[Mtngrl]

I've been reading up on drug-induced interstitial lung disease (ILD) and gastroesophageal reflux disease (GERD). It's fascinating, but also kind of worrisome. This isn't internet chat room stuff. It's all from peer-reviewed journals and/or national web sites.

In an earlier post I shared that many chemo drugs can cause lung damage, and that oxygen treatment, radiation, aspirin, and nonsteroidal anti-inflammatory drugs (Motrin, Ibuprofen, Alleve, Naprosen) can also harm the lungs. In a more recent post I noted that acid reflux (called GERD when it's chronic) can make you cough. I reported that getting back on Nexium helped me.

It turns out I was wrong about coughing being my only symptom. Because I didn't have heartburn or that acid taste in the mouth, I didn't realize I had acid reflux. But there are other symptoms, including being out of breath, having trouble swallowing or speaking, and having a lump in one's throat.

It gets worse. People with asthma are highly likely to have GERD, and it's often "atypical" like mine. It's not clear which comes first, the chicken or the egg. They are definitely associated somehow. Furthermore, GERD can cause tiny droplets of stomach acid to get into the lungs, causing pneumonitis, pneumonia, or--you guessed it--interstitial lung disease. Many asthma medications (such as the Albuterol I was prescribed) can also exacerbate GERD.

It looks to me like I'm in a negative feedback loop. I think the chemo caused the GERD (and may have done some lung damage) but there was definitely coughing which, itself, can trigger GERD, which can also cause lung damage.

What to do? Well, the Nexium or another proton pump inhibitor is a good start. There are also lifestyle changes that can help, like not over-eating, avoiding fried, overly-acidic or spicy foods, not eating anything less than three hours before lying down (to go to bed), and cutting back on caffeine and alcohol. Those who are obese are also advised to lose weight. I don't drink carbonated beverages, but they are also implicated.

I love spicy foods, coffee, red wine, and chocolate (that's on some of the lists), but I'm also rather fond of breathing, so I'm willing to tweak my habits. Eating and drinking just got a whole lot less fun than they used to be.

I'm sharing this because pretty much every treatment we get, including Herceptin, has "interstitial lung disease" listed as a side effect. I have metastatic cancer, so it's easy for me to say I'll take the risk, given that I'd die of cancer if I didn't get treated. But if you're not Stage IV and you're having this kind of problem, talk to your doctor.