[Stewart]

Here’s what I did in the first few months after I was diagnosed with IPF. I reported about it to the two doctors I was working with about half a year later–last March. (Now, five months later still, I’m continuing the program, breathing fine, and even gained weight now over 150 pounds.) I’m 83.
–Stewart Brand

My report:

Dear Drs. Golden and Andereck…

I’m pleased to see my fibrosis appears to be pretty stable currently. It may be luck, or it may be partly due to what I’ve been doing at home. Since it’s a variety of things, who knows which parts are effective or ineffective? I gather you’re both interested to know what I’ve been doing, so here’s the roster—the various items underlined.

As soon as I was diagnosed with Idiopathic Pulmonary Fibrosis, I was grateful to have something to focus on and I set two major goals: 1) stop losing weight and ideally gain some back; 2) get my lungs more fit.

Two books were helpful. One came from a recommendation by an IPF patient on the Pulmonary Fibrosis News Forums. She said that the book Ultimate Pulmonary Wellness by Dr. Noah Greenspan had encouraged her to exercise her lungs, and that it helped. I bought the book and found it full of useful lore. The second book came with learning that IPF is largely a disease of the aging, which I am. So I got the current leading book on stalling or even reversely the various effects of aging: Lifespan by David Sinclair at Harvard. He recommends trying a daily dose of NMN and Reservatrol; I mix the powder (half a gram each) into kefir at breakfast.

Dr. Golden, since you mentioned reflux as a possible cause of IPF inflammation, I got a wedge pillow to keep my head higher at night (and I sleep on my left side, which is said by some to help keep stomach contents where they belong). Also at your suggestion, I commenced taking a green tea extract capsule (670 milligrams) every day—between meals when supposedly it is more bioavailable. You also encouraged me to keep exercising.

That I did—in part to exercise my lungs, but even more to see if I could build up muscle mass. Wariness of Omicron covid kept me from the CrossFit gym, so I got a set of dumbells and a bench, adding to them as I got stronger. I now work out pretty intensely every other day for an hour or more. For guidance I tried several fitness apps and settled on an excellent one: Fitbod. To keep track of runs and walks I use Strava.

To track my weight I got an app-connected scale, the iHealth Nexus scale. The iHealth app keeps beautiful track of my weight—which I measure several times a day to get a detailed sense of what drives it up and down. (The app also connects to my pulse oximeter. It’s fascinating to watch my blood oxygen respond to exercise—down a bit, then way up.)

Last November I found my weight sinking to new lows (136.2 pounds) when I traveled. (That’s largely driven by my ongoing dental issues that make me a slow, picky, unsocial eater whose appetite wanes fast.) Dr. Andereck prescribed the antidepressant Remeron (Mirtazapine) to improve my appetite, which it really did. I take just the half-dose, 15 mg. To supplement my mealtime food, I drink several protein drinks (especially after exercise)—Ensure Plus, Ensure Max Protein, and Muscle Milk.

Between the exercise and better eating, my weight stopped going down and has been steadily going up for four months. I’m currently averaging above 144 pounds—8 pounds above my low—and feeling great. [Later as high as 152 pounds–16 pounds above the low.]

A couple of other items have helped. One is the Oura Ring I learned about from David Sinclair’s book. It measures sleep in detail and reads out values on sleep, readiness, and activity in the iPhone app. It is surprisingly revealing and does adjust my behavior toward better sleep and exercise discipline. Ryan got one too; we compare notes in the morning. [Note: the Oura ring now measures nighttime blood oxygen level–mine is currently 98%.]

When my Pulmonary Function Test was approaching, I decided to “study-to-the test” and bought an Airofit spirometer. It turns out to be something athletes use to enhance their performance by increasing their lung capacity and their strength and control of breathing. It is a nifty device that I suspect could be useful to anyone with lung issues. I train with it for a few minutes every morning. In just a couple of weeks my lung capacity (its version) has gone up steadily (from 3.5 to 4.3 liters) [later to 6.5 liters], and so has my inhalation strength.

So, my relevant meds are:
Green tea extract
Remeron
NMN
Resveratrol
Prilosec (for reflux)
Protein drinks (Ensure, Muscle Milk)

Relevant things:
Wedge pillow
Dumbbells and bench
iHealth scale
iHealth pulse oximeter
Oura Ring
Airofit training spirometer

Relevant apps:
iHealth
Apple Health
Fitbod
Strava
Oura Ring
Airofit

[Stewart]

You might want to try an Airofit device.  It’s a kind of training spirometer that athletes (and others) use to increase their lung capacity and the strength and control of their breathing.

I’ve been using one for a couple weeks, training for a few minutes every morning.  Even in that time my lung capacity and inhaling strength increased markedly.

The Airofit and smartphone app cost about $300 at Amazon and elsewhere.

[Stewart]

(Ahem. It was my DOCTOR who said flu shot effectiveness is short-lived.)

[Stewart]

Got booster 10 days ago just by walking into CVS and asking. No qualifications required. I wanted Moderna (said to be better against the Delta variant), but they said CDC required I get same as before, Pfizer it was.

They offered a flu shot as well, so I got that as well. (My said it’s better to get flu shot in September, just before flu season, because its effectiveness declines pretty quickly.

Slightly sore arm for a day.