What We Treat

 

There are many different diseases that can affect the lungs, either alone or as a multisystem disorder. The more common diseases we see on a regular basis in Cork are:

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) - COPD is a multisystem disorder associated with progressive airflow obstruction leading to chronic cough which can be productive, shortness of breath and wheeze. It usually occurs in smokers. Early detection and smoking cessation is important in control and treatment. It is diagnosed through a combination of clinical symptoms and pulmonary function testing which is available at CUH. Our staff includes a COPD Nurse Specialist, whose input helps in providing a holistic approach to this chronic disease. We aim to provide advice on the 4 key strands of COPD care including diagnosis with spirometry, chronic disease management, pulmonary rehabilitation for all suitable COPD patients and the prevention and management of acute exacerbations of COPD. The pulmonary rehabilitation program has been a recent recipient of the CUH jubilee award for an innovative and excellent service. 

Ms Bernadette Bowen is the lead clinical nurse specialist for COPD and leads the pulmonary rehabilitation program in SFH. Her other roles include provision of diagnostic spirometry, education and provision of information to patients on COPD and inhaler type and technique. Ms Bowen co-ordinates appointments for the pulmonary rehab program.  Bernadette’s contact details are: 086 8228176. 

Ms Carmel Casey is the Senior Specialist Physiotherapist who co-ordinates the COPD early supported discharge program and Carmel’s contact details are:  Carmel Casey,  Senior Physiotherapist,  COPD Outreach 086-4182004.

For more information: http://www.goldcopd.comhttp://copd.ie/

 

Asthma

Asthma is a disease which commonly leads to intermittent and reversible airway obstruction with cough, shortness of breath and wheeze. These increases in symptoms are often termed exacerbations, and the factors which precipitate these events termed triggers. Typical triggers include allergens such as dust and grass, and irritants such as smoke and aerosols. Asthma symptoms can also be caused by exercise and infection. It is diagnosed through a combination of clinical symptoms and pulmonary function testing available at CUH. With advances in therapy, not all asthmatics need regular follow-up at hospital, however a sub-set of asthmatics have ‘difficult’ asthma and attend the “difficult to treat” asthma clinic in CUH.  Reference: the Global Initiative for asthma: http://www.ginasthma.com/

 

Cystic Fibrosis

Cystic Fibrosis (CF) is Ireland's most common life-threatening inherited disease. Approximately 1 in 19 people are carriers of the CF gene and where two carriers parent a child together, there is a 1 in 4 chance of the baby being born with CF. 

CF affects the CFTR protein, a chloride channel expressed in most cells of the body, damaging many organs including the lungs, the pancreas, the liver, the digestive tract and the reproductive system. It causes thick sticky mucus to be produced, blocking the bronchial tubes and preventing the body's natural enzymes from digesting food. (http://www.cfireland.ie). For the majority of patients the disease culminates with recurrent and increasing numbers of Respiratory Tract infections requiring either home or inpatient intravenous antibiotics. The Department of Respiratory Medicine is one of the National designated CF centres. It’s expanding clinical and research program is currently looking after in excess of 170 adult patients with cystic fibrosis.  

The service operates out of the Adult CF day centre and is staffed by three full time CF nurse specialists (Ms. Cathy Shortt CNS, Ms. Mairead McCarthy, CNS and Ms. Claire Fleming, CNS, a dedicated Clinical Specialist Registrar (SpR), Senior Physiotherapist (Ms. Claire Hickey), Senior Dietician (Ms Ciara Howlett) with additional support from allied services including diabetes and renal medicine. In addition a CF specific research staff work closely with the clinical team to offer ‘new/future’ therapies as part of standard care.

90% of all care is provided on an ambulatory basis through the Adult CF centre, however, when necessary patients are admitted to State of the Art, single en suite CF designated beds in the Respiratory ward on 5B. 

The CF service can be contacted directly on 087-2241824.

CF nurse specialists email: cathy.shortt@hse.ie / mairead.mccarthy1@hse.ie / claire.fleming@hse.ie

 

Lung Cancer

Members of the Department of Respiratory medicine work in conjunction with our Multidisciplinary Thoracic Oncology Group which includes radiologists, thoracic surgeons, palliative care specialists, oncologists, and radiation oncologists in the care of patients with lung cancer. A rapid access clinic allows quicker diagnosis and staging of lung cancer. The rapid access clinic is held weekly and we aim to see all patients referred within 10 working days. For information on the how to refer to this clinic:

http://www.hse.ie/eng/services/list/5/cancer/profinfo/resources/gpreferrals/GP_Lung_Referral_Form_and_Guidelines.html  

This form can be faxed to the department of respiratory medicine at Fax: (021) 4922391 

For further details of the lung cancer service contact the cancer control office CUH Tel: (021) 492 0453 or contact Sharon Guiry our lung cancer nurse specialist through CUH switchboard 021 4546400. 

Our Specialist Nursing Staff have led a project regarding lung cancer survivorship which is in operation with success at Cork University Hospital (http://www.cancer.ie/cancer-information/newsletter/cancer-information-service-update-Spring15/lung-cancer-survivorship#sthash.thnF3Gdm.dpbs) 

The division also has expertise in treating complications of cancer, including complications of treatment in cancer survivors and has been a recent recipient of the CUH jubilee award for excellence. (http://www.cancer.ie/cancerInfo/lung_cancer_information.php)

 

  • Interstitial Lung Disease - The Department includes expertise in the diagnosis and management of many forms of lung fibrosis including idiopathic pulmonary fibrosis and sarcoidosis. The department runs a twice monthly dedicated clinic for patients with interstitial lung disease / pulmonary fibrosis on the first and second Wednesday of each month. Here patients are assessed for diagnosis and provision of novel therapies for IPF including Pirfenidone and Nintedanib. Ms Bernadette Bowen is the Clinical Nurse Specialist for this service also Tel: 086 8228176. She provides information on the various interstitial lung diseases including idiopathic pulmonary fibrosis (IPF)  www.ilfa.ie and helps co-ordinate the education of patients and provision of information on these newer drugs

     

  • Dr Henry also runs a joint clinic with the department of rheumatology for patients with connective tissue disease related pulmonary disease including pulmonary fibrosis, pulmonary hypertension and vasculitis. This is the only such service available nationally and has been a recent recipient of the Bernard O’Connor Bursary.

 

  • Non- CF Bronchiectasis- This is an emerging and import cohort of respiratory patients with significant burden of disease from recurrent pulmonary exacerbations. Professor Barry Plant and Dr. Marcus Kennedy run this service as a quaternary referral clinic every fifth Wednesday of the month. Equally new therapies for this group of patients are emerging as this clinic is now affiliated with an Innovations in Medicine Initiative iABC (http://www.imi.europa.eu/content/iabc)

 

  • Other Respiratory Diseases- The Department has expertise in treating all other lung diseases prevalent in Ireland including but not limited to tuberculosis, bronchiectasis, pulmonary hypertension, drug induced lung disease, alpha one antitrypsin deficiency, occupational lung disease, pleural disease, and patients pre- and post- lung transplant.