If you've been diagnosed with idiopathic pulmonary fibrosis (IPF), then you're sure to have a lot of questions. People with IPF can experience a variety of physical and emotional challenges throughout the day , ranging from fatigue to powerful emotions and frustration. Understanding how IPF affects you as an individual will help you to better manage your symptoms and anticipate what lies ahead. The good news? People with IPF can play a big role in managing their IPF symptoms.

Customizing a Plan That Works For You

Because IPF disease affects each person differently and progresses at different rates, prescribed treatment plans are tailored to meet each person’s individual needs. Creating a comprehensive disease treatment plan with your doctor, along with a Personal Action Plan tailored to your specific needs, are great tools to help you to manage your IPF.

Getting Involved in Your Own Treatment Makes a Difference

You are the biggest factor in managing your IPF treatment. As with all diseases, it is important to live a healthy lifestyle. Activities such as physical conditioning, breathing exercises, nutritional counseling, and anxiety, stress, and depression management may all be a part of your personal disease treatment plan your doctor may create for you.

There Are a Number of Things You Can Do to Help Manage Your IPF Symptoms:

Quit Smoking	If you're still smoking, the most important thing you can do is to seek help and stop smoking as soon as possible. Remember, additional potential benefits to quitting include: increased oxygen levels in your blood, lowered blood pressure, and improved circulation.
Eat Well	A healthy diet plays an essential role in your overall physical and mental health. A diet rich in nutrients and low in saturated fat, trans fat, cholesterol, salt, and added sugar, along with a healthy balance of fruits, vegetables, whole grains, lean meats, poultry, fish, beans, and fat-free or low-fat dairy products, will help you get the fuel you need throughout the day. Remember, eating several smaller meals (rather than a few large meals) may prevent feeling too full, which can make it hard to breathe.
Exercise	A lack of exercise can work against people who have IPF, as inactivity weakens the muscles, making even the simplest activities more difficult. Developing an active lifestyle is often key in decreasing ‘air hunger' and strengthening the muscles to make them more resistant to fatigue. Regular exercise can help you develop the energy you need to accomplish daily tasks with less shortness of breath, and also help you to ease feelings of anxiety and depression.
Oxygen Therapy	Supplemental oxygen can make a substantial difference in a person’s ability to manage many of the lifestyle-altering effects that can accompany IPF. Oxygen therapy may provide the additional oxygen the body needs to help people with IPF maintain an active lifestyle, and can also decrease shortness of breath and the additional strain on the heart due to low oxygen saturation levels.
Get Rest	Getting at least eight hours of sleep every night can boost your overall sense of well-being. Rest can also help you deal with the stress of living with IPF.
Connect with Others	Whether it's friends and family or support and advocacy groups, staying connected to others who can provide good company and a positive outlet for what you're going through can make a powerful difference in adding meaning to your life and helping you cope with living with IPF.
Manage Emotions	Psychological and spiritual support is often an important factor in keeping a positive outlook, reducing fears, and enhancing the daily lives of people with IPF. Keeping a positive attitude and staying relaxed may conserve valuable oxygen by avoiding its excessive use that can come with tension.

Pulmonary rehabilitation (or “rehab”) is a term that covers many different approaches. The goals are to decrease the severity of breathlessness as much as possible during daily activity and to increase energy and activity levels in general. Pulmonary rehab is recommended for patients with idiopathic pulmonary fibrosis (IPF), but most studies of its effectiveness have been done in patients with chronic obstructive pulmonary disease (COPD). Your doctor may prescribe pulmonary rehab as an addition to other types of care. Not every patient is a candidate, however. It’s also important to understand that pulmonary rehab will not prevent the loss of lung function that occurs over time with IPF. It is extremely important to participate in pulmonary rehabilitation if recommended by your doctor.

Pulmonary rehab includes activities such as physical conditioning, exercise training, and breathing exercises. It may also include anxiety, stress, and depression management, as well as nutritional counseling, education, and other programs.

The Possible Benefits and Risks of Pulmonary Rehab

As mentioned above, pulmonary rehab has been studied as a treatment in several different lung diseases and shown to have benefits for many patients who use it. Although there are not as much data on pulmonary rehab for people with IPF, a number of studies have shown it to provide at least some benefits in IPF. These include:

There are a few risks associated with pulmonary rehab that are generally related to the exercise part of the program. As with any physical training activity, muscle or bone injuries may occur. Also, for people with heart disease, physical activity can increase the risk of a heart attack or arrhythmia (irregular heartbeat). Your doctor will determine how much additional oxygen you need as your rehabilitation program is developed.

Although leading medical guidelines recommend that most patients with IPF receive pulmonary rehab, it may not be right for everyone. You should discuss the option of pulmonary rehab with your doctor to see if your condition allows it and if it might be of benefit to you.

A Team Effort

If your doctor decides that pulmonary rehab is right for you, you should know it involves working with a team of healthcare providers. This team may include nurses, respiratory therapists, physical therapists, social workers, dieticians, and others. It may also include several exercises and lifestyle changes at home. Working closely with your treatment team will help you to know what is expected of you.

Your body needs a certain amount of oxygen for its organs to function properly. But as idiopathic pulmonary fibrosis (IPF) progresses, the fibrosis prevents enough oxygen from being transferred into your bloodstream. This is why your doctor may prescribe supplemental oxygen therapy as part of your care. (Learn how your lungs work.)

Many IPF experts believe that all people with IPF should be evaluated to see whether oxygen therapy can help them improve their low oxygen levels. Low oxygen levels may occur during exercise, during sleep, or may be present when the person is at rest. When they occur will affect how often you need to use oxygen. Oxygen therapy has been demonstrated to be helpful to patients who have low oxygen levels across a variety of serious lung conditions. Even though the data supporting its use are limited, current medical guidelines recommend using oxygen therapy in appropriate patients with IPF.

Your doctor will use tests, such as an arterial blood gas test and a pulse oximetry test, to determine whether you need oxygen therapy and, if so, how often and how much. These tests measure how much oxygen is in your blood. A low level of oxygen is a sign that you need oxygen therapy.

How Oxygen Is Delivered

Oxygen therapy is provided in a metal cylinder or other container. It flows through a tube and is delivered to your lungs in one of the following ways:

	Nasal cannula	Two small plastic tubes, or prongs, that fit within both of your nostrils
	Face mask	Fits over your nose and mouth and straps onto your head
	Transtracheal (“tranz-TRAY-kee-ul”) oxygen therapy	A minor surgical procedure is performed to insert a small tube into your windpipe through the front of your neck This is the least common form of oxygen therapy

Your doctor will work with you to determine which type of oxygen delivery device you should use, as well as how much oxygen you need and how often.

The Possible Benefits and Risks of Oxygen Therapy

The use of supplemental oxygen in people with IPF who have low oxygen levels at rest has been shown to:

In addition to reducing breathlessness, in studies of people using oxygen therapy to treat COPD, patients reported that oxygen therapy improved their ability to perform everyday activities such as cleaning, reading, and shaving.

However, it’s important to note that there are a number of risks that come along with using oxygen therapy, including a number of possible complications and side effects, such as:

Tell your doctor if these problems persist. Your doctor may be able to help relieve some or all of these issues.

If you start using home oxygen therapy, you should ask your home equipment provider to give you a complete list of safety steps you'll need to follow.

The Importance of Sticking with Your Therapy

Remember to use oxygen therapy as prescribed by your doctor. While some people may feel embarrassed by having to use oxygen therapy in public, remember that it’s an important medical therapy. Low blood oxygen levels can lead to additional health problems. Your need to use oxygen therapy shouldn’t prevent you from taking part in social activities.

Some patients with idiopathic pulmonary fibrosis (IPF) may be prescribed oxygen therapy after being assessed by a doctor. For those patients, oxygen therapy may allow them to be more physically active. While medications and alternative therapeutic treatments are available, taking supplemental oxygen can help patients with IPF feel better and get the oxygen they need today to maintain a more active lifestyle. It's important to remember, however, that for some, oxygen therapy may only be needed during activity, but for others, it may also be needed at rest.

Ensuring your body has the oxygen it needs plays an important role in IPF management. Because IPF reduces the capacity your lungs have to deliver enough oxygen to your blood, muscles, heart, brain, and vital organs—they can become oxygen deprived, resulting in many side effects, including: placing additional strain on your heart, shortness of breath, fatigue, and aching muscles and joints.

Supplemental Oxygen Addiction

As IPF progresses, the body is unable to inhale the oxygen it needs. Supplemental oxygen helps your lungs deliver more oxygen to the body and brain. Oxygen therapy helps the lungs to increase the level of oxygen transferred to the blood, bringing the oxygen in your blood to a better level.

Easy Answers to Big Questions

What Will People Think? One of the biggest challenges patients can face is the stigma that is sometimes associated with IPF. Patients can become self-conscious when carrying around an oxygen tank, or when suffering from uncontrollable symptoms such as shortness of breath and coughing, in public. Taking charge can make a difference. There are many ways patients can learn to handle the stigma often associated with IPF and carrying oxygen in public. Become an Advocate Many patients work to make a difference by using their condition to help others and to help bring awareness to IPF.   Join a Support Group Joining a support group and sharing your experience with other IPF patients can make a real difference in coping with the emotions and challenges patients face when living with IPF. Whatever the challenge, it's always better to brave the public than to stay at home and miss out on living a full life. Fresh air, nature, socializing with other people, and remaining active are key ingredients to maintaining a normal and fulfilling lifestyle.

Is Oxygen a Drug? Supplemental oxygen is a prescription medication. Oxygen therapy is considered a medical treatment, and therefore must be prescribed by a doctor. Some patients may require oxygen therapy at home throughout the day, while others may need it only while at the doctor's office or when exerting themselves. If you're a candidate for supplemental oxygen therapy, your prescription may include: How much oxygen you need, and when (at rest, during exercise, while sleeping, etc.). How many hours a day you will need supplemental oxygen. What type of oxygen and delivery system best suit your lifestyle.

What is the Cost of Oxygen Therapy? Can I Afford It? Most insurance plans, including Medicare and Medicaid, will cover most costs related to your supplemental oxygen therapy, as long as your test results show that you need the oxygen. Additional costs can also be covered by your supplemental policies. Insurance coverage varies, so check with your insurance provider about your coverage. Your health care provider can help you choose the right company to meet your needs for supplemental oxygen. Learn more at medicare.gov

Living with Oxygen

Lung transplantation is an option for certain people with idiopathic pulmonary fibrosis (IPF). It is one form of treatment currently available for IPF, but not everyone is eligible, and finding a donor lung isn’t guaranteed. Lung transplants have been shown to improve both life expectancy and quality of life in people with IPF, but there are serious risks involved.

In order to qualify for a lung transplant, you must meet certain criteria. For one, you must have no other significant health problems, such as cancer; heart, liver, or kidney disease; or chronic incurable infections. This can be a challenge in people with IPF, as many suffer from other lung conditions, coronary artery disease, or other problems that make them ineligible to receive a transplant. Your doctor will be able to tell you if you are eligible for a transplant based on your overall health status.

In the past, individuals over the age of 65 rarely received transplants. However, because surgical techniques and results have improved, more centers are performing transplants in older patients.

Risks of Lung Transplantation

Lung transplantation is a highly risky procedure and there is no guarantee that it will be successful. Risks include:

Only your doctor can say whether or not you are a possible candidate for a lung transplant. Medical guidelines recommend that the option of lung transplant be brought up at the time IPF is diagnosed if the patient meets all the criteria for transplant. Before pursuing the option of a lung transplant, you should discuss all the potential risks and benefits with your doctor.

Waiting is Now Reduced for Eligible Patients

The new lung allocation system (LAS) used by the United Network for Organ Sharing (UNOS, www.unos.org) has set new standards for how they evaluate transplant candidates. LAS is now based on the severity of lung disease. As a result, wait times have been reduced considerably for patients with severe lung function issues, including people with IPF.