Questions about Idiopathic Pulmonary Fibrosis (IPF) -- Can a Pulmonologist answer?

This past summer I took my husband (early-60s) to the ER because he was having a hard time breathing, after dealing with it for many days. He was admitted for pneumonia and afib. He was in the hospital for 3.5 days. They drained 2.5L from his right lung, and treated him for afib. By the end of Aug this ultimately resulted in a diagnosis of IPF (after multiple CT scans and review of bloodwork), and by Sept he had procedures (cardioversions and ablation) to correct the afib, and is to this day in normal rhythm. He was on O2 in the hospital, but O2 has not been prescribed at home, however he does have O2 hooked up to his CPAP machine for sleeping.  This is from the printout the doctor we saw for a second opinion  in January gave us: Visit Date         FVC      FEV1    DLCO\_SB         FRCpl  TLC       RV 1/6/2026          3.36     2.96     10.41   2.55     4.76     1.40 8/26/2025       4.59     3.51                                                  2/11/2016       4.92     4.20     32.14   Here are some details: * When he had the Jan 2026 pulmonary tests he was experiencing severe back pain, which we think (but have yet to confirm with his Neurosurgeon) is a herniated disc requiring a next level up fusion. Could that possibly affect his breathing and related test results? Is it possible that without that pain, his FVC would have been closer to the 4.59 value and not the 3.36 value? The tester knew about his back pain and this is written on his report: "Spirometry data is acceptable. Good efforts demonstrated throughout testing. PFTs are performed today to assess respiratory function", but still, I wonder. * His chronic cough started in 2019, before the pandemic. He pursued the cough with doctors, but back then no one told us IPF even though he had a CT scan (we've been told that since '19 CT scan imaging has gotten better). His chronic cough has gotten worse since '19, but I have noticed especially ever since this past summer. * Also he has lost \~25lbs since early July (varies between 25-29), without trying. One caveat to that is that he is on Ozempic, but he's been on that since July 2024, and it wasn't until since July 2025 that he's lost the weight (he was \~194lbs on 7/5/25 and now he’s \~174-177lbs), so for the first year of being on Oz his weight was relatively stable. * The Pulmonologist is referring us to their lung transplant team. He says it’s not immediate, but that we have to start planning. But, like I mentioned, there may be co-morbidities that complicate this.   Some questions: * The Pulmonologist stressed to us to not take literally the 3-5 year life span *from time of diagnosis* that we read in search results and I really like him so I'm taking that to heart, but given my husband's lungs were probably forming scarring as long ago as 2019 (or before) and definitive diagnosis came in 2025, what does that mean now in 2026? * The doctor is in the process of working to prescribe Jascayd, but of course with it being so new we're having insurance issues and so as of now my husband isn't on anything for IPF. Is that significant? How much “time” matters when taking any of the FDA-approved drugs for IPF relative to the info I've detailed? The first Pulmonologist he saw prescribed him Esbriet, which he started, but due to insurance reasons he had to stop it after only 1 month (grrr). * And I know every case is different and without you knowing more about his personal medical history (ex: other co-morbidities, other than Type II diabetes since I mentioned Ozempic, but there's more history), can you help with what can we expect with this disease? How quickly does it tend to progress? See next point… * I'm concerned because just late last week we noticed he was short of breath, so he went to his doctor on Monday morning (I'm posting this on Wed night) and they did a chest x-ray but it was "inconclusive" since it did seem to suggest some type of infection (they didn’t say “pneumonia”), but it is in the area of the lungs that has the scarring. So he's on 2 antibiotics and seems to be improving from having noticeable shortness of breath. Our pulse oximeter measures him throughout the day from 87-92%. I just measured him \~1hr before posting this and it was down from 92 to 87 (earlier reading was \~7hrs ago) * **As his wife and main caregiver, what should I be on the lookout for? I noticed the shortness of breath last week right away, and I'm taking (weekly/almost daily) notes on his weight (I was able to take a log of his weight to the Pulmonologist to show the loss since July, and he confirmed the weight loss can be due to the IPF because of the coughing and his body is working harder to breathe), and I'm being mindful of fatigue,** ***but what else should I be on the lookout for? What are other subtle signs that something may not be right*****?**  I am beyond scared and worried and I'm trying to manage my own stress (not sure I'm succeeding) so as to be able to act positive around my husband and not contribute to what is already a stressful situation for him. I need advice, PLEASE.