Pneumonia or COPD or Pulmonary Fibrosis?

During my visit with dad today, I got to talking with the nurse he has had the past two days.  I told her that I had prepared some questions for the doctor and wanted to know if she could get them to the doctor to review since I keep missing him/them.  She said that she could and I gave her a copy of the questions.  This sparked a conversation that left me with more questions and more confused about what the heck is going on with dad.

The nurse was saying that one of the pulmonary specialists that make the rounds came by to see dad.  Apparently he came to the conclusion that dad has some sort of infection in his lung.  Really?  Nine days on antibiotics and you waltz in with that sort of statement?  In addition to this shocking and revealing diagnosis, which by the way I could have done myself for a lot less money, we started hearing some new terms thrown around.  Terms like COPD and pulmonary fibrosis.  We also got bits of information that suggested either he never had pneumonia or the pneumonia was been cleared up.  My head is spinning with all the strange information I am getting.  Mind you this information is coming by way of a nurse (a very wonderful nurse I might add) and a patient who frankly has a hard time recalling who he last talked to and whether or not that conversation happened in person or over the phone.

So, lets assume for a moment that the words I am hearing are correct.  COPD is a blanket term for a condition that includes one or more diseases.  It consists of Emphysema, Chronic Bronchitis, Refractory Asthma, and/or Bronchiestasis.  Since none of these terms has been mentioned, I do not know in what context COPD is being referred. I will need to ask more questions about this COPD thing as it relates to dad’s condition.  The term pulmonary fibrosis makes sense when thinking about what dad has experienced, as it is a term that literally means scarred lungs.  Common causes of pulmonary fibrosis include chemotherapy and radiation, both of which dad has experienced.  The scary thing about this disease is that there is no cure and it progressively gets worse until it kills you (usually within five years).  Diagnosis of this disease usually requires a lung biopsy, so I am just a tad skeptical about this term being used in relation to my father until a bronchoscopy and biopsy are performed.  Though, I am not clear if this procedure could be performed on someone in my father’s condition.  Yet another set of questions to ask.

As for the pneumonia part of this story, I am equally confused because in one instance it is being suggested that he no longer has pneumonia and in another there seems to be some question of whether he ever had it.  I suppose in all likelihood, he did indeed have pneumonia and that is now cleared up, making way for the COPD and/or pulmonary fibrosis diagnosis.  The story gets a little more involved when you consider that pneumonia is a misleading term.  When you break pneumonia down by causes rather than just the blanket term, things become a little more clear.  Pneumonia (in general terms, an inflammation of lung parts) is broken down into infectious pneumonia (caused by viruses, bacteria, fungi and parasites) and non-infectious pneumonia.  Non-infectious pneumonia, also known as idiopathic interstitial pneumonia is a whole other branch of various diseases including usual interstitial pneumonia which is characterized by fibrosis (scarring) of the interstitium of the lung.  When the cause of the scarring is unknown it is called idiopathic pulmonary fibrosis.  Sounds like a chicken and egg thing to me.  Was pulmonary fibrosis caused by radiation and/or chemo and contributed to the development of pneumonia or did pneumonia cause the pulmonary fibrosis?

Seeing as how I am just an armchair quarterback when it comes to my father’s medical woes, I guess I will just need to come up with questions and rely on the doctors to answer them.  However, I have a better appreciation now for how confusing this all gets, even for the doctors.

My concern at this point is that these new terms are coming up for a specific and possibly sly reason.  I hope that my gut is wrong here, but I can see a scenario whereby the hospital can say there is nothing more that they are able to do for him and that leads to them discharging him into a care facility that would be focused on trying to get him well enough to come home on an oxygen and steroid (keep in mind that the generic term is inflammation in the lungs and inflammation is usually treated with steroids) treatment.  Diagnosing him with some form of pulmonary fibrosis also clears the hospital of malpractice when there is a recurrence of pneumonia.  I hope they have his best interest at the forefront and are not getting to the point where they toss up their hands, put some generic label on it and call it a day.  I am not sure how either mom or dad are going to get through this if there is no ‘curing’ dad.  I suppose we will just have to see if I am wrong about where this is all headed.  I certainly hope I am wrong.

After all that long winded garbled mess above, I should point out that today was my father’s birthday.  Happy seventy-sixth to you pop!  I know that spending your birthday in the hospital is not really how anyone wants it to go, but that is just our reality at the moment.  We made it the best we could though.  His room is decorated with some mylar balloons and a couple bags of goodies from family members.  Dad also got several phone calls from friends and family wishing him a happy birthday.  To those of you that did call him, THANK YOU, it really made his day.  To those of you still afraid to call him… get over it and call.  He ain’t doing much but lying in a bed and mulling over how bad things are, so brighten his day and call him 🙂

Well I think that sums up the day.  We shall see what fun stuff tomorrow brings!