Keep the Whole System Running by Maintaining the Parts

The medical facility at the military base where my husband is stationed is enormous. Almost every specialty you can imagine is under one roof.

The first time I had an appointment there, the scheduler instructed me over the phone to visit the “Jay Team” in the “medical mall.” When I timidly uttered, “The, uh, what? Where is that?” she dictated a mile-long list of steps to find the office. I showed up an hour early just in case.

When I first walked into the medical mall, a three-story wing off the main hospital with an open center and atrium ceiling, my jaw dropped. It really did look like a mall: a one-stop shop for all your healthcare needs!

I had the impression of shopping as I navigated the escalators and promenades to find my primary care office. I took stock of all the storefronts and window-shopped for healthcare I might need in the future.

“Oh look, an ophthalmologist! And the gynecologist, and ooh, look at that, orthopedics, I hope I don’t end up there!”

Before my mom’s transplant, I saw these offices as separate entities. I would go to my appointment and not think too much about the several dozen other specialty offices I had to walk by to get there. Now, I can’t walk through the medical mall without seeing that every one of those offices is part of a bigger picture. The way the specialties are on display in the concourse makes it plain how complex the human body is.

Throughout our lives, we will all need to visit some of these clinics. We should get semiannual dental cleanings, occasional dermatology checkups, and annual physicals. Depending on our age and sex, we should also see doctors for things like reproductive health, colonoscopies, cancer screenings, and eye exams.

We all know that we need to change the oil often to keep the engine healthy, but how many of us actually do the maintenance before the check engine light comes on? I’ll be the first to admit that I once went three years without going to a dentist, and I definitely turned down my doctor’s last request to do a Pap smear.

I like to think that I should run my car — and my body — ’til the wheels fall off. Maintain as needed, but what harm could a hundred more miles do before I change the brake pads, am I right?

To the doctor who is reading this and cringing, I will say that pushing the limits on scheduling those regular healthcare visits isn’t the smartest idea. We should all get in the habit of scheduling those appointments in advance and keeping them. Preventive medicine is a huge contributor to better overall outcomes, especially when it comes to rare diseases.

One good thing about the transplant journey is that those regular healthcare visits become mandatory. Transplant teams evaluate patients before they get on the list to make sure that they will comply with all of the rules, which includes keeping appointments. Since the medications can cause side effects and secondary health issues, taking a systemic approach to post-transplant health is crucial.

Immunosuppressant medications, for example, make it easier for cancers to grow. Skin cancer is a common secondary condition in transplant patients. Thankfully, it is often easy to catch and to treat — provided you go to your dermatologist once a year as advised. Colonoscopies are recommended every five years.

Prednisone can also cause vision changes, which can go away as the dose is lowered. An ophthalmologist can look for changes, such as cataracts and glaucoma, and an optometrist can make sure your prescription is accurate if you use glasses.

Dry mouth is another side effect, and it contributes to gum disease and tooth decay. Keeping semiannual dentist appointments is the best way to prevent painful and costly dental procedures.

Musculoskeletal health is one that may be overlooked, but since prednisone can cause joint pain and bone loss, bone density scans are important to catch any new or worsening arthritis or osteoporosis.

Of course, there are also all the transplant-specific appointments you will need to have to monitor the health of your new lungs. Bronchoscopies, CT scans, spirometry, and regular lab work are all part of post-transplant life. Surveillance is an important part of keeping your lungs healthy. All of these tests can catch early signs of infection and rejection.

Much like the medical mall, this can seem overwhelming when it’s all written in one place. The good news is that each thing is only one day of your life. It’s a few hours that you will have to spend in an office throughout the year to make sure your body is running at its peak ability. One appointment at a time, it seems like nothing at all. 

***

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.