My name's Dr. Jim Allen.
I'm a pulmonary and critical care physician
at the Wexner Medical Center at The Ohio State
University.
I'm also a professor of internal medicine
at Ohio State.
The focus of my outpatient practice is in
interstitial lung disease.
And interstitial lung diseases are a large
group of about a hundred and fifty different
diseases that are all brought together by
having inflammation, or scarring or both in
the lungs.
And these are a rare group of diseases that
can be very similar appearing to each other
and so it really requires a very careful and
multidisciplinary evaluation of these patients.
My own general approach to patients with interstitial
lung disease is to start off with a careful
history and physical examination and then
do additional laboratory testing, pulmonary
function testing and high resolution CAT scanning.
When we talk about the inflammation and scarring
in the lung in interstitial lung disease,
the best way to see that early on is really
with imaging like a chest x-ray or a CAT scan.
And in that situation you can actually see
the inflammation and the scarring within the
lung tissues themselves.
Now sometimes you can't tell how much is scar
and how much is inflammation just on the CAT
scan and that's why a surgical lung biopsy
is sometimes necessary.
With interstitial lung disease it's really
important to establish a confident diagnosis.
Now sometimes we can do that just with the
outpatient testing, but in other patients
we have to do a surgical lung biopsy, which
requires admission to the hospital.
After the biopsy we'll present our patients
at our multidisciplinary interstitial lung
disease conference where we get the lung specialists,
the pathologists and the radiologists all
in one room so that we can talk amongst each
other and really come up with a confident
consensus diagnosis of what the patient actually
has.
After that we then see the patients back in
the office and can work out a treatment plan
that's unique and specific to that person's
diseases.
And since there's about a hundred and fifty
interstitial lung diseases that can involve
a lot of very different treatment plans.
Some of the interstitial lung diseases are
more severe and they can even be fatal.
But we do have medications that can slow them
down and improve the quality of life and often
improve the duration of life.
For many patients with interstitial lung disease
we can offer them lung transplantation if
they otherwise meet the criteria for transplant.
One of the exciting things about caring for
patients with interstitial lung disease at
Ohio State is that we also have access to
a lot of clinical trials.
And these are experimental medications that
wouldn't necessarily be available through
your regular pharmacy but offer a lot of hope
for treatment for the patients who come down
with interstitial lung disease in the future.
So we really have a fairly comprehensive program
for interstitial lung diseases here at Ohio
State and we really think that having the
research component of it gives our patients
the best chance for not only standard treatment,
but also for the cutting edge, new, possible
treatments that are in the future.
Interstitial lung diseases can present with
really very nonspecific symptoms.
So cough and shortness of breath are often
the main symptoms and patients can have those
same symptoms with many forms of of lung disease.
Some of these diseases can be inherited, some
of them are acquired, some of them can be
occupationally related like asbestosis or
silicosis.
So it's really important to take a careful
history that is going to include the family
history, the occupational history, any recreational
exposures, pets, travel history, medications,
all of those can sometimes be related to the
ultimate diagnosis.
In being an interstitial lung disease doctor
is often a lot like being a detective and
you have to take all the clues and put them
together.
And it often takes several detectives in one
room to really come up with a confident diagnosis
and that's why the pathologist and the radiologist
can be just as important as the pulmonologist.
