Srivatsa Lokeshwaran’s Post

Transcript

Hi, I'm doctor Shiva Ishwaran. I'm a consultant interventional pulmonologist and lung transplant physician at Astor Whitefield Hospital. Today, let's talk about lung fibrosis or pulmonary fibrosis or otherwise called as interstitial lung disease and many other terminologies in other ways. Some patients come to me telling that they have lung scarring, yes, so basically. What it means is there is a wall between the blood vessels in the lung and the oxygenation system in the lung, which becomes thicker and thicker because of various causes. Now what causes lung scarring? Most of us know that certain types of infection, especially more pronounced after the recent COVID pandemic that most people come in with. Some amount of lungs carry well, not only infections. The most common type of lung scarring is because of an idiopathic. Or unknown cause called idiopathic pulmonary fibrosis. Exposure to bird feathers and pigeon droppings can also cause some lung scarring. Certain types of fungus can cause lung scarring called as hypersensitivity pneumonitis and we have some of our patients or relatives who suffer through autoimmune diseases like arthritis or something else which is causing thickening of your skin like Scleroderma who present with thickening in the wall between the blood vessel and the oxygenation. System and most of these patients present to us pretty late with a lot of breathlessness cough that is very disturbing, unable to perform their daily activities with the limitation and not knowing what to do with their life. So how do we do manage these patients at Astor Whitefield. So we have a multidisciplinary team here with our radiologist, the rheumatologist, myself and other aligned physicians who will sit and work through your case to understand. First, what exactly is causing your disease and then we run you through a panel or battery of tests to conclude or zero in on what is causing that type of scarring. Once we understand your scarring then comes to the question whether you need a biopsy from the lung. Well rest assured that we have done these procedures many at times and having a lung biopsy is far more simpler nowadays minimally invasive where we put in. Bronchoscope or a camera right down your breathing tube and in the comfort of the patient under anesthesia, we take out very tiny bits of your lung and send it to the pathologist will help us with what type of diagnosis we arrive at. Now, how do we treat or you know, optimize the medication in patients who have lung scarring? The first and foremost is to understand what type of problem you have, and there are various classes of medicines, some that reduce the rate of scarring in the lungs. Some that are able to reverse it completely if come early and also optimizing oxygen. We also have our physiotherapist who helps in rehabilitating these patients and of course our aligned specialties like rheumatology, radiology and also in some cases we enter the question whether this patient requires a lung transplant. Well at Astor Whitefield we have enough experience to offer lung transplant in our patients who are terminally ill. His lung scarring can no more be reversed and who requires a new set of locks. So for any such queries, reach out to us at Astor Whitefield Hospital. The Department of Pulmonology will be glad to help. Thank you.