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Welcome to the VCU Adult Cystic Fibrosis Program!
We are a team consisting of a doctor, nurse, dietitian, respiratory therapist, social worker, pharmacist and research coordinator working together to fully meet any and all needs of our patients and families. We access other specialists when needed to meet the identified issues.
Cystic Fibrosis patients usually transition to the adult center between the age of 18-21 years.
The VCU Cystic Fibrosis (CF) Center is dedicated to providing the very best care and disease management to all of the patients with CF in Virginia and the bordering areas.
Mayland Clinic [View Image]The Mayland Clinic is a component of the VCU Department of Internal Medicine. It is designed to provide comprehensive specialty medical care, nursing care and education information for patients in a variety of Internal Medicine Subspecialties.
The Adult Cystic Fibrosis Clinic is an outpatient service of the Division of Pulmonology, Department of Internal Medicine. The Adult CF Clinic is a part of the Mayland clinic. Routine follow-up visits are provided in the clinic on Tuesdays and Wednesdays by the physician and the CF Team. Sick visits may be seen same day in clinic if schedule permits.
Because Cystic Fibrosis is a multi-organ system disease that affects the lives of both the patient and his/her family, the Adult CF Program Team includes multi-disciplinary healthcare professionals working together to fully meet any and all needs of our patients and families.
Nauman Chaudary, MD, FACP, FCCP
We have one CF physician who is responsible for pulmonary care in both the outpatient clinic and in-patient management of adult patients with CF in central virginia. In addition to caring for patients, our physician participate in laboratory research and direct both investigator-initiated clinical trials and those initiated through the CF TDN. Our physician strive to provide optimal clinical care for our patients while conducting research that will increase our understanding of CF and improve the lives of our patients.
The Adult CF Clinic at VCU has one nurse coordinator who organize clinic and schedule patients, necessary procedures, follow-up clinic visits and hospital admissions. Nurse coordinate care between patients and physicians, endocrinologist, dietitian, social worker and respiratory therapist. In addition, nurse take care of insurance precertification for clinic visits, laboratory procedures and hospital admissions.
Respiratory therapist is available at all clinic visits. RTs are responsible for the following:
A registered dietitian (RD) is available to help CF patients optimize their nutritional status. When a person's nutrition status is better, so is his or her lung function. The RD's goal is to help an adult CF patient personalize nutrition-related goals to his or her own lifestyle. Nutrition visits include discussing the following:
Social workers in the CF team have an important role to play in helping patients and their families cope more effectively with the inevitable stress of having a chronic illness. By acting as an advocate for patients, social work assessments guide CF patients toward the following:
We have one research coordinator who prepare Institutional Review Board (IRB) submissions for new research studies, including research study protocol summaries, consent forms, assent forms and required IRB forms, as well as protocol amendments, safety updates, and serious adverse events. These studies are part of the CF TDN or investigator-initiated by our physicians.
We have compiled resources to help you better understand Cystic Fibrosis. Please click on the following headings for more information.
Cystic Fibrosis (CF) is an inherited disease of your mucus and sweat glands. It affects mostly your lungs, pancreas, liver, intestines, sinuses, and sex organs.
Below you will find the following information on Cystic Fibrosis:
Symptoms and Diagnosis
The most common symptoms of CF are frequent coughing with phlegm, frequent bouts of bronchitis and pneumonia, salty-tasting skin, dehydration, poor growth, and infertility, mostly in men. A sweat test is the most common diagnostic test for CF – it measures the amount of salt in your sweat. Other tests that can be used to help diagnose CF include a chest x ray, sinus x ray, CT-scan, lung function tests, analysis of sputum cultures and/or stool samples, and genetic testing of a blood sample. Prenatal genetic testing can help you find out if your baby is likely to have CF.
Associated Health Issues
Normally, mucus is watery. It keeps the linings of certain organs moist and prevents them from drying out or getting infected. But in CF, an abnormal gene causes mucus to become thick and sticky which can have negative affects on multiple areas of health. The symptoms and severity of CF vary from person to person. Some people with CF have serious lung and digestive problems. Other people have more mild disease that doesn't show up until they are adolescents or young adults.
In people with CF, mucus builds up in the lungs and blocks the airways, creating an environment that makes it easy for bacteria to grow and leads to repeated serious lung infections. Over time, these infections can cause serious damage to the lungs. Respiratory failure is the most common cause of death in people with CF.
The mucus can also block tubes, or ducts, in your pancreas. As a result, digestive enzymes that are produced by your pancreas cannot reach your small intestine. These enzymes help break down the food that you eat. Without them, your intestines cannot absorb fats and proteins fully. Nutrients leave your body unused, and you can become malnourished. Your stools become bulky. You may not get enough vitamins A, D, E, and K. You may have intestinal gas, a swollen belly, and pain or discomfort.
The abnormal gene also causes your sweat to become extremely salty. As a result, when you perspire, your body loses large amounts of salt. This can upset the balance of minerals in your blood. The imbalance may cause you to have a heat emergency. It is extremely important, especially in hot summer days, to always stay well hydrated.
CF can also cause infertility (mostly in men).
Antibiotics are the primary treatment for lung problems in CF. They treat airway infections. Other treatments include chest physical therapy, exercise, mucus-thinning drugs, and other medications to reduce inflammation in your airways and help open them up.
Lung transplantation is an option for some people with CF. The digestive problems in people with CF can be managed with nutritional therapy, enemas, mucus- thinning drugs, and medications to reduce stomach acid.
Ongoing medical care from a team of health care providers who specialize in CF is important. Good self-management includes eating a healthy diet, avoiding tobacco smoke, exercising frequently, doing chest physical therapy every day, drinking lots of fluids, and washing your hands often to reduce your chances of infection.
CF research continues to seek better treatments and a cure. However, much progress has been made in the past 50 years. Until the 1980s, most deaths from CF occurred in children and teenagers. Today, with improved treatments, people with CF live, on average, to be more than 38 years old.
Cystic Fibrosis (CF) is caused by a defect in a gene called the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This gene makes a protein that controls the movement of salt and water in and out of the cells in your body. In people with CF, the gene does not work effectively. This causes the thick, sticky mucus and very salty sweat that are the main features of CF.
Each of us inherits two CFTR genes - one from each parent.
Children who inherit an abnormal CFTR gene from each parent will have CF. Children who inherit an abnormal CFTR gene from one parent and a normal CFTR gene from the other parent will not have CF. They will be CF carriers.
When two CF carriers have a baby, the baby has a:
The diagram below illustrates how CF is passed on.
Cystic Fibrosis (CF) affects:
National Occurance Rates
About 40,000 people in the United States have Cystic Fibrosis (CF). About 1 in every 3,000 babies born in the United States has CF. About 12 million Americans are carriers of an abnormal CF gene. Many of them do not know that they are CF carriers.
CF Amongst Different Ethnic Groups
CF is one of the most common inherited diseases among Caucasians. CF is also common in Latinos and Native Americans, especially the Pueblo tribes. CF is much less common among African Americans and Asian Americans.
Most of the symptoms of Cystic Fibrosis (CF) are caused by the thick, sticky mucus. The most common symptoms include:
CF can also lead to other medical problems, including:
First, your doctor will obtain a detailed medical and family history and perform a thorough physical examination.
Next, your doctor may order some tests to ensure an accurate diagnosis. The sweat test is the most useful test for diagnosing Cystic Fibrosis (CF). It measures the amount of salt in your sweat. For this test, doctors rub a small amount of a chemical called pilocarpine (pi-lo-KAR-pen) on your arm or leg. They then attach an electrode to this spot. The electrode provides a mild electric current that produces sweat. This may cause tingling or a feeling of warmth. They then cover the area with a gauze pad or filter paper and wrap in plastic. After 30 to 40 minutes, they remove the plastic so the sweat that collected on the pad or paper can be analyzed. The test is usually done twice. High salt levels indicate CF.
Your doctor may also do the following tests to understand more about your condition and how to treat it:
If you are pregnant, prenatal genetic tests can find out if your baby has CF:
All States are now testing the blood of all newborns for CF.
CF Carrier Testing
A genetics counselor at VCU hospital can take a blood or saliva sample to see if it contains the abnormal CFTR gene that causes CF. It will detect 9 out of 10 cases of CF. Some insurance plans cover genetic testing.
There still is no cure for Cystic Fibrosis (CF), but treatments have improved greatly in recent years. The goals of CF treatment are to reduce symptoms and improve quality of life by:
Below you will find information on the following CF Treatments:
Recently small molecule therapies have become available for a small subset of the patient population with CF in which a drug acts at basic defect in CF and improves hydration of secretions resulting in substantial improvement of quality of life. More research is ongoing to investigate these drugs for a large group of CF patients.
Most people with CF have ongoing, low-grade lung infections. Sometimes, these infections become so serious that you may need to be hospitalized. Antibiotics are the primary treatment. Sometimes it may be possible to receive intra-venous (IV) antibiotics at home.
Chest Physical Therapy is also called chest clapping or percussion. It involves pounding your chest and back over and over again to dislodge the mucus from your lungs so that you can cough up the mucus. CPT for Cystic Fibrosis should be done three to four times each day.
CPT is also often referred to as postural drainage. This involves sitting or lying on your stomach while you do CPT. This allows gravity to help drain the mucus from your lungs.
If the level of oxygen in your blood is too low, you may need oxygen therapy. Oxygen is usually given through nasal prongs (cannula) or a mask.
Nutritional therapy can improve your growth and development, strength, and exercise tolerance. It may also make you strong enough to resist some lung infections. Nutritional therapy includes a well-balanced, high-calorie diet that is low in fat and high in protein.
If you have Cystic Fibrosis (CF), you should learn as much as you can about the disease and work closely with your doctors to learn how to manage it.
Ongoing medical care is important. You should seek treatment from a team of doctors, nurses, and respiratory therapists who specialize in CF. These specialists are often located at CF Foundation Centers in major medical centers.
Good Self-Care Includes:
You can expect to have a normal sex life.
If you are a parent of someone with CF, do not feel guilty about passing it on to your child. And do not be overprotective; encourage your child to be active and self-reliant.
Patients with CF should avoid social contact with other CF patients.
A minimum of 6 feet distance is to be maintained among 2 CF patients as recommended by the CF Foundation guidelines.
There should not be more than one CF patient in any CF Foundation sponsored CF indoor event.
Below you will find information and resources on various CF Related Topics. These documents are in PDF form for ease of viewing, downloading, and printing.
Instructions for Various Techniques and Therapies:
Information on Preventative Practices:
Participation in research trials helps bring new drugs to CF patients. To learn more about clinical research, please see the Cystic Fibrosis Foundation's Clinical Trials Page.
To find out how you can participate in CF research studies at VCU, please go to our contacts section.
Adult Cystic Fibrosis Program Clinic
3470 Mayland Court
Henrico, Virginia 23233
Phone: (804) 527-4540 (appointments)
We welcome the opportunity to work with patients and primary care physicians in Virginia, Washington D.C, West Virginia, Kentucky, Maryland, and Carolinas.