Newspaper article St Louis Post-Dispatch (MO)

Rheumatoid Arthritis Sometimes Affects Lungs

Newspaper article St Louis Post-Dispatch (MO)

Rheumatoid Arthritis Sometimes Affects Lungs

Article excerpt

Dear Dr. Donohue: I had pneumonia last winter, and my doctor sent me to a pulmonary specialist, who said I had "rheumatoid lung." I have had rheumatoid arthritis for years. How can a joint problem affect the lungs? I was having terrible coughing.

Only a few patients ever experience lung difficulty as part of general rheumatoid arthritis.

Were you to do a man-in-the-street poll, not one in a hundred would be aware of rheumatoid arthritis manifesting itself any place other than in joints, much less in lungs. But it happens, and it suggests why we call rheumatoid arthritis a "systemic" - system-wide - illness.

When rheumatoid arthritis does affect a patient's lungs, the rheumatoid process usually affects the pleura, the lung coverings, with inflammation and sometimes fluid buildup. That's pleural effusion.

Less commonly, the rheumatoid lung produces nodules or sometimes a scarring that we refer to as "pulmonary fibrosis." From your coughing, I suspect you have that.

Treatment depends on just what kind of lung involvement is occurring. Your present treatment, which you detailed in an edited portion of your letter, seems to be aimed at pulmonary fibrosis.

Dear Dr. Donohue: I do not recall you commenting on the practice of some people drinking no water whatever. I mean the people who substitute milk and colas.

You suggest your own answer here - when you mention the substitutes for the water.

Plain water itself adds little or no harm to the nutritional equation. Not so the substitutes. Colas add a good deal of useless calories and harmful sugar. If you go overboard with milk as a fluid substitute, you have to accept not only its calories but also its fat and cholesterol, unless the product is skimmed.

When I mention water in this context, I am asked how much of it a person should drink a day. There is no rule beyond what common sense and comfort dictate. You need two to three quarts of total fluid daily, and given the negatives inherent in substitutes, a substantial amount ought to be as plain tap water. …

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