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Shortness of breath. A persistent cough or chest congestion. Unexplained fatigue and weight loss. Any of these symptoms can be a sign of lung disease. Because there are many different lung disorders, accurate diagnosis can be challenging.

The advanced lung disease experts at the Froedtert & the Medical College of Wisconsin health network can pinpoint the problem and make breathing easier.

“People concerned about a lung or breathing problem can start with pulmonologists available across our network,” said Julie Biller, MD, pulmonologist and MCW faculty member. “Additionally, many of our pulmonologists further specialize in pulmonary medicine for conditions such as interstitial lung disease, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and lung transplant.”

The Froedtert & MCW team offers a depth of experience and expertise in diagnosing and treating the major lung diseases. Many different components go into lung disease treatment and diagnosis within the Froedtert & MCW health network.

“We offer all of the cutting-edge therapies, including clinical trials and lung transplant,” said Alan Betensley, MD, pulmonologist, medical director of lung transplantation and MCW faculty member. “Patients with severe lung disease don’t have to figure out what to do next, except know that we provide optimal diagnostic and treatment approaches.”

Interstitial Lung Disease

This large group includes disorders that produce inflammation in the mesh-like tissue around the air sacs of the lungs. It can lead to scarring that restricts the flow of oxygen into the bloodstream.

“There are a variety of causes for interstitial lung disease,” said Mark Barash, DO, pulmonologist and MCW faculty member. “They include ‘idiopathic,’ meaning the cause is unknown; environmental factors like asbestos and silica dust; inhalation exposures; chemotherapy, chest radiation and a variety of medications; and autoimmune disease where the body’s immune system attacks organs like the lungs.

“Our approach is highly individualized. We begin with a detailed history and physical, get high-resolution chest images and do breathing and blood tests. Research shows that academic medical centers like ours that see more people with pulmonary issues and discuss cases with multidisciplinary teams are generally able to make a more accurate diagnosis.”

This type of lung disease treatment can include steroids to reduce inflammation, antifibrotics to slow down progressive scarring and medications to suppress the body’s immune response. Additionally, as researchers, our team is continually studying new medications that can help patients with advanced lung disease, and we participate in national and multicenter clinical trials.

“Many of these lung conditions continue to progress and can be life altering or life ending,” Dr. Barash said. “For the most common interstitial lung disease, idiopathic pulmonary fibrosis, lung transplant is the most effective therapy for long-term lung function improvement and survival.”

Cystic Fibrosis

A genetic disorder, cystic fibrosis prevents an important protein from functioning correctly, resulting in the buildup of abnormally thick mucus in the sinuses, lungs, pancreas and bile ducts. It can cause frequent lung infections, damage the airways and obstruct breathing. The most severe cases may require lung transplant.

New medications are increasing life expectancy and reducing the need for transplant. “These options include drugs that improve protein function and the health of people with cystic fibrosis,” Dr. Biller said.

Additionally, Froedtert & MCW physicians are continually involved in national research studies to evaluate the newest medications aimed at helping those with cystic fibrosis, including options to reduce patients’ need for at-home inhalation lung disease treatments.

COPD

COPD is a broad category of inflammatory conditions that constrict airflow out of the lungs. Most commonly, it refers to emphysema and chronic bronchitis.

“Both are related to the cumulative effect of smoking,” Dr. Betensley said. “If people quit smoking early, they don’t develop COPD.”

While uncommon, COPD and emphysema can also be caused by environmental lung irritants or genetics.

One of the newest treatments is bronchoscopic lung volume reduction (BLVR), a minimally invasive procedure that places tiny, one-way valves into the most diseased lung lobe. The lungs of emphysema patients lose elasticity, preventing them from exhaling effectively. BLVR valves allow air out but not in, enabling the lung to deflate better, and help relieve shortness of breath.

“We see about a 15% improvement, and often patients considered for lung transplant improve enough that they no longer need a transplant,” Dr. Betensley said.

On the research front, the pulmonary team is investigating bronchoscopic procedures that shrink or freeze the glands responsible for the production of excess mucus to reduce airway congestion.

Researchers are also focusing on so-called “overlap syndrome,” where features of COPD, asthma and interstitial lung disease occur together. “We’re looking at how to treat all components,” Dr. Biller said.

COVID-19

A respiratory virus, COVID-19 inflames the lungs. “Mild cases may not affect the lungs that much, but moderate to serious cases can progress to viral pneumonia,” Dr. Biller said.

Patients at Froedtert & MCW hospitals receive treatments tailored to the severity of their illness, including oxygen to assist breathing, the steroid dexamethasone to reduce inflammation, various monoclonal antibodies to help the body’s immune system, antiviral agents to block the virus, and antibiotics if bacterial pneumonia arises.

“We estimate that 10% to 30% of people with acute COVID may develop long-term symptoms, and we’ve established a multidisciplinary clinic to treat their unique needs,” Dr. Biller said.

Froedtert Hospital and Froedtert Menomonee Falls Hospital are recognized by U.S. News & World Report as high performing in pulmonology and lung surgery. Froedtert Hospital is also recognized as high performing for COPD and pneumonia treatment. Learn more about our lung disease treatment options.

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