Do I need to see a specialist?

[wjgoode]

Three years ago I was diagnosed with mild COPD.  I was a stay-at-home Mom and have never smoked but my father smoked 4 to 5 packs of Camels a day and I lived in that environment for 18 years.  At that time I was experiencing SOB occassionally while climbing the stairs.  My PFT's where normal with a mild abductive component.  In December I had a second chest x-ray which shows slight fribrosis in left costophrenic angle.  My chest is otherwise normal and normal heart size vascularity.  My most recent PFT still shows a normal value.  

I had this second x-ray because SOB has increased and I feel breathless at times while sitting in a chair.  I noticed this change about 7 months ago and it is slowly getting worse.  I use albuterol with a spacer when I exercise and have had to use it 2 other times in the last 6 weeks because I felt so short of breath.  I have been in a Pulmonary Rehab Maintenence program for the last 6 weeks and easily become short of breath while exercising on the bikes or elliptical machine.  The oxygen level in my blood at rest is 99.  At my last visit with my internist, I questioned him about the 'scarring' he reported to me when he told me the results of my x-ray.  He says I have idiopathic pulmonary fibrosis and there is some wheezing in my left lung.  I have not had a CT scan or any of the other advanced testing recommended for a diagnosis of IPF.  I will be 60 in July.
  
Should I be seeing a specialist for further testing and possible treatment or should I wait until I'm showing a decline in my pulmonary function.  My doctor has not mentioned sending me to anyone for further treatment.

[Sunny602]

I would definitely see a specialist, especially if there is consideration that you may have IPF. You need to have imagining (CT scanning), possible biopsy etc...for an accurate diagnosis. I have also read that there are different types of pulmonary fibrosis with different treatments., more of a reason to see a specialist. I am not a doc, this is just my opinion. Push for that specialist referral. Sunny

[wjgoode]

Thanks, Sunny!  I have been so anxious about this and just haven't know how to approach my doctor.  We don't have any pulmonologists (or other specialists) in our area so I think he usually treats his patients himself.  He's a good doctor--just a little old-fashioned.  I've done a lot of reading on the internet and what I have read doesn't sound at all encouraging.  I'll keep my progress posted.

WGoode

[Sunny602]

Please do keep us posted. I live in a pretty rural area that doesn't have many specialists. I have some major lung issues as well as other problems that are definitely more than the local doctor can bite into so I do travel pretty far to see the specialists that I need. I would go to a university type of setting as far as finding a specialist in IPF. Like I said, there are different types of IPF, it is important to get the right diagnosis and treatment.
Oftentimes, asking the doctor for help in finding the right specialist is helpful as well as searching online. Keeping you in my thoughts...Sunny