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By: Anthony Chiringa
"Tony, this is a harsh dose of reality, I'm sorry your X-ray clearly shows you have sub-acute Pneumonitis, you have to accept the fact that you're going to live with it," Dr. Mutuku diagnosed me, looking intently at me. My gut muscles clenched, my eyes became glassy, I was breathless for a bit. I was on the verge of breaking down, but I pushed my tears back into the tear ducts. I finally understood what was giving me sleepless nights within the second half of 2018.
What exactly is Hypersensitivity Pneumonitis?
The American Lung Association defines hypersensitivity pneumonitis as a disease of the lungs in which your lungs become inflamed due to an allergic reaction triggered by inhaled dust, fungus, molds or chemicals. It is a rare immune system disorder allergy. Only a few number of people in the population develop Hypersensitive Pneumonitis. In-depth research needs to be done to support why some people are more hypersensitive than others.
Tell me more...
Usually, the immune system monitors any foreign substance and airborne irritants that enter the body. These are known as antigens. The immune system then acts on the antigen causing normal inflammation - clearing the foreign substance. Afterward, it shuts off and inflammation stops.
The immune system of people with HP is unable to shut down, causing inflammation in the tiny air sacs of the lungs known as the alveoli. Eventually making breathing to be labored, affecting the exchange of gas in the alveoli. The alveoli are the part of the lung where the exchange of carbon dioxide and oxygen take place.
What causes of Pneumonitis?
1) Molds and Bacteria. Lungs become inflamed after repeated exposure to some molds and bacteria from the environment such as;
- Indoor molds at home, commonly found on walls, ceilings and below the carpets.
- Inhaling of molds from hay, straw, and grains. Commonly affects the farmers. (Farmer's Lung)
- Airborne particles from bird feathers and droppings(Bird Fancier's Lung)
- The Fungus from air conditioners and heaters, especially when not well maintained(Humidfier's Lung)
- Inhaling bacteria in the vapor from indoors hot bathtubs (Hot Tub Lung)
2) Certain medicines such as some antibiotics, chemotherapy drugs, and drugs for the heartbeat.
3) Radiation treatments especially when done around the chest section, such as chemotherapy for breast and lung cancer. Whole-body radiations done to people who are about to undergo transplants such a bone marrow transplant.
What are the symptoms of Hypersensitive Pneumonitis?
1) Acute Hypersensitive Pneumonitis - Symptoms appear 4 -6 hours after exposure to the irritating substance. These symptoms mimic that of flu and usually disappear within a few days when one is no longer exposed to the irritant, these include:
- Shortness of breath (Which was the most common symptom I experienced)
- Dry cough
- Chills
- Fever
2) Sub-acute and Chronic Pneumonitis - occurs when one is repeatedly exposed to the irritant for months or years. These two are both long term conditions and cause symptoms such as shortness of breath, cough, fatigue, lung fibrosis and clubbing of fingers.
So, how did I end up getting Hypersensitive Pneumonitis?
When I changed jobs in mid-2018, I was ecstatic to land in a new Sales and Marketing position in food ingredients. I had to move houses to be close to the job location. I moved to a new house that looked neat and polished at first. When the cold season approached, mold growth started growing on the walls of the new house. The growth was mainly on the lower part of the wall near the floor.
All my savings were gone because of the expenses in moving. I couldn't afford to move again. So I advised myself "Why don't I clean the mold with a soaked chlorine-based cloth and I'm sure it won't pop up again." I did that, little did I know I was making the condition worse.
Rapidly, the molds grew extensively because I increased moisture content on the surface when I scrapped it off. I started experiencing shortness of breath, dry cough, and mild fever especially when I lay down at night. It went on for approximately 2 months. Other doctors advised I treat the condition with cough syrups and strong antibiotics but the condition became worse.
It was one of the lowest moments of my life. At one point I thought I would buy the farm. I even speculated I was developing asthma. After consulting over three doctors and doing blood tests, the results showed I had abnormally high levels of lymphocytes and finally after a series of tests, my doctor concluded from my chest X-ray that I have sub-acute HP caused by inhaling the indoor mold.
Treatment and how I'm living with Hypersensitive Pneumonitis
1) The best way to prevent HP from reoccurring is complete avoidance of the airborne irritant. Your lungs can become normal and HP can completely disappear at the early stages if the irritant is completely avoided. I was forced to move into a new house to lower the chances of HP progressing further.
2) Medications such as corticosteroids, which are drugs that lower inflammation by suppressing the immune system. Corticosteroids should be used conservatively and check with your doctor for how long you should take the medications, normally not for a very long time.
Even though I have completely avoided the mold irritant, I still can't comprehend why my body sometimes I get triggers from just a speck of indoor dust. Most times I'm forced to use Ibicar S which is a combination of Beclometasone Dipropionate (corticosteroid)and Sablutamol. Sablutamol helps to open up the airways of my lungs.
Sometimes I'm forced to use a combination of Ibicar as and Glemont L during seasonal allergies. Glemont L works by making breathing easier by reducing swelling in the airways; blocking the action of histamine.
3) If HP is not adequately controlled, it can progress and cause lung fibrosis. You may require to have a lung transplant to replace the damaged lung. This procedure is not a cure; and not for everyone. HP may still occur even after a lung transplant.
I'm thanking God every single day for saving my life. HP is not a death sentence, I'm living a normal life.
Thank you:-)!