phassoci ation.org/ Find_A_Doctor/

Unfortunately, there is not an expert PH doctor in West Virginia or

South Dakota or North Dakota or Wyoming or New Mexico or Idaho and many

other states only have one. Regular Cardiologists are not qualified for

PH. Regular Pulmonologists aren't.

The same situation exists with PF. I'm not pointing this out to be an

alarmist, but there are areas of the country you can't find the

expertise you need. If you live in Mississippi, you may have to drive to

Alabama or Louisiana. I drove 900 miles initially for a thorough second

opinion and work up because although there were those with experience in

Texas, they weren't yet a Center of Excellence. I suspect those same

states i listed above that don't have PH doctors may not have

pulmonologists I would trust to diagnose or recommend treatment plans on

PF. Which brings one to a personal decision of choosing a good doctor

not properly trained in PF or traveling. Traveling adds time and

certainly expense. I'd recommend the compromise of local maintenance

under remote expert supervision, but each must make their own choices.

We have a member who lives in GA but chose Duke because at the time

Emory wasn't at current levels. Jack Marshall is in Maine and travels to

Duke. We have those from Mississippi going to Alabama and Joyce Rudy

went from remote Arizona to Denver. MangoMan who keeps us entertained

would love to return to Mexico, but we've lost a member who made a trip

back to Mexico and he recognizes the facts of medical exposure and risks

enough to realize its not the best place to live with PF.

Mostly, we don't choose where we live based on medical needs but other

factors led to it long ago. However, two years ago I was contemplating

where to live and my medical needs were an overriding part of that

decision and that was before the PF diagnosis. I feel for those who

can't move and can't get what they need locally. However, I don't want

us to overlook the fact that some locations just don't have doctors

expert in PF. As important as research may be and as national attention

may be, one thing that is sorely lacking is training within the

Pulmonology profession in Pulmonary Fibrosis. I'm sorry the answers

aren't as we wish when some look for medical expertise in their area. I

would personally do anything I could to get to the best I could find,

but that may not be possible for some nor the choice others feel is

right for them. I do suggest one thing though to those saying they can't

travel the distance. Reread Joyce Rudy's story. She sacrificed the birds

she loved, made the trips by herself at great expense, and had to beg

friends to take care of her dogs. She went against the recommendation of

her local pulmonologist and made the trip. I remember her lost and

frustrated. Now I see her upbeat and off to her exercise program. Likely

her life has been lengthened. No doubt the quality improved and not just

from a physical standpoint. Even more from a comfort and control

standpoint.

August 3, 2009

Hello Jack

I have only been in the group for a short time. I have learned so much from everyone sharing information - it is just great.

I also searched for over two years for a good doctor who really knew and understood PF/UIP. How ironic is this - I went to Boston for 18 months but

finally got to Duke in August 2007. I was fortunate to be accepted by Dr. Noble and he is one great doctor. Everyone in Pulmonary seems to be so knowledgeable and compassionate. I travel from Atlanta to Durham every 2-3 months. My next appointment is on Aug. 20.

I just wanted to say hello to you - maybe we will meet at Duke one of these days

Dorothy Reinecke-Fayetteville,GA

UIP-7/05

From: Breathe-Support [mailto:Breathe-Support ] On Behalf Of Jack MarshallSent: Monday, August 03, 2009 3:48 PMTo: Breathe-Support Subject: Re: Convenient doctors

Excellent commentary, Bruce. I second your recommendation that we each seek the best trained doctors

we can find and afford. I am blessed that I can afford to travel from Maine to NC to see a doctor, and sometime in the near future to actually move there so that I am near to Duke. As Beth would testify,

Dr. on is one of the best. I am grateful that he took me on as a patient when he probably had more that he needed. But privately, I think it was because I made him laugh. Jack79/IPF - UIP/dx06/05 Maine

From: Bruce Moreland <brucemoreland (AT) gmail (DOT) com>To: Breathe-Support Sent: Monday, August 3, 2009 1:57:05 PMSubject: Convenient doctors

Sometimes when you're seeking a convenient doctor with expertise,depending on where you live, thats just not possible. Joyce Rudycouldn't find one in her area of Arizona and in fact was being done muchharm by her pulmonologist' s ignorance. Going to National Jewish was ofgreat trouble and expense but she'd tell you today its value. Many ofthese means of finding expert pulmonologists will not give those expertin Pulmonary Fibrosis. However, a good compromise might be finding oneof those for routine help while going to a major ILD center fordiagnosis and treatment. Ideally then they would coordinate with thelocal doctor.I don't have or know of any lists of doctors with PF expertise. I wouldask any doctor how many PF patients does he currently treat and wheredid he gather his knowledge of the disease. Those are very fairquestions. The Pulmonary Hypertension Association actually does have alist of those expert in PH and since they often work closely with PFdoctors, one might look there and ask them for a cohort. I live in theDallas area and there are only two doctors here who make their list.None of them are in the city I live in, Plano.I use PH as an example because its the information readily available anda disease many of us may face. Here is their find a doctor tool:http://www.phassociation.org/Find_A_Doctor/Unfortunately, there is not an expert PH doctor in West Virginia orSouth Dakota or North Dakota or Wyoming or New Mexico or Idaho and manyother states only have one. Regular Cardiologists are not qualified forPH. Regular Pulmonologists aren't.The same situation exists with PF. I'm not pointing this out to be analarmist, but there are areas of the country you can't find theexpertise you need. If you live in Mississippi, you may have to drive toAlabama or Louisiana. I drove 900 miles initially for a thorough secondopinion and work up because although there were those with experience inTexas, they weren't yet a Center of Excellence. I suspect those samestates i listed above that don't have PH doctors may not havepulmonologists I would trust to diagnose or recommend treatment plans onPF. Which brings one to a personal decision of choosing a good doctornot properly trained in PF or traveling. Traveling adds time andcertainly expense. I'd recommend the compromise of local maintenanceunder remote expert supervision, but each must make their own choices.We have a member who lives in GA but chose Duke because at the timeEmory wasn't at current levels. Jack Marshall is in Maine and travels toDuke. We have those from Mississippi going to Alabama and Joyce Rudywent from remote Arizona to Denver. MangoMan who keeps us entertainedwould love to return to Mexico, but we've lost a member who made a tripback to Mexico and he recognizes the facts of medical exposure and risksenough to realize its not the best place to live with PF.Mostly, we don't choose where we live based on medical needs but otherfactors led to it long ago. However, two years ago I was contemplatingwhere to live and my medical needs were an overriding part of thatdecision and that was before the PF diagnosis. I feel for those whocan't move and can't get what they need locally. However, I don't wantus to overlook the fact that some locations just don't have doctorsexpert in PF. As important as research may be and as national attentionmay be, one thing that is sorely lacking is training within thePulmonology profession in Pulmonary Fibrosis. I'm sorry the answersaren't as we wish when some look for medical expertise in their area. Iwould personally do anything I could to get to the best I could find,but that may not be possible for some nor the choice others feel isright for them. I do suggest one thing though to those saying they can'ttravel the distance. Reread Joyce Rudy's story. She sacrificed the birdsshe loved, made the trips by herself at great expense, and had to begfriends to take care of her dogs. She went against the recommendation ofher local pulmonologist and made the trip. I remember her lost andfrustrated. Now I see her upbeat and off to her exercise program. Likelyher life has been lengthened. No doubt the quality improved and not justfrom a physical standpoint. Even more from a comfort and controlstandpoint.

August 5, 2009

Thank you Dyane, I'm doing alright really. I've just been under a lot of stress the last few days. Bob will drive me. He won't mind. I was just used to being married and feeling sorry for myself because I don't have that kind of support now. Bob has taken care of me through several illnesses though. Beverley Joy,71, UIP,NSIP 1-09,Diabetes,Sjogren's,Fibromyalgia Idaho

From: Bruce Moreland <brucemoreland@ gmail.com>Subject: Convenient doctorsTo:

Breathe-Support@ yahoogroups. comDate: Monday, August 3, 2009, 10:57 AM