Good Oxygen levels with cronic HP

[Pat2398]

When sleeping my oxygen levels fell to 88% for 3 minutes and 89% for 6 minutes.  I was put on oxygen to sleep by my primary pulmonary doctor.  Upon going to the University of Michigan  for my 6 months follow up visit with a specialist there he suggested I did not need oxygen to sleep and suggested it could do me more harm than good at this point in my disease.  The diagnosis of HP rather than UIP was determined by a team of patholigist and pulmonary specialist at the University of Michigan.  My primary pulmonary doctor dismissed their diagnosis and said he felt I had UIP.  My primary pulmonary doctor has been out of college about 3 years and was trained by the doctors who evaluated my case and he referred me to them, but refuses to accept their diagnosis.   The doctor from the U of M is sending my primary doctor his views and suggestions and I will be seeing him in May.  Do you think I need to find a new pulmonary doctor in my home town?

[National Jewish Health]

If the oxygen desaturation and duration of it were the only abnormalities during a full night’s sleep, then you almost certainly do not need to use supplemental oxygen at night.  You should discuss this with your pulmonary doctor and ask about his rationale for prescribing the oxygen.  Low-flow oxygen is very unlikely to cause any harm.

The distinction between hypersensitivity pneumonitis (HP) and usual interstitial pneumonitis (UIP) should, with rare exceptions, only be made on examination of an open lung biopsy.

Clinicians and pathologists can honestly disagree about the diagnosis, some of the time.  I suggest that you have the University of Michigan send you their views and suggestions and you then send it to us.

I would not recommend that you find a new doctor.  I suggest that you await the report reaches your doctor and then discuss it with him.

Good luck.

[Pat2398]

I did have a lung biopsy; and the original slides and a Lung Scan were  available for the doctors and pathologist at the University of Michigan when they made their diagnosis.  I have a report from the U of M as does my Pulmonary Doctor.  The only problem is my Pulmonary Doctor in my home town doesn't agree with their diagnosis and he was the one who referred me to the U or M.  

The following is the report my pulmonary doctor received from the U or M. and I received a copy also.

Reviewed at ILD conf.  CT with Lower more than upper ground glass with some consolidation and no honeycomb.  Pathology with a chronic interstitial pneumonia, airway centered, lymphocytic bronchiolitis.  No granulomas.  Fit better with chronic HP rather than UIP.  

Thank you for your opinion in this matter.

Pat