FEV1

Question

Hello,
I am a 46-year-old CF woman and my FEV1 has decreased after a pneumonia, that has been treated for 4 weeks with an i.v. cure because of Pseudomonas, about half of the value from 52% to 28% and I still need oxygen, two months after discharge from the hospital, in spite of the fact the physician tells me, the CT would not look bad. It is not clear to me, how this could happen so fast. What happens to the lung? How can I now work-up the FEV1 again and how do I get away from the oxygen?
Many thanks for your efforts, best regards,
S.

Answer

Dear S.,
you want to know, why your health status after a pneumonia has not been returned to the former condition yet with all measurable values (here lung function test and blood gas analysis) and what you can do against this.
A pneumonia, in your case with high probability caused/complicated with Pseudomonas aeruginosa, can (as you experienced yourself) lead to a marked deterioration of the health status with decrease of the lung function and worsening of the blood gases. A remaning deterioration after such a strong airway infection can not be excluded.
With a corresponding treatment (like it has been done in your case): Pseudomonas aeruginosa-effective, intra-venous antibiotic therapy, oxygen therapy and with high probability also supportive therapy (e.g. broncho-spasmolytic drugs, mucolytic drugs, physiotherapy, much physical exercise, nutritional therapy etc.) it is in general possible to control the inflammation and the health status is improving and returns to the status before. A full regeneration however, can take "a bit" more time and here patience but also further therapy is necessary. You have for sure already heard, that after severe pneumonias in-patient rehabilitation measures are following in order to support the healing process. Not always it has to be an in-Patient rehabilitation, however a more intensive basis therapy is probably necessary for you. Details about this have to be discussed with your treating CF physician. Chek together with your physician at what point your "routine"-therapy can be intensified. An in-patient rehabilitation can of course also be considered.
Yours sincerely,
Yours,
Dr. med. Christina Smaczny

17.02.2014