COPD has no cure but many treatments


DEAR DR. DONOHUE: My wife was diagnosed with COPD. She is on medicines and has been given lung tests that confirm COPD. Is there a cure? — C.F.

ANSWER: About 24 million Americans suffer from COPD, chronic obstructive pulmonary disease. Half of them have been diagnosed; the other half have its signs and symptoms but do not have a medical diagnosis. Two illnesses constitute COPD: emphysema and chronic bronchitis. The two are almost always seen together.

Emphysema is the destruction of the lungs’ tiny air sacs, through which oxygen passes into the blood and carbon dioxide leaves it. The main sign of emphysema is shortness of breath when doing any kind of physical activity.

Chronic bronchitis is an inflammation and plugging of the airways (bronchi) with thick mucus. Air has difficulty reaching the lungs because of this obstruction. Cough with the expectoration of thick sputum is the primary sign of chronic bronchitis.

Cigarette smoking is the No. 1 cause of COPD. However, some people have never put a cigarette to their lips but have come down with COPD. People who have worked in places where the air is full of irritating dusts or fumes, people who must breathe air filled with pollutants, and those with inherited genes that make their lungs susceptible to airborne materials not destructive to most people are ones who develop COPD without having smoked. Repeated bouts of lung infections are another cause.

A cure is not on hand. Control of symptoms and slowing the progression of this illness are possible. Medicines that dilate the breathing tubes help air reach the lung with greater ease. Inhaled cortisone drugs soothe inflamed airways. And, when necessary, supplemental oxygen provides people with the oxygen boost they need.

Your wife needs a yearly flu shot to protect her lungs. She must report respiratory infections to her doctor so she gets prompt treatment to preserve lung function.

The booklet on COPD provides more information on this common illness. Readers can order a copy by writing: Dr. Donohue — No. 601, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a 55-year-old man who has suffered from blood clots for the past three years. I have been in the hospital so many times that the nurses know my name. I’ve tried to change my eating habits, but the clots still form. I have an umbrella filter in my chest to stop clots from reaching my lungs. My doctor told me to go on a vegetarian diet. Most places are fast-food restaurants and don’t serve such food. I need some advice. — R.W.

ANSWER: Many fast-food restaurants have salads. Or you can make your own meals with grains, vegetables and fruits. I’m not sure why this kind of diet has been stressed for you. Is it for the clots? Are you taking a blood thinner (an anticoagulant), like Coumadin? Recurrent clots call for indefinite anticoagulation. Have you been investigated for some of the inherited conditions that favor clots? Factor V (Roman numeral five) Leiden and deficiencies of protein S and C are examples of such conditions.

DEAR DR. DONOHUE: After years of suffering from hip, back and knee pain, I happened to read on the Web that unequal leg length can be the cause. I put a quarter-inch liner in my shoe on the short side, and relief was instantaneous. I’m really disappointed that medical providers had never checked me for this. One doctor I mentioned it to dismissed it out of hand. My simple solution saved me thousands of dollars. — R.R.

ANSWER: An inequality of more than two-fifths of an inch (1 cm) can lead to the kind of pain you had. The pain can occur on the side of the shorter or longer leg. A reliable measurement has to take place between the same landmarks on both legs. The two most used landmarks are the anterior superior iliac spine (just above the hip and on the side) and the medial malleolus, the bony projection on the inner side of the ankle. If you can’t locate these two points, mark off two points at the same place on both legs. Your doctor can take a more exact measurement.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from