PF - Nonspecific Interstitial Pneumonia related to autoimmune

Posted by bleo @bleo, May 5, 2018

Hi. I’m 36yo Asian female diagnosed with NSIP 2 years ago related to my autoimmune disorder, which my doctors still unable to find out which type of disorder as they think it hasn’t fully blown out yet. It’s a condition under Interstitial Lung Disease / Pulmonary Fibrosis. I was on 40mg prednisone for about 10 months in 2016 and stopped for about 9 months in 2017 when my condition was stabilized. Then I had an episode of pneumonia during winter in Dec 2017 that got me hospitalized twice, and has made my condition worse with mild pulmonary hypertension. I became more breathless even short walks to the bathroom and during showers.

I’m now back in my own home country where the weather is warm but since the pneumonia, I have started back on 40mg prednisone in Feb and last month, I was also given 500mg Cellcept daily (2 tabs a day) as a steroid sparing agent so I could reduce my prednisone sooner. I’ve been advised by my docs not to travel for work, so I can now only work from home. So I’m now on these two main medication along with my other vitamins.

And I’m also on 24/7 oxygen now too. But it doesn’t really help when I’m moving because of my limited lung capacity that I can’t inhale very deep. What makes me breathless is when I cough really hard from my itchiness of my throat and whenever I needed to expel my mucus. And when I get breathless, my nails turn purple. Both my lower limbs occasionally get numb too and turn pale, which my doc tells me that it’s because I dont have enough oxygen in my body that can cause that to happen.

What scares me now are showers and toilet breaks. There are always risks of getting choked up and out of breaths if I couldn’t hold my coughs. I’ve been reading from researches and posts from others that mild exercise and breathing exercise helps. As much as I want to do so, I don’t like the feeling of coughing and seeing my SpO gets to as low as 80% while doing just slow walks of treadmill and deep inhalation makes me cough.

My question is - is there anyone out there with similar diagnosis (NSIP with autoimmune) and how do you guys cope with your daily activities? Especially in showers, exercises, any kind of life hacks of people like us?

I’m also trying to get onto the transplant’s waiting list and will be meeting my new lung team soon in a few weeks’ time to get the transplant conversation started. In just two years, my condition has deteriorated pretty fast and it’s worrying. Hope to hear from anyone!

Interested in more discussions like this? Go to the Lung Health Support Group.

@bleo

Oh and.. forgot to ask you all @windwalker @penlee do you guys know of anyone or if you have personally experienced this before - involuntary inhalation like short gasps for air, sometimes through my nose, sometimes through my mouth. it happens from time to time for me.. when i sleep or when i'm sitting at rest. i wonder why..

and also, jerky breathing when I walk.

and I could hear my own wheezing sounds during sleep and this only happens after a really tiring day or after I cough really hard.

any thoughts?

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@bleo Omg! You are the only other person I know of that has said that. I mentioned it to my Mayo doctor and he said he'd never heard of such. I have a feeling that some people might be doing it but are unaware, or just don't mention it to their doctors. My husband says he knows when I fall asleep because I toot my horn. LOL.

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@penlee

Hi Bleo, Your NSIP condition seems complicated. I admire your desire to try and improve. Here is where I am now. I have a similar unspecified pulmonary fibrosis probably autoimmune related. Recently one pulmonologist called it Unclassisied PF after no triggering cause has been found and I don’t fit neatly into any category. This has been frustrating but I try not to dwell on it which is hard. I am taking first 5mg now 2.5mg Prednisone and Cellcept (mycophenolate) 1,000mg/day for eight months. It seems to have stabilize my lung changes and I usually feel good, just not as much energy as in the past. Most days I try to exercise by walking with my dog, some breathing exercises and mild yoga and general fitness classes. Coughing and classes can be a problem so a good supply of cough drops help. doTerra (essential oils company) has some that especially help when it is smoky. Also, I use Breathe Easy tea by Traditional Medicine as someone else has mentioned. Very soothing to the throat, cuts the cough. PF seems a bit isolating which I sense in others who post here at Mayo Clinic Connect. When a friend invites me to walk with them I gently decline because I walk so slowly and can’t really talk. It sounds like you are trying to walk a treadmill and do breathing exercises. I feel exercise helps me. My lungs feel more open after exercise (does that make sense?) Keep it up as you can tolerate. Especially if you go for a lung transplant it will keep your muscles in better shape for your recovery. Some months ago another person on Connect recommended a book published in 2017: Ultimate Pulmonary Wellness by Dr Noah Greenspan. I found it very helpful! PF is a tough diagnosis. Thank goodness there are helps/hacks and many encouraging people! I am glad you joined in the discussions.

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Betty, i am happy to hear you found the Ultimate Pulmonary Wellness helpful! May it give you some ideas to help you on this tough journey. I have not had the involuntary breathing difficulties you mention several posts ago. Sometimes I do have wheezing in the morning. Take care.

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@bleo

Oh and.. forgot to ask you all @windwalker @penlee do you guys know of anyone or if you have personally experienced this before - involuntary inhalation like short gasps for air, sometimes through my nose, sometimes through my mouth. it happens from time to time for me.. when i sleep or when i'm sitting at rest. i wonder why..

and also, jerky breathing when I walk.

and I could hear my own wheezing sounds during sleep and this only happens after a really tiring day or after I cough really hard.

any thoughts?

Jump to this post

@bleo Come to think of it, mine hadn't tooted much recently either. Probably because much of my infection has been cleared up. You mentioned your sister. Does she help you with things?

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@penlee

Hi Bleo, Your NSIP condition seems complicated. I admire your desire to try and improve. Here is where I am now. I have a similar unspecified pulmonary fibrosis probably autoimmune related. Recently one pulmonologist called it Unclassisied PF after no triggering cause has been found and I don’t fit neatly into any category. This has been frustrating but I try not to dwell on it which is hard. I am taking first 5mg now 2.5mg Prednisone and Cellcept (mycophenolate) 1,000mg/day for eight months. It seems to have stabilize my lung changes and I usually feel good, just not as much energy as in the past. Most days I try to exercise by walking with my dog, some breathing exercises and mild yoga and general fitness classes. Coughing and classes can be a problem so a good supply of cough drops help. doTerra (essential oils company) has some that especially help when it is smoky. Also, I use Breathe Easy tea by Traditional Medicine as someone else has mentioned. Very soothing to the throat, cuts the cough. PF seems a bit isolating which I sense in others who post here at Mayo Clinic Connect. When a friend invites me to walk with them I gently decline because I walk so slowly and can’t really talk. It sounds like you are trying to walk a treadmill and do breathing exercises. I feel exercise helps me. My lungs feel more open after exercise (does that make sense?) Keep it up as you can tolerate. Especially if you go for a lung transplant it will keep your muscles in better shape for your recovery. Some months ago another person on Connect recommended a book published in 2017: Ultimate Pulmonary Wellness by Dr Noah Greenspan. I found it very helpful! PF is a tough diagnosis. Thank goodness there are helps/hacks and many encouraging people! I am glad you joined in the discussions.

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@bleo Thank you again for the book recommendation. Good to know that it can be read online. I will check it out. BTW do you have an appointment yet for your transplant consult or pre-qualifying tests?

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@windwalker

@bleo Hi there bleo, do you have another name that you prefer to be addressed by? It breaks my heart when I read stories like yours because I know how miserable it feels to deal with lung disease. I was equally as sick as you describe from 2005 until 2013. My lung function steadily dropped year after year and I coughed non-stop. I was told in 2016 that I needed to get pre-qualified for a double lung transplant because my lung function had dropped to 37% and continues to drop. Of course I was terrified. I went through the two weeks of pre-transplant testing and was found not quite bad enough to be listed yet. I have been in treatment with monthly antibiotics for years and I feel a whole lot better and no longer cough. Have you been tested for mac, also known as NTM? It is a bacteria that attacks compromised lungs and compromised immune systems? That may possibly why you are coughing along with your PF. 'Hacks' that I have learned to help cope with lung disease are: Number one thing is try to have a positive attitude, stressing over the disease can make you sicker. I know that that is really hard to do when you are seriously ill, but it is important to practice that because you will need that positivity to get through your transplant. Are there any post-transplant survivor groups near you? There is one on Mayo Connect. I found that gluten, food dyes, scented clothing detergents (especially Tide & Downey) scented candles, air freshners and cold air were BIG triggers that irritated my lungs and brought on phlegm and coughing fits. Find your triggers and eliminate them. I used 'Breath Easy' tea by Traditional Medicine. It contains licorice root and other airway opening herbs. You should ask your dr first if that would be ok for you to drink. I found it was the only thing that would get the elephant off of my chest. Eat enough protein to help keep muscle. Exercise is key, even if it is in little bits. Do it in your chair if it is easier for you. I suggest working on only your arms for example in the a.m. and then leg lifts like marching movement while seated in the afternoon. I find that if I do only parts of the body at a time, then oxygen doesn't have to service all of your muscles at the same time and will help with shortness of breath. Perhaps do your exercises to your favorite music. Fact: exercised muscles use less oxygen than weakened withered muscle. There are great breathing exercises on Youtube. Also, there is breathing yoga techniques as well. I am going to close for now, but I could chat on and on with my experiences and also my mother's. (She had serious lung disease also). I can chat more again with you if you'd like. Feel free to share whatever you are comfortable sharing and ask any questions, we are here for you. Did you say you moved back to your country? May I ask where that is? You will be in my thoughts. Hugs-Terri

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@bleo Hi Betty. I don't think I ever answered you when you asked if I had my lung transplant yet. No, I have not. I got put on the back burner for now, thank God. I am on the referred list. That means I am healthy enough (no cancer or other bad organs) and cleared for a transplant if my lungs take a nose-dive. I have known lung diseases and unknown genetic lung disease. My doctors say that they cannot pinpoint exactly why my lung function keeps dropping a little more each year because my other lung issues aren't so bad that I should have such low function. So, I have to be at the ready just in case. I wanted to share with you that I went to a lung transplant support group for awhile. Those survivors were very inspiring. They are enjoyiing the new lease on life and said they'de do all over again if they had to. Actually, two of the patients are on their second transplant due to rejection. You know, these transplants have come a long way and they are constantly improving the technique. Have faith and courage that things will work out. XOXOOX -Terri

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@bleo Hi Betty. Just want you to know that you are in my thoughts and prayers. Big hug!

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@windwalker

@bleo Hi there bleo, do you have another name that you prefer to be addressed by? It breaks my heart when I read stories like yours because I know how miserable it feels to deal with lung disease. I was equally as sick as you describe from 2005 until 2013. My lung function steadily dropped year after year and I coughed non-stop. I was told in 2016 that I needed to get pre-qualified for a double lung transplant because my lung function had dropped to 37% and continues to drop. Of course I was terrified. I went through the two weeks of pre-transplant testing and was found not quite bad enough to be listed yet. I have been in treatment with monthly antibiotics for years and I feel a whole lot better and no longer cough. Have you been tested for mac, also known as NTM? It is a bacteria that attacks compromised lungs and compromised immune systems? That may possibly why you are coughing along with your PF. 'Hacks' that I have learned to help cope with lung disease are: Number one thing is try to have a positive attitude, stressing over the disease can make you sicker. I know that that is really hard to do when you are seriously ill, but it is important to practice that because you will need that positivity to get through your transplant. Are there any post-transplant survivor groups near you? There is one on Mayo Connect. I found that gluten, food dyes, scented clothing detergents (especially Tide & Downey) scented candles, air freshners and cold air were BIG triggers that irritated my lungs and brought on phlegm and coughing fits. Find your triggers and eliminate them. I used 'Breath Easy' tea by Traditional Medicine. It contains licorice root and other airway opening herbs. You should ask your dr first if that would be ok for you to drink. I found it was the only thing that would get the elephant off of my chest. Eat enough protein to help keep muscle. Exercise is key, even if it is in little bits. Do it in your chair if it is easier for you. I suggest working on only your arms for example in the a.m. and then leg lifts like marching movement while seated in the afternoon. I find that if I do only parts of the body at a time, then oxygen doesn't have to service all of your muscles at the same time and will help with shortness of breath. Perhaps do your exercises to your favorite music. Fact: exercised muscles use less oxygen than weakened withered muscle. There are great breathing exercises on Youtube. Also, there is breathing yoga techniques as well. I am going to close for now, but I could chat on and on with my experiences and also my mother's. (She had serious lung disease also). I can chat more again with you if you'd like. Feel free to share whatever you are comfortable sharing and ask any questions, we are here for you. Did you say you moved back to your country? May I ask where that is? You will be in my thoughts. Hugs-Terri

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@bleo Betty, are there good medical centers there in Malasia that have good reputations for lung transplants and good outcomes?

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@windwalker

@bleo Hi Betty. Just want you to know that you are in my thoughts and prayers. Big hug!

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@windwalker Hi Terri! Always nice to get your messages! Thanks for thinking of me, Terri. 🙂

To be honest, in Malaysia there aren't many transplant procedures done before especially lung transplants. Liver and kidney transplants are probably more. Also because we don't have many organ donors. I sure hope in the future, more people will be aware of this.

Yes! I managed to get an appointment with my new lung doctor next Friday (referred by one of my lung doctors) at a National Respiratory Unit. It's also a National Transplant Centre. So blessed! I really hope to be eligible for the pre-qualifying tests and fingers crossed I can get on the waiting list too during this visit. Not sure what the procedures are.... and I'm also trying not to get my hopes up too high. But I'm hopeful! At least I'm one step closer...

How are you doing there? Have a great day ahead Terri! xx

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@bleo It is important to be very picky about who does a lung transplant. It is the most delicate of surgeries there is. Some peope don't survive the operation, some die within a year after. Where you have one done matters. Do you want me to look into international patient transplant for you at Mayo?

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@bleo I will keep you in my prayers that your visit next Friday is a positive one. Sending you many hugs. -Terri

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