Post by Sarcoidawareness on Dec 18, 2005 0:04:14 GMT -5
For sarcoidosis, corticosteroid treatment has appeared to improve the radiographic findings, yet whether the medication has an ultimate effect on whether a person is going to have residual scarring has not been proven. For this reason, there has been a change in the approach to treatment as noted above. In some situations, the scarring process may progress.
In these situations if the scarring is combined with a decreased oxygen value, supplemental oxygen can be beneficial. The heart has to work harder because of the increased pressure in the lungs from the fibrosis and soon fails. Oxygen has a direct benefit for the heart. Oxygen will prevent the heart from enlarging and weakening. The heart will not fail. In order to be effective, supplemental oxygen is required for at least 18 hours per day. Generally, it is recommended that the oxygen is utilized 24 hours daily. It seems excessive at first, but individuals become use to it and are able to lead an active and zestful life.
A pulmonary rehabilitation program should also supplement the oxygen program. Exercise is very useful in improved conditioning and efficiency of the muscles from the remaining good lung. The rehabilitation program is useful because an individual can be pushed to a higher level of exertion in a protected environment. The exercise program (e.g., 30 to 45 minutes of daily walking) can be continued on a home basis after the controlled, supervised program.
For patients who are not able to take prednisone or who require high doses of prednisone, methotrexate at 10 mg per week may enable patients to decrease their prednisone use after six months. Methotrexate treatment in some patients may be related to abnormal blood tests and certain infections. It is important to review and discuss possible adverse reactions with the doctor so a person can be aware of a potential reaction early.
There have been anecdotal reports of other treatments. Some of these may appear to be effective on an individual basis, yet studies of a large number of patients are needed to confirm the success of these treatments.
In life threatening, disabling disease and progressive disease that has not responded to treatment, lung transplantation may be utilized.
