The chronic forms of aspergillosis (i.e. those suffered by people with a normal immune system) can be lifelong illnesses so treatments and maintenance are key issues. All are the result of the fungus gaining a foothold in part of the body and growing slowly, all the while irritating the surface of the delicate tissues they come into contact with, causing changes to the tissues concerned.
Most of these types of aspergillosis affect the lungs and sinuses. As far as the lungs are concerned, the delicate tissues irritated by the fungus are important, as they allow us to breathe. These tissues must be flexible in order to stretch as we breathe in, and thin in order to allow efficient exchange of gases to and from the blood supply which runs just below the membranes.
Irritation causes these tissues to inflame and then to thicken and scar – a process which makes the tissues thick and inflexible.
Doctors try to manage this process firstly by diagnosing as early as possible – something that has been difficult in the past but is starting to get easier with the new technology starting to become available.
The next most important thing is to reduce or prevent inflammation, so steroids are prescribed. The dose is often varied by the doctor according to symptoms (N.B. NOT something to attempt under any circumstances without your doctor’s agreement) in an attempt to minimise the dose. Steroids have many side effects and minimising the dose also minimises those side effects.
Antifungals such as itraconazole, voriconazole or posaconazole are also often used as, although they cannot eradicate the infection, they do reduce symptoms quite markedly in many cases. The dose of the antifungal is also minimised to prevent side effects but sometimes also to minimise cost, as antifungals can be very expensive.
Antifungal medication aims to lower your fungal burden, to minimise your symptoms and prevent further damage to your lungs. These are strong drugs that can have unpleasant side effects. Antifungals interact with many other medications – you can check whether your antifungals interact with any other medications you are taking using the Antifungal Interactions Database.
Some patients will find themselves on antibiotics from time to time as bacterial infections can be a secondary form of infection in chronic aspergillosis.
The most important parts of your treatment are the medication and recommendations that your doctor and care team give you, and these cannot safely be replaced by treatments or supplements bought online.
Our support groups are packed with lively discussions about what patients can do alongside their treatment to ease symptoms and get the most out of life. Some of this information is captured in the pages linked below, and backed up with hard science wherever possible.
Lifestyle changes and skills-based therapies (mindfulness, CBT, etc) can help to improve quality of life factors such as mood, sleep quality, pain or muscle tension.
Diet plays a huge role in health, but there is a lot of poor-quality information both online and in print media that may not be wise for patients with serious illnesses like aspergillosis.
Complementary therapies can help some people to feel more well in themselves, but they come with certain risks and cannot replace proper medical treatment. In particular be very cautious about buying supplements over the Internet as some can be dangerous (even if they are labelled ‘natural’).
Self-care tools such as emergency cards or health tracking apps can help you to communicate more effectively with clinicians and take the best possible care of yourself.