Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Respiratory Disorders (Expert Forum)
NSIP
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
NSIP
by AAAHUbbard, May 07, 2003 12:00AM
I have been diagnosed with NSIP and a lung transplant has been recommended. Within the 3 months I need to use oxygen 24/7 on levels 4-6 during activity and 2 while sleeping. I use Prednisone (15 mg) and Imuran (150 mg). When I used higher doses of Prednisone (30-40) I did not experience the extreme shortness of breath like I do now with the tapering. Why can't I stay on higher doses if it makes me feel better? Also, what causes me to desaturate so rapidly while walking or exerting my self? It is not uncommon for me to drop in low 70's and gasp for breath when doing even mild activities, which then starts me with a hard and dry cough?
Thank you.
Art
Thank you.
Art
Doctor's Answer
by National Jewish, May 08, 2003 12:00AM
, May 08, 2003 12:00AM
Non-specific interstitial pneumonitis (NSIP) is one type of interstitial lung disease (ILD). This causes inflammation that leads to scarring of the lungs in the area between the air sacs and the blood vessels. It may be due to toxic fume exposure, lung infection, or connective tissue disease such as arthritis. Most of the time it is not possible to determine exactly what has damaged the lungs. The most common symptoms are shortness of breath with activity and a dry cough. Please read our Interstitial Lung Disease MedFact at http://www.nationaljewish.org/medfacts/interstitial.html for further information. You are welcome to share this information with your doctor.
Steroids like prednisone are frequently the first medicine used. They need to be started early, before the inflammation has become scar tissue. For some people, steroids will help decrease the inflammation so it doesn't become scar tissue. This will cause a dramatic improvement in symptoms as you have noticed with your shortness of breath. However, some people have only slight improvement with steroids. It can take at least 3 months of steroids to begin to see improvement. The response to steroids is related to the type of ILD and the amount of inflammation present. Although the chest x-ray is usually abnormal, it takes a lung biopsy to be certain of the type of ILD. The goal of treatment is that there will be less inflammation or at least no further scarring. This is measured by a follow up chest x-ray, exercise tests, and pulmonary function tests. As soon as possible the steroid dose is decreased to avoid side effects. Many side effects are possible from steroids. Please read our Corticosteroid MedFact at http://www.nationaljewish.org/medfacts/corticosteroid.html for further information about the side effects and their prevention. Talk with your doctor about preventing and watching for these side effects.
Sometimes adding other medicines, like Imuran® (azathioprine), make it possible to decrease the prednisone dose and still control symptoms. Since your shortness of breath in worsening, please check with your doctor to see how your treatment should be adjusted.
When enough of the lung is affected by ILD you may desaturate. This means that the oxygen saturation of your blood drops below 90%. Desaturation is more likely to happen when you’re active rather than when you’re just sitting. Even mild activity can cause a rapid drop in the oxygen saturation. Supplemental oxygen is used to try to keep the oxygen saturation as close as possible to 90%. Being at sea level may improve the oxygen saturation so that it doesn’t drop as rapidly.
Pulmonary rehabilitation is a program to bring back your quality of life through aerobic exercise done on a regular basis. When done routinely, this conditions the entire body so that the muscles are working as efficiently as possible. This allows the breathing muscles to use the least amount of energy and oxygen to move air in and out of the lungs. Over time this helps to lessen shortness of breath. Some programs will also include education about your lung condition and nutrition. Please read our Pulmonary Rehabilitation MedFact at http://www.nationaljewish.org/medfacts/pulmonary.html for more information. Share this information with your doctor to see if this would be helpful and where in your area there are programs.
Steroids like prednisone are frequently the first medicine used. They need to be started early, before the inflammation has become scar tissue. For some people, steroids will help decrease the inflammation so it doesn't become scar tissue. This will cause a dramatic improvement in symptoms as you have noticed with your shortness of breath. However, some people have only slight improvement with steroids. It can take at least 3 months of steroids to begin to see improvement. The response to steroids is related to the type of ILD and the amount of inflammation present. Although the chest x-ray is usually abnormal, it takes a lung biopsy to be certain of the type of ILD. The goal of treatment is that there will be less inflammation or at least no further scarring. This is measured by a follow up chest x-ray, exercise tests, and pulmonary function tests. As soon as possible the steroid dose is decreased to avoid side effects. Many side effects are possible from steroids. Please read our Corticosteroid MedFact at http://www.nationaljewish.org/medfacts/corticosteroid.html for further information about the side effects and their prevention. Talk with your doctor about preventing and watching for these side effects.
Sometimes adding other medicines, like Imuran® (azathioprine), make it possible to decrease the prednisone dose and still control symptoms. Since your shortness of breath in worsening, please check with your doctor to see how your treatment should be adjusted.
When enough of the lung is affected by ILD you may desaturate. This means that the oxygen saturation of your blood drops below 90%. Desaturation is more likely to happen when you’re active rather than when you’re just sitting. Even mild activity can cause a rapid drop in the oxygen saturation. Supplemental oxygen is used to try to keep the oxygen saturation as close as possible to 90%. Being at sea level may improve the oxygen saturation so that it doesn’t drop as rapidly.
Pulmonary rehabilitation is a program to bring back your quality of life through aerobic exercise done on a regular basis. When done routinely, this conditions the entire body so that the muscles are working as efficiently as possible. This allows the breathing muscles to use the least amount of energy and oxygen to move air in and out of the lungs. Over time this helps to lessen shortness of breath. Some programs will also include education about your lung condition and nutrition. Please read our Pulmonary Rehabilitation MedFact at http://www.nationaljewish.org/medfacts/pulmonary.html for more information. Share this information with your doctor to see if this would be helpful and where in your area there are programs.
