DEAR DR. DONOHUE: In the past you wrote: “There are many things that can make life with emphysema more livable.” However, you didn’t mention what those things are. I would sure like to know them. – A.B.

Emphysema is the destruction of air sacs, the delicate lung structures through which oxygen passes into the blood. With emphysema, oxygen cannot 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, and they are referred to as COPD, chronic obstructive pulmonary diseases. The treatments I discuss 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.

Oxygen is, of course, an important adjunct in treating COPD.

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 not being able to breathe easily.

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 can help themselves by adopting a different breathing technique.

They should inhale slowly for about four seconds and exhale even more slowly, taking six seconds and doing so with lips pursed as though they were going to whistle. By leaning slightly forward when they breathe, they permit the lungs to expand more and to hold more air.

Many hospitals sponsor pulmonary rehabilitation programs.

The booklet on COPD provides detailed information on this common malady. 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./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My son is dating a young lady who had lupus. She was diagnosed with it as a teenager, but 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. – M.B.

Lupus is an autoimmune disease, one in which the immune system turns on its own 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.

DEAR DR. DONOHUE: I have uterine prolapse and a rectocele. I am going to have my uterus removed and the rectocele repaired. My gynecologist is going to perform the surgery. Is this normal? Don’t I need a specialist? – C.W.

The specialists who do most uterine removals and rectocele repairs are gynecologists. You have made a most normal choice.

DEAR DR. DONOHUE: My grandson, 42, insists that cooking in a microwave destroys the nutrients in food.

He also says that if you heat water in a microwave and, after it cools, use it to water house plants, the plants will die. This has become a bone of contention. – G.G.

All cooking destroys some nutrients in food, but microwave cooking destroys less than any other method. One reason why is the speed with which it cooks food. Another reason is the small amount of water needed to cook vegetables with microwaves. All the water needed for vegetable cooking is 2 or 3 tablespoons.

Cooled microwaved water kills house plants? I’ve never heard of that. But then I’ve never heard of people microwaving water for watering their plants.

DEAR DR. DONOHUE: I am a 57-year-old woman and have not had sex for many years. Does that make me a virgin again? – C.N.

No. A virgin is a person who has never had sexual relations.

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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