Living with Pulmonary Fibrosis

Toxic habits. The exposure to tobacco smoke, as well as other lung toxins (from heavy metals, from wood dust, or from occupational activities with livestock and agriculture), are related to the development of pulmonary fibrosis. There are currently several effective methods available for quitting the tobacco habit, as well a support groups, that are achieving high success rates. In the cases of work activity related to exposure to toxins, protection measures are advised (face masks, isolation methods), as well as adapting the work environment or changing the activity for other tasks without exposure. 

Diet. To follow a healthy and balanced diet helps to maintain a suitable weight. The patients must follow a varied diet that includes carbohydrates, fruit and vegetables, as well as protein of animal origin, and dairy products. The consumption of saturated fats, oils, salt and sugar, should be avoided or limited. It is also advisable to eat meals in small amounts distributed throughout the day instead of eating less and much larger meals. The shortness of breath in these patients may be aggravated with the abdominal distension and the secondary displacement of the diaphragm. If symptoms of gastro-oesophageal reflux appear, which is common in patients with interstitial lung diseases, antacids may be added to the pharmacological treatment, as well as recommending postural measures.  

Exercise. It is advisable for all patients with chronic respiratory disease to perform regular aerobic exercise adapted to the situation of each patient. It will allow them to keep in physical shape, as well as to increase their personal well-being, to reduce the feeling of baseline dyspnoea, and to improve tolerance to effort. The patients may also take part in respiratory physiotherapy groups within specialist centres with lung rehabilitation programs designed for teaching breathing techniques to help control the symptoms of the disease, as well as to promote social interaction between the patients.  

Rest. Patients with respiratory disease can present desaturation during the night due to the physiological relaxation of respiratory musculature during sleep, as well as elevation of the diaphragm when lying down on the back. If there is desaturation, it may be advisable for oxygen therapy to be prescribed in order to ensure correct oxygen supply to the body during the night.  

Healthy rest contributes to decrease daytime drowsiness, increase the capacity to maintain attention and correct productivity, improve mood, as well as regulate physiological parameters like blood pressure and heart rate, among others. 

Sexuality. Like all physical activity, the practice of sex relations may be limited due to the symptoms of the respiratory disease itself, like exertional dyspnoea and chronic cough. It is advisable to take contraceptive measures in patients taking anti-fibrosis drugs (pirfenidone, nintedanib), since animal studies have shown possible embryonic toxicity (may cause miscarriage, defects at birth or problems of development).  

Travel. When travelling in an airplane, it should be taken into account that the amount of oxygen in the environment decreases at a higher altitude. Patients with chronic respiratory disease may note greater difficulty in breathing during a high altitude flight, particularly in long-distance journeys. This could give rise to symptoms like general discomfort, dizziness, dyspnoea at rest, and a feeling of tightness of the chest. For this reason, it is advisable to consult the medical team beforehand in order to determine the need for supplementary oxygen therapy during the journey.  

Social and emotional support. The disease has a significant impact on social and emotional aspects of the patients and their families. Psychological and emotional support services from hospital centres are recommended. It is also advisable to participate in pulmonary fibrosis family and patient associations, where common experiences may be shared between patients and offer mutual support in difficult situations. Various sessions and informative activities can be organised from these associations that could contribute to create social links and improve the emotional situation of the patients.