Exercise essential to fight emphysema
Monday, March 12, 2007
PAUL G. DONOHUE
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Q: You have previously written, “There are many things that can make life with emphysema more livable.” What are these things?
A: Emphysema is the destruction of air sacs, the delicate lung structures through which oxygen passes into the blood. With emphysema, oxygen can’t get into the blood. Its principal symptom, therefore, is breathlessness even on minor physical activity. Emphysema’s twin is chronic bronchitis, an irritation of the bronchi (the airways). Its identifying symptom is persistent cough with thick yellow sputum. Most people have both conditions simultaneously, or COPD, chronic obstructive pulmonary diseases. The treatments below apply to both.
Drugs that soothe and open irritated airways filled with mucus improve breathing and lessen coughing. Most are taken as mists generated by a mouth inhaler. Albuterol, terbutaline, tiotropium and ipratropium are a few examples.
A prednisone inhaler is used when there’s a flare-up of symptoms. Prednisone is a cortisone drug, and it’s a powerful inflammation fighter and irritation soother.
Exercise is essential for all COPD patients. That sounds like a mindless piece of advice for people who have a hard time getting enough air. But it has to be done, if possible. Muscles quickly become deconditioned when they aren’t exercised, and deconditioned muscles add to the burden of breathing problems. Even if people start out by taking only 20 extra steps a day, they can build on that gradually until they are walking for 10 or more minutes at a time. COPD patients should inhale slowly for about four seconds and exhale even more slowly, taking six seconds and doing so with lips pursed as if whistling. By leaning slightly forward when they breathe, they permit the lungs to expand more and to hold more air. Many hospitals sponsor rehabilitation programs.
Q: My son is dating a young lady who had lupus. The problem was diagnosed when she was a teen, but she has had no recurrence of it since then. She seems fine except for her pale, chalky skin color.
I am afraid that this disease is hereditary and might be carried to their children if they marry. I am also afraid that the illness might recur and she won’t be able to take care of their children.
A: Lupus is an autoimmune disease, one in which the immune system turns on its tissues. In this case, the tissues are the joints and skin, along with other internal organs.
About 10 percent of lupus patients have a relative who had or has it. So genes do play a role in its genesis, but that’s a far cry from saying the children of every lupus patient will come down with it.
You have far too bleak a picture of lupus. It’s a serious illness, but today’s medicines can generally control it. The 20-year survival rate for lupus is greater than 70 percent. Your son’s friend can expect a long and fulfilling life.
Pale, chalky skin color is not a sign of lupus.
Q: I have uterine prolapse and a rectocele. My gynecologist is going to perform surgery. Do I need a specialist?
A: The specialists who do most uterine removals and rectocele repairs are gynecologists. You have made a most normal choice.