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Workers who believe they are or have been overexposed to silica dust should visit a doctor specializing in lung diseases, a pulmonologist. Silicosis often goes untreated and undiagnosed, especially chronic silicosis, because its symptoms are not unique. A person's occupational history with silica dust exposure will help doctors evaluate possible medical problems. A thorough medical examination using a chest X-ray and lung function test can determine if a person has silicosis. Workers at risk of exposure, such as miners or sandblasters should have lung examinations at least every 3 years. Above all, prevention of the disease is key, because there is no way to reverse the disease.

Lung function tests are useful in early diagnosis of the disease, often showing poor airways and bronchitis associated with irritation from the dust. As the disease progresses, emphysema may be seen in and the lung capacity is decreased.

Imaging tools like CT scans, MRIs, or invasive procedures are almost never required to make the diagnosis of silicosis as a simple Chest X-Ray will suffice. However, patients at risk should let their doctor know, because the doctor may not think to look for the disease which is relatively uncommon. As with any uncommon condition, there are risks of misdiagnosis. It may often be misdiagnosed as pulmonary edema (fluid in the lungs), pneumonia, or tuberculosis.


Treatments and Management of Silicosis

Since the disease cannot be reversed, few lasting treatments are available. The first step is obviously stopping continuing exposure. This will not stop the gradual progression the disease, but will prevent it from an even faster rate of progression.

Most treatments aim to relieve pain and suffering. Most patients are administered oxygen and steroids to help them breathe as the disease runs its course. Most doctors use corticosteroids, some immunosuppressive drugs, and a few experimental medications to slow down the inflammation, but effect is only temporary. Unfortunately, the only good treatment for end-stage silicosis is a lung transplant, which can be a lifesaving treatment. See more below.

The general control of the disease includes:
Use of Oxygen
Make sure the patient stops smoking
Monitoring the person for signs of lung infection, (which can be treated with early detection)
Doctors have also tried aluminum powder, d-penicillamine, and polyvinyl pyridine-N-oxide. The Chinese herbal extract tetrandine in clinical trials may slow progression of silicosis.

Lung Transplant Surgery

Having a single lung transplant is an operation to remove one diseased lungs and replacing it with a new lung. Having a double lung transplant means having an operation to remove both diseased lungs. These lungs are replaced with the healthy lungs from another human being. This new lung(s) will work to help the person breathe by providing the body with oxygen and removing carbon dioxide just as the person's own lungs did when they were healthy. This new lung or lungs will come from a person who is an organ donor. This person has suffered and injury to the blood supply to the brain which results in "brain death". This person's lungs are normal and not affected by this injury.

Before the transplant the doctor matches donors with the people who are awaiting transplants. This matching is based primarily on the size of the donor and the blood type. The lungs from the donor are removed by a surgeon from the Transplant Team who brings the lungs to the Hospital. While this is happening the patient may be notified to come to the emergency room at the Hospital. The patient is then transferred to the operating room where an anesthesiologist will prepare them for surgery.

In a single lung transplant, the incision is made on the side, either right or left, about six inches below the underarm. A small section of the rib is removed permanently to allow access to the surgical site. The old lung is removed through this opening and the new lung is implanted.

In the case of a double lung transplant the incision runs across the lower part of the chest. One lung is removed, and the new one implanted; then the second lung is removed and the new one implanted.

The lung, whether single or double, is connected to the pulmonary artery, pulmonary veins, and the mainstem bronchus(airway). The incision or incisions are closed and a dressing is applied.

Prognosis

A lung transplant generally prolongs the life of a patient who otherwise would die because of advanced stage of silicosis. A transplant is performed only in patients where there is a very good chance of success. According to the United Network for Organ Sharing (UNOS) the patient survival rates for all patients that had a lung transplant are 85% at one month, 69% at one year, and 51% at three years for patients transplanted between 1987 and 1992. Results since those years are likely to be much better.

The problems related to heart lung transplants are finding a donor, fighting the rejection effect, and the cost of the surgery.

Finding a donor for heart-lung transplant is difficult. The organs must come from a person who has been declared brain-dead but is still on life-support while the patient is still in healthy-enough condition to survive the surgery.

After the surgery the body may reject the organs. The body's immune system may consider the transplanted organs an invader and rejects the organs the same way it would fight an infection. To stop the body from reacting in this way, organ transplant patients are given anti-rejection (immunosuppression) drugs (such as cyclosporine and corticosteroids) that suppress the body's immune response and reduce the chance of rejection. Unfortunately these drugs also reduce the body's natural ability to fight off other dangerous infections.
A patient undergoing a lung transplant will often remain in the hospital for months, the full recovery period is about 6 months. Follow-ups along with blood tests and X-ray will be necessary for the remainder of the patients life.



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