DEAR DR. DONOHUE: A short time back you wrote about emphysema and bronchitis but didn’t discuss their treatments. My dad lives with my family, and he has emphysema bad. I’d like to know what’s available for him. – J.D.

ANSWER: Emphysema and chronic bronchitis are the two important illnesses constituting COPD – chronic obstructive pulmonary disease – which affects more than 16 million North Americans and comes in fourth on the list of causes of death.

These two ills are different, but they often exist together, so they can be spoken of as if they were one illness. “Obstruction” in COPD refers to the blockage of airflow into the lungs and into the blood. COPD people are unable to fill their lungs and blood with enough oxygen. They live in a state of chronic breathlessness. Taking only a few steps leaves them panting for air. Cough is often a part of the picture.

Although both conditions are permanent, there are treatments that improve the quality of life for people who have them.

Inhaled sprays such as Proventil and Atrovent widen blocked airways. Both have a rapid onset of action, so they can be used when breathing suddenly gets worse. They can also be used on a daily basis to keep the airways wide open.

A long-acting spray is Serevent. It too keeps airways opened, and its attraction is the length of time it expands airways. It is not, however, suitable when quick action is needed.

Some doctors prescribe cortisone sprays to reduce airway irritation and inflammation.

Oxygen, of course, is a huge benefit for some.

An exercise program specifically designed for each individual is a must.

The pamphlet on COPD explains these illnesses in depth. Readers can obtain a copy by writing: Dr. Donohue – No. 601, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I found out that people are not supposed to eat before having blood drawn for lab tests, and therefore they pass out when blood is taken. Now I see an announcement asking for people to have their cholesterol checked, and it says not to eat before they have their blood drawn.

What are the correct requirements for giving blood? – H.O.

ANSWER: Many blood tests require an overnight fast to obtain an accurate reading. The fast is not so rigorous that it makes people swoon. I can’t imagine that a person, unless under most unusual circumstances, would pass out from skipping breakfast. I have, however, seen many people faint from watching their blood being drawn into the test tube.

If there is a question of the necessity of fasting and if the doctor’s office or the lab cannot be reached, it’s safer to fast for blood tests. If eating is prerequisite, that can be taken care of easily. If fasting is a prerequisite, the person would have to return on another day if he or she has eaten.

Fasting is not necessary for a valid cholesterol reading. However, rarely is only a cholesterol test sought. To get a true picture of cholesterol and fats in the blood, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides are usually requested. A person does need to fast to obtain valid results for all four lab tests.

I worked with an Army medic who was a master in making those getting shots faint. He painted such dire consequences of the shots that even I felt a little woozy. Imagination can rule the body.

DEAR DR. DONOHUE: My dad had psoriasis for as long as I can remember. I am 38 now. Am I destined to get it because he had it? – R.M.

ANSWER: If a mother or father has psoriasis, a child has between a 10 percent and 25 percent chance of coming down with it.

If both parents have it, the percentage rises to 50.

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.

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