Chronic Obstructive Pulmonary Disease with Interstitial Lung Disease and Usual Interstitial Pneumonia

Clinical Case Report: A case of 61 year old gentleman from Uganda with Chronic Obstructive Pulmonary Disease, Interstitial Lung Disease, Usual Interstitial Pneumonia, Fibrosis and Honeycombing in lungs, Pulmonary Arterial Hypertension and Osteopenia suggested for Lung Transplant and Medical Management

According to the shared reports, Patient is a known case of Chronic Obstructive Pulmonary Disease (COPD) with a superimposed ILD (Interstitial Lung Disease) and Usual Interstitial Pneumonia (UIP). Patient also has Pulmonary Arterial Hypertension (PAH) and Diffuse Osteopenia (Bone thinning) with chronic moderate collapse of D11 (11th thoracic vertebra) vertebral body.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive, incurable lung disease that causes restricted airflow and breathing difficulties. It primarily includes emphysema (damaged air sacs) and chronic bronchitis (inflamed airways).

A superimposed ILD (Interstitial Lung Disease) typically refers to acute, or subacute inflammatory changes, such as ground glass opacities or consolidations that develop on top of an existing, chronic fibrotic lung condition.

Usual Interstitial Pneumonia (UIP) is a specific pattern of lung scarring and inflammation characterized by patchy fibrosis and honeycombing in the peripheral and lower sections of the lungs

Pulmonary Arterial Hypertension (PAH) is a serious, progressive disease characterized by high blood pressure in the arteries of the lungs. The narrowing and stiffening of these small arteries force the right side of the heart to work much harder to pump blood, which can eventually lead to right-sided heart failure.

Investigations needed to confirm the diagnosis – Patient will need a lung biopsy, CT Scan, Bronchoscopy and other necessary scans to confirm the diagnosis of the disease.

Possible line of treatment – Patient will be offered medical management on IPD basis to manage his symptoms and improve his lung condition.

In medical management, the doctor’s mange the symptoms with high end medications and steroids. This improves the quality of life and slows down the progression of the disease.

**However, in case during the investigations, it is found that lung function is below 20%, In such a case, patient will be candidate for a lung transplant.

We recommend following doctors at top hospitals:

1.  Amrita Hospitals, Faridabad // Dr. Sourabh Pahuja

2. Max Healthcare, Gurugram // Dr. Shivanshu Raj Goyal

3. Paras Health, Gurugram // Dr. Arunesh Kumar

4. Fortis Healthcare, Gurgaon // Dr. Karn Mehra

5. Artemis Hospital, Gurgaon // Dr. Arun Chowdary Kotaru

6. BLK Super Specialty Hospital, New Delhi // Dr. Sandeep Nayar

Estimated costs:

Estimated cost of Initial Evaluations will be approx. USD 900-1200 on OPD basis-

Estimated cost of Lung Biopsy – $2000.

The Estimated Cost of Medical Management with 10 days of admission and 20 days of post discharge at a guest house at various hospitals is as below on out-patient basis: – 

Kindly Note: The above rates are on approximate basis; actual charges will depend upon the final plan confirmed on the basis of medical evaluation at the hospital.

Stay in India: Patient will require 3-5 days for initial evaluations on an OPD basis.

For medical management, he may need 7-10 days. 

Inclusions: 

1. The cost of all investigations related to the surgery

2. The cost of the treatment.

3. The doctor’s fee and surgery charges.

4. The stay of the patient and 1 attendant during hospital admission.

5. All meals for the patient and the attendant as per the available menu while in hospital.

6. Medical Consumables and Medicines while in hospital.

7. The fee for dietician and nursing while in hospital.

8. It also includes complimentary Airport Transfers, Forex Services, and assistance.

Exclusions:

1. Any consultation other than in discussion.

2. Extended stay

3. Treatment for any other illness

4. If & when the patient is shifted to ICU (Intensive Care Unit) then attendant has to vacate the room and shift to a Guest House near the Hospital.

In case a Lung Transplant is Needed –

A Lung Transplant is a cadaver-based program, and a patient may need to wait close to a hospital for a donor lung to be available. The organs such as lungs are distributed based on a registry system which works on a 3D model. One first needs to register for a lung transplant and wait till a donor comes up. The donor is them matched for suitability with available set of patients registered chronologically and then is given to a patient who needs it the most. The waiting time may last from 3 months to 9 months depending upon availability of the organ and waiting list.

Till the time a suitable donor lung is not available patient will need to stay in India, close to the hospital so that she can be notified and arrive at the hospital within 3-4 hours.  During this waiting time, she will be managed via medical management protocol.

Estimated costs:

Estimated cost of Initial Evaluations will be approx. USD 2000-2500 on OPD basis

Estimated cost of Medical Management Per month will be approx. USD 1500- USD 1800.

The Estimated Cost of Lung Transplant at various hospitals is as below: –

Kindly Note: The above rates are on approximate basis; actual charges will depend upon the final plan confirmed based on medical evaluation at the hospital.

Stay in India: Patient will require 3-5 days for initial evaluations on an OPD basis.

The waiting time for organ may last from 3 months and can go up to 9 months.

For Surgery– Patient will require 1 month of hospitalization for surgery. Post-Discharge she may require 1-2 months for follow up and recuperation.

Total Length Stay in India will be approx.-12 months.

Inclusions transplant Package:

1. The cost of all investigations related to the surgery

2. The cost of the treatment.

3. The doctor’s fee and surgery charges.

4. The stay of the patient and 1 attendant during hospital admission.

5. All meals for the patient and the attendant as per the available menu while in hospital.

6. Medical Consumables and Medicines while in hospital.

7. The fee for dietician and nursing while in hospital.

8. It also includes complimentary Airport Transfers, Forex Services, and assistance.

Inclusions in Medical Management – Medicines and regular follow up with the doctor as an outpatient during the waiting time. 

Exclusions: 

1. Any consultation other than in discussion.

2. Extended stay

3. Treatment for any other illness

4. If & when the patient is shifted to ICU (Intensive Care Unit) then attendant has to vacate the room and shift to a Guest House near the Hospital.

On Arrival: Patient and attendants will be received at the airport by our Representative. Apart from the medical and nursing team, one Case Manager will take care of all the needs. We shall also assist them with the reasonably charged accommodation near the hospital. You and attendant may arrange 35-50 USD per day toward accommodation and food at Guest House. 

Hope I have been able to give you a satisfactory answer to the query. Do kindly ask for any clarifications needed. I will be happy to answer & shall look forward to assisting you.

Regards,

Dr. Anmol