
Common questions, with answers on miscellaneous topics, about sarcoidosis,
by the late Dr. Om P. Sharma.
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122. If a sarcoid patient is traveling overseas,
what inoculations, should he take?
There are no special inoculations for sarcoidosis patients. They
need the same inoculations as other individuals.
123. If I travel to Europe, Asia, Canada
or any other country, would I be able to find a sarcoidosis specialist
in case of emergency?
Yes. For the addresses, write to your local sarcoidosis support
group. There are many such support groups exist in the US, UK, and
Europe. Some of the addresses are in this brochure.
124. Who is the best physician to take care
of my illness?
Sarcoidosis is best controlled by a doctor whose special interest
is sarcoidosis. Since the lungs are the most frequently affected
organs, a lung specialist is often the physician who treats sarcoidosis
patients. There are many sarcoidosis specialists, most of them at
major medical schools and research centers.
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125. Where can I read more about sarcoidosis?
Your local chapter of the American Lung Association and the American
College of Chest Physicians will help you with sarcoidosis
literature.
126. What is a Holter monitor?
EKG and Holter monitoring are two simple tests to assess the heart
activity and function sarcoidosis of the heart. While an EKG traces
the heart activity over a short period, the Holter monitor is worn
for a period of 24-48 hours and records the heart rate over a longer
period.
127. I have Stage III sarcoidosis. Do I need
oxygen?
Oxygen is needed when the level of oxygen in the blood is below
normal. If the blood oxygen level at rest and on exercise is normal
then oxygen is not required. Most of the patients with stage III
disease have advanced fibrosis and have shortness of breath; these
patients need oxygen. However, some of the patient with state III
disease may have normal oxygen level. Staging of the disease is
based on the chest x-ray abnormality. A chest x-ray may suggest
severe disease, but it does not always reflect the functional severity
of and need for oxygen.
128. Do I need a 'flu shot'?
Sarcoidosis patients with lung disease and those taking drugs that
suppress the immune system should get flu vaccination every year.
The best time to get a flu vaccine is late October or November,
because most influenza occurs in January of later. The flu shot
is an inactivated vaccine containing a killed virus. An allergic
reaction may occur. You need to discuss it with your doctor
if you have an allergy to eggs or previous flu injection.
129. I have joint pains in the mornings it
usually goes away in a few hours. Is it related to my sarcoidosis?
Sarcoidosis may affect the joints in about a third of the patients
with sarcoidosis. Joint pains and arthritis are more common than
sarcoidosis. It is necessary to know what is causing joint pain
in a given patient. In sarcoidosis inflammation of the joints can
be acute and associated with raised tender, red nodules on the left
called erythema nodosum. This type of joint inflammation subsides
in a few days to weeks and requires no more than aspirin, Tylenol
or other anti-inflammatory drugs. The other type of joint inflammation
is chronic and last for months to years, and in some cases associate
with bone lesions called 'bone-cysts' involving the small bones
and joints of hand and feet.
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130. What is a pacemaker and why do some
of the patients with sarcoidosis need the device?
A pacemaker is a battery operated device that regulated the heart
rhythm in patients who either have very slow heart rate (heart block)
or have an irregular rhythm that interferes with heart function.
In a combined pacemaker-defibrillator device the defibrillator.
131. How is eye sarcoidosis diagnosed?
Every patient should have complete work up, including a slit lamp
eye examination at the time the diagnosis of sarcoidosis is made.
Many patients with ocular sarcoidosis have no eye symptoms. In a
patient with uveitis, lacrimal gland enlargement, papilloedema,
or other unexplained eye lesions, sarcoidosis should be considered
a possible diagnosis and a chest x-ray should be obtained to find
evidence of hilar adenopathy with or without pulmonary infiltrate.
Lacrimal gland and conjunctival biopsies are very helpful in diagnosing
sarcoidosis.
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