My CF Exacerbation Complication: Atelectasis

Living with CF, I know pain–all kinds of different types, locations, and degrees of pain. Pain from lung infections and coughing, abdominal pain or “CF belly” pain, joint pain, and pain from procedures or testing are all just a part of CF life. Frankly, the list can go on and on.

A new kind of pain

Last month, I felt a pain in my shoulder that I experienced once before back in May when I had a bout of pneumonia. it followed the typical pneumonia vibe-- a sharp pain that got worse when I inhaled, coughed, or bent over. With this pain it was really hard to breathe beyond shallow breaths. Plus, I could barely lay down on my back without wincing. At the time, I relied on pain meds to sleep and Tylenol during airway clearance to help control it. however instead of the pain going away once I started IVs like last time, this pain continued for days and got worse over time.

I called my CF care team and asked for an X-ray to triple check this was just pneumonia. In fact, the X-ray gave us a clue to explain the source of the pain: atelectasis. That’s a new one!

What is atelectasis?

Atelectasis occurs when a portion of the lung or the entire lung itself collapses. With atelectasis, small sacs in the lung called alveoli cannot properly inflate with oxygen due to obstruction (i.e. mucus plugs), infection, tumors, or foreign objects.¹ This causes the sacs to collapse on themselves. In addition, atelectasis is fairly common after anesthesia used for surgery.

Symptoms of atelectasis can include:¹

• Shortness of breath
• Coughing
• Chest pain
• Rapid breathing Low blood oxygen level

Atelectasis vs. pneumothorax

Many people are aware of a pneumothorax, or collapsed lung, but not atelectasis. The difference between the two is primarily what causes the collapse. Atelectasis is when the alveoli cannot properly inflate with oxygen and the lung tissue collapses. In comparison, pneumothorax is when air leaks into the space between the lung and chest wall.² The pressure from the outside causes the lung to collapse. Both can cause serious complications and need to be evaluated by a doctor and treated right away.

Treating my atelectasis

The good news about the X-ray was the validation that the treatment I was doing was the right route to go. Atelectasis is treated by addressing the underlying respiratory problem. In my case, that meant treating the pneumonia with IV antibiotics and increasing my airway clearance to help dislodge the mucus plugs I was coughing up. The goal was to clear up my infection, and hopefully with time, the atelectasis would heal itself and those lobes would open up. Sometimes, scar tissue develops and the collapsed spots do not re-inflate.

After 3 weeks, I stopped IV antibiotics and my pulmonary function test (PFT) remained about the same. I told myself not to feel disappointed because often it takes longer to heal back to baseline than the amount of time it took to get sick. I hope with time my lungs can fully inflate to their biggest and brightest selves.

Have you ever experienced atelectasis or a collapsed lung? Share your experience with other CFers in the comments below!