DEAR DR. DONOHUE: My aunt, who raised me, has been given the diagnosis of idiopathic pulmonary fibrosis. I know nothing about it. I am her only relative, and I want to be as big a help to her as she was to me. Will you give me some details on this illness and how it’s treated? I happen to be financially secure, and I can afford whatever medical costs she might incur. I consider her my mother. — D.R.

ANSWER: “Idiopathic” is a much-used medical word. It means that no one knows the cause. Pulmonary fibrosis is a deposition of scarlike strands throughout the lungs. That tissue interferes with oxygen’s passage into the blood. Patients with idiopathic pulmonary fibrosis are oxygen-deprived and constantly struggle to get enough air. A dry cough is another sign.

A chest X-ray and the person’s symptoms might suggest the diagnosis. A special kind of CT scan called a high-resolution CT scan furnishes the most useful information on which to base the diagnosis. Even with a high-resolution CT scan, there might be doubts. In that case, a lung biopsy provides definite proof.

The course of IPF is unpredictable. Usually, it relentlessly worsens. Most patients eventually have to rely on a constant supply of oxygen to carry on. There is no medicine cure. Some medical centers, when the disease is in its early stages, use a combination of three drugs to slow its progression. Those drugs are cortisone, azathioprine and N-acetyl cysteine.

A lung transplant holds the promise of cure or a great prolongation of life. That’s a matter that has to be discussed with your aunt and her doctor. It depends on many considerations. Your aunt’s age will be one of those considerations.

DEAR DR. DONOHUE: I read an article about gangrene in a popular magazine. I am not one of those who read about an illness and then think they have it. This one, however, worried me. I have diabetes. The article mentioned an association of gangrene with diabetes.

Is gangrene a common diabetes complication? I thought gangrene was something that happened to soldiers wounded on the battlefield. — H.M.

ANSWER: Gangrene can happen to people with diabetes, but it’s not all that common. Gangrene is death of tissue due to loss of its blood supply.

You know that one complication of diabetes is obstruction to blood flow in arteries. It’s for this reason that heart attacks are more common in diabetics. The same process goes on in many arteries. When blood flow to a part of the foot or to the toes is cut off, then those blood-deprived areas die. The skin turns black. If the process cannot be reversed, amputation is a prospect.

Nowadays, with the attention given to diabetes, gangrene is infrequent.

Another kind of gangrene exists, the kind you mentioned happening to soldiers wounded on the battlefield. That’s gas gangrene. It’s cause by a bacterium that lives in the soil. Gas gangrene was a prevalent problem for soldiers before helicopters made rapid evacuation to hospital facilities possible.

DEAR DR. DONOHUE: I don’t mean to try your patience, but I have an idea that suddenly occurred to me. I want to check it out with you.

Would standing on your head put an end to a headache? I understand that a headache occurs when not enough oxygen gets to the brain. Standing on your head increases blood flow to the brain. Do you see where I’m coming from? — M.L.

ANSWER: I see where you’re coming from, but it’s not from the right place. Most headaches are not caused by a lack of oxygen. Furthermore, I don’t think that standing on your head delivers that much more blood to your brain.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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