what it feels like to have 'feather duvet lung' — and how the doctor figured it out

martin taylor has swapped his feather-filled bedding for hypoallergenic linens after his fluffy feather duvet caused such severe lung injury he could barely crawl up the steps to bed at night.on reflection, he should have stayed on the sofa.in 2016, taylor developed “feather duvet lung,” a form of hypersensitivity pneumonitis, or “bird fancier’s lung,” of which feather duvet lung is a rare, and under-appreciated subset.the condition results from inhaling organic dust from duck or goose feathers found in duvets and pillows, doctors warned tuesday in the journal bmj case reports.with repeated exposure, the air sacs and airways in the lungs become severely inflamed, causing progressive, and potentially irreversible, scarring of the lungs.soon after he and his wife acquired a feather duvet and pillows, “having formerly had synthetic bedding,” taylor, of aberdeenshire, scotland, began experiencing malaise, fatigue and breathlessness, dr. owen dempsey, a consultant chest physician at aberdeen royal infirmary and colleagues reported. taylor couldn’t stand or walk for more than a few minutes without feeling he was about to pass out.a non-smoker, taylor was normally well, except for occasional bouts of sciatic nerve pain and tinnitus, or ringing in the ears.after three months of symptoms, he saw his gp but a chest x-ray came back “normal.”“i started getting dizzy spells on exertion,” taylor, now 45, wrote in a first-person perspective published by the journal. the software engineer was signed off work and spent most of his time asleep.during the day, he slept on the sofa. “we thought the best thing at night would be to get upstairs to bed,” taylor said when reached at his home tuesday. it took 30 minutes to climb the stairs. “a couple of steps on the staircase and i was really feeling quite dizzy and sick, and i’d sit down and take five minutes to muster up the will to tackle another couple of steps.”“of course, we didn’t know at the time that by me going to bed, i was actually making the problem worse.” he woke constantly at night feeling breathless, as if he was suffocating.

taylor’s gp called dempsey for advice. during the phone call, dempsey pulled up taylor’s chest x-ray on his computer screen, the one initially reported as normal.lungs normally look fairly black. not jet black, “but they look pretty black,” dempsey said. taylor’s looked grey.that was one of the first bits of the jigsaw. the other came when dempsey called taylor for more information. taylor sounded “alarmingly tachypnoeic” on answering the phone, his doctors wrote, meaning seriously winded, as if taylor had just sprinted 100 metres and not simply walked from the living room to the kitchen to pick up the phone.dempsey began assembling taylor’s history: he and his wife lived in a warm, dry house. there was a loft, or attic, which he rarely entered. they had an en-suite bathroom with a modest bit of mould above the shower and window. a cat and dog, but no birds. did he play any wind instruments? (taylor plays guitar in a band. “i do have a saxophone, which i’m not very good at.”) his work was office-based. no exposure to aerosols, or paints, or solvents.dempsey also asked him about bedding.while doctors are typically taught to ask people with breathing problems whether they have pets at home, including birds, “history taking does not usually extend to asking about feather exposure in duvets and pillows,” dempsey and his co-authors wrote — an important oversight, given the huge popularity of feather bedding. in the u.k. alone, 7.6 million duvets were sold in the first four months of 2015, the authors reported.symptoms of feather duvet lung can be “nonspecific”— a vague feeling of malaise or flu-like symptoms, to acute breathlessness four to eight hours following exposure to feather antigen. people can also experience night sweats, dry cough, weight loss and fever. “it is therefore entirely probable that cases of fdl are missed, or at best, diagnosed late,” the researchers wrote.taylor’s blood tests came back negative, except for oddly abnormal levels of antibodies against different avian proteins. “his immune system was primed and quite aggressive towards bird protein,” dempsey said.a ct scan showed a “ground glass, mosaic pattern” in both lungs. air was getting into some bits of lung better than others, and that difference in density was causing the differences in shadowing, the mosaic appearance.the most likely diagnosis was hypersensitivity pneumonitis, or hp.bird fancier’s lung is the most common type of hp, affecting up to 20 per cent of pigeon breeders, and up to eight per cent of “budgerigar fanciers,” dempsey and colleagues wrote.taylor was advised to remove the offending antigen — the feather bedding. he was advised to have his bathroom mould treated, and to check for nesting birds in his loft or chimney. his symptoms began to improve rapidly. after six months of treatment with steroids, he felt completely well, his doctors reported. taylor said the dizzy spells are gone.dempsey is surprised at the media coverage for a report on a single patient. “having said that, it’s clearly under-recognized,” he said.“you shouldn’t crawl into your duvet and be afraid of dying,” he said. however, if someone develops chest symptoms, he said — cough and breathlessness that doesn’t settle — it wouldn’t hurt to ask a doctor, “could it be feather duvet lung?”email: skirkey@postmedia.com | twitter: sharon_kirkey