DEAR DR. DONOHUE: I am a 48—year—old man who was recently told that I have COPD. I was a heavy beer drinker and cigarette smoker for much of my life. I have quit both, but I have a beer belly and I get short of breath easily. Will you tell me more about COPD and how I can get rid of my beer belly? — P.T.
Emphysema and chronic bronchitis are the two principal COPD (chronic obstructive pulmonary disease) illnesses. Both usually are present; it’s unusual to have only emphysema or only chronic bronchitis. Cigarette smoking is the chief cause, but people can and do develop COPD without ever having inhaled a single cigarette.
Emphysema is distention and destruction of air sacs — the millions of tiny, delicate structures through which oxygen passes from the lungs into the blood and through which carbon dioxide passes from the blood into the lungs for disposal. Shortness of breath on even slight activity is the hallmark of emphysema. Chronic bronchitis is inflammation of the airways (bronchi), the tubes that deliver fresh air into the lungs. The inflammation causes the airways to fill with thick, yellow mucus, and it narrows the diameter of airways. Cough with the production of sputum is the chief sign of chronic bronchitis.
Medicines to soothe airway inflammation and expand the airways come as inhaled sprays and as oral medicines. Breathing tests quantify how great the lung damage is and permit the doctor to prescribe the appropriate medicine or combination of medicine. If those tests haven’t been done, I’m sure they will be.
Treatments you can do for yourself include exercise. It sounds inane to suggest exercise to someone who’s coughing and short of breath. But gradually building up exercise tolerance is an important element of combating the disease. Short walks, gradually lengthened and gradually increased in intensity, are an exercise most COPD patients can cope with.
A beer belly is lost only through calorie restriction and abdominal exercises like sit—ups.
DEAR DR. DONOHUE: Please give information on what effect birth—control pills have on the development of breast cancer. Do they cause it? Is estrogen a factor? How is it prevented? — B.D.
Reliable studies show that birth—control pills have little, if any, involvement as a cause of breast cancer. Estrogen is a factor if it’s taken for a long enough time after menopause.
Things that lower the risk of breast cancer include: having a late onset of menstrual periods and an early onset of menopause; having children at a relatively young age; breastfeeding; staying lean; minimizing the consumption of fat and red meat; limiting alcohol to one drink a day; not smoking; having the good luck not to inherit genes that promote breast cancer; and, according to some, staying physically active.
The booklet on breast cancer covers this topic in detail. Readers who would like a copy can obtain one by writing to: Dr. Donohue — No. 1101, 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: My husband yawns a lot, and I mean A LOT! So much so that it becomes annoying. I keep thinking, How can someone be that tired? Maybe it doesn’t come from being tired, but from a health condition. Could that be so? Is there anything I could encourage him to do so he doesn’t yawn so much? — T.G.
No one has a universally accepted explanation of a yawn’s benefits. It does not bring more oxygen to the brain. It might, however, cool the brain. Boredom, sleepiness and seeing someone else yawn promote yawning. All animals yawn, including birds and fish.
If your husband is chronically tired, he should find the reason for that. That’s the chief medical reason for yawning. If it’s not fatigue or boredom, then your husband can suppress his yawning without a great deal of effort. Yawns are partly voluntary, so we can stifle them.
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

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