In March I introduced readers to the issue of hot tub lung disease. At least to how little has been reported about it.

People who don’t change their water or filter enough are probably most at risk. As an avid hot-tubber -- that sure got my attention.

Symptoms appear to include cough, difficulty breathing, and low oxygen transfer. Antibiotics and steroids appear to make people better, although it can take a long time to fully recover.

After writing about this, I received a phone call from a 52 year old Floridian who criticized me for not being serious enough about this topic. She told me that she has hot tub lung disease, that it took a long time to get a proper diagnosis, and that this is a serious issue. While she identified herself during our talk, I will not identify this caller in view of her privacy concerns.

We spent about an hour together on the phone. I suspect she had enough information to fill many hours. To me, she seemed bright and sincere.

Unlike others who have been affected, this caller reports suffering no symptoms at all. The problem was detected through a chest x-ray. A very small speck on her lung appeared.

The spec was biopsied and from that they were able to rule out lung cancer. That was very good news indeed.

However, the spec was cultured and from the culture they were able to find out that she had the bacteria associated with hot tub lung disease.

You should know that the biopsy was not an easy procedure. She indicated that this can be painful and not a procedure that should be taken lightly.

The caller reports that her pulmonary doctor failed to inquire whether she had a hot tub. She was mad at this doctor for not asking this question as it prolonged accurate diagnosis.

Here is the problem that hot tub lung sufferers seem to find themselves in. Often they do not feel well and use the hot tub to feel better.

In reality, it may be that the hot tub is what made them ill in the first place, and the hot tub may be the last place in which they should seek comfort. So not having a valid diagnosis early on may be dangerous for a patient. It may make matters worse.

According to the caller, chlorine does not kill the offending hot tub bacteria. What is necessary is absolutely perfect, pristine maintenance of a hot tub.

The caller's advice: you need to be your own medical advocate. You need to do your own research and you need to understand your illness.

She cautions people who use hot tubs to be very careful. She says that she feels that even super shocking a hot tub may not address the problem. According to this woman, this is a problem that is going to have to be dealt with by the hot tub industry.

Neither this woman who called me, nor I, are doctors. However, since at least one major US medical center has identified this issue, and since CBS News has also reported on this issue, I thought it was fair to share this story with you.

As the caller opined: The hot tub industry may have to confront this health issue.

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