The developed world has seen a strong increase in both the lifespan and quality of life for individuals diagnosed with cystic fibrosis. In both the United States and Canada, better treatment options and earlier diagnosis have made living with the chronic illness much more manageable.
Interestingly, the increase in lifespan and median age of survival is not even across the two neighboring nations. Recent studies have suggested that people diagnosed with cystic fibrosis in Canada are expected to live 10 years longer than those in the United States.
As recently as 30 years ago, the median age of survival in Canada for those with CF was estimated to be 25 years. Today, that number has doubled to approximately 51 years, while the median age of survival in the United States stands closer to 40. For a chronic illness that used to have a prognosis of six months in young children, it is clear that the fight against cystic fibrosis has taken great leaps.
Still, the gap in lifespan between Canada and the United States suggests that some approaches are more effective than others in managing and treating CF. Identifying key differences in the approaches of the two nations over the years could help increase lifespan and quality of life for all diagnosed with cystic fibrosis.
Emphasis on Diet
The nature of cystic fibrosis makes it difficult for the body to absorb essential vitamins, utilize essential minerals, and fight off infections. Common symptoms of cystic fibrosis include being short and underweight for one’s age, and frequently catching colds or the flu.
In the 1970s, Canadian implemented a dietary strategy that focused on high caloric intake and high levels of fat. The goal of the diet was to provide the body with more energy and more nutrients to fight infections and keep the body strong. By focusing on nutrition from an early age, children diagnosed with cystic fibrosis demonstrated higher survival.
The United States did not implement this diet until ten years later, and it is no coincidence that ten years after Canada began to see a dramatic improvement in median survival age, the United States began to see much of the same. Today, the benefits of strong nutritional support and dietary consciousness from early age may continue to increase life expectancy.
The dietary recommendations for children diagnosed with cystic fibrosis are often those that adults are told to stay away from. Cheeseburgers, pizza, and ice cream are all considered highly desirable items, as are any items high in fat and caloric content. Low fat or nonfat options that typically fall under the “dieting” category can be damaging to a growing youth living with cystic fibrosis.
This does not necessarily mean that an individual will be happy with their diet, as maintaining such an aggressive diet often proves difficult. As much as someone might want to skip a meal or simply lack hunger, it is important for people with cystic fibrosis to eat a lot, and eat frequently.
People with cystic fibrosis still require a balanced diet, complete with fruits and vegetables, and a specific person’s diet will change from person to person. Focusing on dietary support and monitoring a developing child’s overall health can ensure that they grow to be strong, healthy adults.
Accessibility of Lung Transplants
The area of the body that cystic fibrosis affects the most strongly is the lungs. Repeated clogging of the airways due to mucus buildup and inflammation, among other difficulties, often leaves the lungs structurally weakened or damaged.
For this reason, a lung transplant can be one of the most immediately beneficial and impactful survival strategies for those living with cystic fibrosis. The procedure is more common for Canadians to undergo than Americans, possibly contributing to the higher lifespans of Canadians over Americans.
While there are many factors at play in the treatment and management of cystic fibrosis, it is a widely held belief that the lung transplant is the most beneficial procedure that one can undergo to increase survival. In Canada, the procedure is more widely available than it is in the United States, on account of a scoring system that the US employs to prioritize individuals placed on the waiting list.
The Cystic Fibrosis Foundation provides a detailed guide and much useful information in approaching receiving a lung transplant. Suffice to say that the process is long and demanding, and part of the process of undergoing a lung transplant is in ensuring that the lung received will be taken care of and properly transplanted.
As with much of living with cystic fibrosis, receiving a transplant requires much discipline both during and after the new lungs are received. Still, the Cystic Fibrosis Foundation has made it one of their central goals to improve the possibilities and outcomes of receiving a lung transplant.
Healthcare and the Status of Insurance
It is a well-known fact that Canadians receive publicly funded, universal health care, and citizens of the United States do not. Those living in the United States typically pay for private insurance, or receive some form of Medicare.
This difference is perhaps the most overarching factor in determining how at-risk an individual may or may not be when diagnosed with cystic fibrosis. Without access to care, the chances of a longer survival with cystic fibrosis and living with a high quality of life sharply declines.
In the case of US private health insurance, there is no differentiation between Canadians and Americans. Oftentimes, complications surrounding living with cystic fibrosis can be solved or temporarily subdued simply by having access to prescriptions or examination. The quality of care received in the United States may in some ways differ in terms of private coverage, but it is clear in comparison with the universality of health care in Canada. There is no obvious decline in the quality of care received in either case.
The first discrepancies in risk levels arise with reliance upon Medicare. Canadians have a lower risk of death than individuals in the United States receiving both continuous and intermittent care through a Medicare program, approximately 44% and 36% lower risk respectively. Higher out-of-pocket premiums and fewer benefits through Medicare may contribute to the elevated American risk for death, but the system remains effective for instances in which antibiotics or common treatments are called for.
The largest gap in lifespan occurs when an individual has unknown or no insurance. Canadians have a 77% lower risk of death compared to individuals without coverage in the United States. Without access to care, even slight complications can compile and lead to more serious, irreversible damage.
As mentioned earlier, cystic fibrosis impacts the lungs the most. Progressive lung disease is the most common cause of death for people diagnosed with CF, which means that care of the lungs is imperative for those diagnosed.
Diet, transplants, and insurance are part of a larger picture in approaching the treatment and management of cystic fibrosis. Each contributes to the likelihood that someone living with CF will be able to fight off infections, mucus buildup, and permanent damage to the lungs and other critical body systems.
Ultimately, management of the illness and quality of life come down to the pursuit of the healthiest, most proactive measures to stay strong and healthy. Exercising and nutrition go hand in hand, as do insurance coverage and willingness to seek out different opinions and take on the most effective treatments.
In all cases, with cystic fibrosis or without, seeking to be the healthiest individual you can be is the only way to ensure the longest, most rewarding life possible.