Hello doctor, My mother is 68 years old. She has been diagnosed for lung fibrosis she was taking Lumenac 600mg three times, Iveprid 10 mg for last years, no progression in disease but her saturation was 90 later fell to 60 on excretion. Now she is taking Pirfenex 800 mg a day, and Benz for cough her saturation is 84 while sitting and 65 while walking she is on two lpm oxygen also her feet and face is swelling, but her echo test is normal. We like to know the below questions, 1. Why is her feet and face swelling? 2. Can she take both Lumenac and Prifenex together? 3. Her PFT test is excellent, but still, saturation is not returning. 4. Her X-ray shows only each lung is 35 % white shading rest looks black. Please help.
Hello. After going through your history, it is obvious that your mother is suffering from IPF (UIP). She is taking Ivepred 10 and Lumenac 600 mg for the last two years. Swelling on face and legs could be because of the steroid side effects as she is on long term Ivepred. You said her X-ray shows white shadows and her PFT is within normal limits. For your information, IPF is a chronic progressive lung disease. Though she is started on Tab, Pirfenex it will not convert the fibrosed lung to normal. It is only to save the remaining lung from further damage (Fibrosis). Now the question is can she take Lumenac and pirfenex together. Yes, She can take both the tablets together. Next issue is about her saturation. As the damaged lung is not capable of coping up ventilation, her baseline resting saturation is remaining good, but on exertion, it is getting down because of decreased lung function due to fibrosis. The only way to maintain saturation throughout any activity is to supplement oxygen from outside.It should be given two lpm to maintain saturation above 90 %. Intermittently it should be checked in the hospital by doing ABG that is arterial blood gas. Overall she should continue tablet Pirfenex (Pirfenadone) and Lumenac (Acetylcysteine and supplemental oxygen as required. Try to avoid steroids as they have their sets of side effects.