Desert Lung
Desert Lung, ārwa-anib" in Arventiri is an old and historically incurable physiological condition widespread in the interior of the Pāll-tanír. Caused by the inhalation of fine silica particles, the disease's prevalence increases in the wake of Arventir. As a result, a catastrophic epidemic followed the Stormcaller Crisis and the storms that accompanied it, with one in four individuals suffering from some degree of the illness during the peak of the epidemic in 333.30 NL. Fortunately, the arrival of the Dominion and the consequent availability of blood magic intervention meant that the severity of the disease was markedly decreased.
Causes
Desert lung was originally believed to be a curse inflicted on the denizens of the Pāll-tanír by desert storm spirits as incidence of the disease spiked whenever a particularly bad Arventir swept through an area. Because most cases would not manifest symptoms until some time after initial exposure, the link between airborne dust during Arventir and the disease remained undiscovered for a long time.
It wasn't until the arrival of the Dominion, with its modern and rigorous methods of studying disease, that the culprit behind desert lung was finally revealed. Comprehensive autopsies of victims in advanced stages of the disease showed severe scarring and fluid build-up in the lungs. Furthermore, researchers discovered fine silica particles embedded deep in the lung tissue, which, coupled with the conventional wisdom that incidences of desert lung increased in the wake of Arventir, was enough to establish a possible causal link between the inhalation of silica crystals and the disease.
Symptoms
Because it can often take years before the initial symptoms of desert lung manifest, many are unaware that they suffer from the disease at all. When symptoms do start to appear, they take the form of a light cough, production of sputum, and mild shortness of breath. As a result, the early stages of the disease can often be misdiagnosed as a mild cough or cold, with treatment largely aimed at resolving symptoms rather than the underlying condition.
As the disease progresses, the patient's cough begins to worsen. As scarring and fluid build-up gets worse, the patient experiences a variety of symptoms, of which the most common are persistent cough, moderate shortness of breath, and general difficulty breathing. Prior to the availability of blood magic intervention, most cases would progress to more severe stages manifesting in weakness, fatigue, fever, night sweats, swelling of the legs, bluish discoloration of the lips, and eventual death.
Treatment
Prior to the arrival of the Dominion, desert lung was considered an incurable disease. Most patients would suffer for years before succumbing, each Arventir exacerbating their condition despite the best efforts of healers at the time. Before blood magic, treatment of desert lung was largely palliative and focused on treating the apparent symptoms of the disease, rarely addressing the underlying cause.
With the subsequent spread and availability of blood magic intervention, for the first time in the recorded history of the Pāll-tanír, curing desert lung became possible. Broadly speaking, the treatment of desert lung commences in three stages: isolation, excision, and regeneration.
Isolation
Before treatment can begin on a patient suffering from desert lung, they must be isolated from the environment as much as possible to prevent further deterioration resulting from dust in the air, as well as due to the potential for infection during the second stage of treatment. Where possible, the patient is taken to a local hospital and placed in a dedicated clean room with filtered ventilation to remove any dust from the air. This is often not the case in rural areas where transporting the patient to a city might take days of travel that can be deleterious to the patient's health. In those circumstances, blocking gaps in the doors and windows and controlling access in and out of a room are considered sufficient measures.Excision
During the second stage of the treatment, the presiding physician, a fane in almost all cases, begins the painstaking process of draining fluid and removing scar tissue and embedded silica from the lungs using blood magic. While this transpires, the patient is almost always sedated or restrained as it can be profoundly uncomfortable and sometimes even painful. As excision further damages the patient's lungs by necessity, the physician cannot perform it across the entire organ at once. A rule of thumb used by the fanes is to stop once a palm-sized area of the lung has been successfully excised, though even doing so can take upwards of six hours. The physician would then proceed to the third stage for that area of the lung, giving the patient a day to recover from the treatment after the conclusion of the third stage, and then moving on to the next section afterward.Regeneration
Once the scar tissue and silica from an area of the lungs have been removed, it becomes possible to heal the damaged tissue. Using blood magic, the fane guides the patient's body into healing the area without scarring. This does not restore healthy functionality to the lung tissue immediately, but instead acts as a scaffold for further recovery. With blood magic accelerating the patient's healing factor, the area of the lungs that has been excised is able to regain 80% of healthy functionality over 24 hours, at which stage the physician will move on to the excision of the next region of the lungs.Post-operation Recovery
Although the newly-regenerated lung tissue is healthy at the conclusion of the treatment regime, it is recommended that patients refrain from going outdoors or engaging in strenuous activity for at least two months to give their bodies time to adjust to the restored functionality of their lungs without undue stress.Prognosis
Prior to the arrival of the Dominion, desert lung was incurable. In many cases, it was fatal, leading to a long, drawn-out and painful death. With the availability of blood magic intervention, however, all but the most severe cases are treatable. In modern times, most cases that lead to death are the result of avoiding treatment for a long time, leading to the introduction of complications. Often, these individuals die during treatment due to severe damage and secondary conditions.
Sequela
Desert lung has a devastating impact on the patient's immune system. The longer it goes without treatment, the greater the chance that a complication will occur. In most fatal cases, death occurs as a result of infection or cancer.
Affected Groups
Historically, desert lung was considered a poor man's disease as it primarily affected poor and underprivileged communities throughout the Pāll-tanír, and largely left the merchant class and nobility untouched. It disproportionately affected the most vulnerable members of a community: the very young and the very old, the former because of underdeveloped lungs, and the latter because of long-term exposure to the conditions that cause the disease in the first place.
There is evidence that there is increased incidence of the disease in those of the stoneworking profession who are exposed to fine silica dust more often than the average person. Though there is literature to suggest that there is a higher incidence of the disease in men, the research is largely inconclusive and more study is required to be certain.
Prevention
Prevention of desert lung is simple. All a person needs to do to minimize their risk of contracting the disease is to avoid breathing in fine dust. It is known that simply wearing a double layer of linen over the mouth and the nose during an Arventir and for three to four days after is enough to reduce the chances of developing desert lung by 50%. Measures to further decrease the risk include staying indoors and blocking gaps in windows, wooden roofs, and doorframes. With the proper precautions, it is believed that the risk of developing desert lung in any given five-year period can be reduced by as much as 95%.
Cultural Reception
As desert lung disproportionately affected poorer communities, upper crust of pre-Dominion Pāll-taniri society viewed the disease as an affliction created by the gods to punish the lazy and the indolent. It was seen as the gods taking away a person's ability to breathe so they wouldn't waste as much of the precious life-sustaining air that the gods gave the world. Invariably, this perception filtered down through society, leading to the development of a socio-cultural stigma against those who suffered from the disease.
The social perspective on desert lung began to change with the arrival of the Dominion and its introduction of policies and projects to increase social equality in the Pāll-tanír. Gradually, as understanding of the disease improved, the perception of desert lung changed from that of a curse that would be lifted if the victim stopped being such a drain on society's resources to that of a serious condition that disproportionately afflicted society's most vulnerable and most hardworking and dedicated individuals.
In the modern day, desert lung is treated as a serious condition in the Pāll-tanír with a robust routine checkup system for the purposes of comprehensive risk-assessment and disease-prevention. Healers of every discipline regularly visit rural communities, which are often the most vulnerable, in order to keep tabs on the condition of the residents thereof and educate them on the proper ways to mitigate risk and prevent contracting the illness.
Type
Physiological
Origin
Natural
Cycle
Chronic, Acquired
Rarity
Common
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