How Do I Manage Symptoms and Side Effects of Pulmonary Fibrosis?

It is important to recognize signs of an acute exacerbation, as well as new, changing or worsening symptoms.  Call your healthcare provider right away if you have tightness in your chest, pain, fever or trouble breathing.

• If you are prescribed supplemental oxygen, use it as directed. 
• Ask your provider about reading and monitoring your oxygen levels at home with a pulse oximeter.
• Talk to your healthcare provider about deep breathing exercises like pursed lip or belly breathing.
• Talk to your healthcare provider about which activities cause you to have shortness of breath. Your provider may prescribe medications like an inhaler or corticosteroid to help lower the inflammation or swelling in the airways.
• Ask your provider about enrolling in pulmonary rehabilitation. This is a program that can help you get active safely, provides PF self-management education and helps you connect with others living with lung disease.

Cough associated with PF is usually a dry, hacking cough. It can be triggered by strong scents, talking, eating, laughing or exercising. It is important to know the difference between PF-related cough and other well-known causes of cough (such as GERD, post-nasal drip and asthma).

• Treat the cause when possible; for example, use medications for acid reflux or post-nasal drip.
• Drink fluids, such as water or hot tea, with honey.
• Use cough drops if recommended by your healthcare provider.
• Ask your healthcare provider about prescription medications available for cough.
• Some people may benefit from speech therapy to learn how to talk without triggering a cough.
• Coughing may cause you to lose control of your bladder. Use products in your underwear that keep you dry if you have urine leakage. 

Being tired or fatigued can be a symptom of PF and it may be caused by several reasons such as lower oxygen levels, a side effect from medication or activity.

• Get plenty of rest and take short naps when needed. Ask your bed partner to watch for signs of sleep apnea such as snoring, waking up throughout the night, or pauses in breathing and report those to your healthcare provider. 
• Talk to your healthcare provider about enrolling in a pulmonary rehabilitation program. This program can help you exercise safely, learn about PF and meet others living with chronic lung disease. 
• Talk to your healthcare provider about assistance doing everyday activities such as grocery shopping or cleaning. Your provider may recommend contacting local community organizations or getting an in-home assessment by an occupational therapist.  
• What you eat is important when living with PF. Everyone’s diet is different and often depends on your weight, other health conditions, medication side effects and food preferences. Work with your healthcare provider and a dietitian to find the right balance of nutritious foods for you.
• If you are prescribed supplemental oxygen, use it as directed.

Some people with PF also have gastroesophageal reflux disease (GERD) which causes stomach acid to flow into your esophagus.

• Ask your healthcare provider about an anti-acid medication, designed to control acid reflux.
• Track and avoid foods that may worsen your symptoms such as tomatoes, coffee and chocolate.
• Talk to your healthcare provider about ways to angle your body upright while sleeping.

Some medications for idiopathic pulmonary fibrosis (IPF) can cause nausea, lack of appetite and diarrhea. Always take your medication with a meal, if recommended. Talk to your healthcare provider about these symptoms. Ask your healthcare provider about lowering your dose if you are unable to tolerate the side effects.

For loss of appetite

• Eat smaller meals throughout the day if you are not hungry for big meals.
• Add milk or yogurt to increase calories and protein in a meal.
• Take a walk before you eat.
• Drink after your meals to help reduce feeling full. 
• Ask your doctor about medication to help increase your appetite.

For nausea or vomiting

• Ask your healthcare provider about prescription medication to ease nausea.
• Eat bland foods such as toast.
• Drink peppermint or ginger tea or ginger ale.

For diarrhea

• Track and avoid foods that may cause diarrhea. These may include fried, dairy, sugar-free, spicy or high fiber foods that are hard to digest (such as beans or raw vegetables).
• Eat bland foods such as toast or rice or try lean proteins like chicken.
• Eat small meals and drink plenty of water between meals.
• Ask your healthcare provider about medications to help reduce diarrhea.