Resolved question:
Hello,
My 79 year old mother was diagnosed with pulmonary fibrosis 9 months ago. She chose not to have a lung biopsy. Until the diagnosis, she was an active and heathy woman with no other health issues except osteopenia. She was a smoker but quit 27 years ago. She is currently on 2 L O2 for all ADLs and when sleeping.
In the past 2 months I have seen her decline rapidly. She has a dry cough, little appetite, fatigue and elevated pulse. She uses her pulse oximeter and stays @ 95% but her heart pounds with activity. She has no edema in her legs/ankles.
I'm not asking you to look in a crystal ball, but based on this information and how rapidly the disease seems to be progressing, would you be able to give me a rough estimate of how much time she has left?
Thank you
Submitted:
4 Days
Category:
Pulmonologist
Hello,
Thank you for your question at DoctorSpring.com. I understand your apprehension, and almost can feel the emotions that might be going through your mind, to see your mother in this condition.However, Pulmonary fibrosis is a vague term that can be caused by a myriad of things. Hence i am not sure about the clarity of the answers i am providing.
Was it mentioned as pulmonary fibrosis alone or as Idiopathic pulmonary fibrosis?
Was an echo done? What about a lung CT scan?
Was there any comment on Pulmonary hypertension in any reports?
How much can she walk on a straight ground with / without oxygen?
Is the sat of 95% with 2 litre oxygen or on room air? Does it remain so even after minimal exertion? If no, till how low does it fall?
The prognosis of the same can be anticipated if we have other reports such as Fev1, DLCO capacity etc.
History of smoking, old age and pulmonary fibrosis - altogether doesn't seem to be a good combination. They are prone for an acute exacerbation of symptoms at any time which will steepen the downward slope of graph.
The very best patient of this diagnosis(in early 60s, no comorbidities, normal echo report ) may have a 76% chance to survive 1 year and approximately 30 % chance to survive 3 years in the absence of exacerbation. However, at the other extreme, the chances remain as grim as 40% mortality in 1 year and almost 80% mortality in 3 years. The mortality however is affected by many factors such as depression, any exacerbation, pre-existing cardiac status, and age. And without the information i have asked, if i answer any thing, i fear it will be worse than a crystal ball! Kindly provide further details so that i may be able to help you out.
Regards
Dr.Jacob George P
MD, FCCP