COPD not curable, but treatable
DEAR DR. DONOHUE: I am inquiring for a friend about COPD. I would like to know what to look for in the last stages of COPD. We are in prison, and my friend is having a hard time with his COPD. He is 60. I want to help him in any way I can. — K.S.
ANSWER: “COPD” stands for chronic obstructive pulmonary disease. “Chronic” indicates that it’s a permanent thing; “obstructive,” that there’s a blockage of air passing into the lungs and oxygen into the blood; “pulmonary,” that the lungs are the site of the trouble. The two main COPD illnesses are emphysema and chronic bronchitis. Usually, both are seen together, and cigarette smoking is the most common cause of them.
Emphysema indicates destruction of the lung’s air sacs, the millions of delicate, tiny, cellophanelike structures through which oxygen passes into the blood from the lungs. Chronic bronchitis is inflammation of airways — bronchi, or breathing tubes. They’re filled with thick, yellow mucus, and they have narrowed. The signs of COPD are shortness of breath on activity and a cough that won’t stop.
The stages of COPD are best defined by lung tests. Symptoms are a rough guide to staging. In the advanced stages of COPD, a person struggles for air on taking only a few steps, and coughing is constantly present.
COPD isn’t curable. It is treatable. Medicines can expand the narrowed breathing tubes and can soothe their irritation. Oxygen is required in advanced stages.
There are two maneuvers that your friend can do for himself that might help him to breathe more easily. One is to exhale through pursed lips. He exhales through his mouth with his lips pursed in the whistling position. This helps keep airways opened. The other trick is to lean a bit forward at the waist when walking. That posture provides more room for the lungs to fill with air.
The booklet on COPD explains this common medical condition in detail. 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 $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Is there really a “triangle of death” on the face in which, if someone pops an acne pimple, it can cause death? — B.P.
ANSWER: The “triangle of death” is the part of the face formed by the bridge of the nose and the corners of the mouth. It’s an area where facial veins have a direct communication to veins of the brain. Forcing bacteria into those veins by popping a pimple can push the germs into the venous blood of the brain and possibly cause a brain infection.
I have heard about the triangle of death since grade school. Seldom have I heard it discussed in medical education meetings. I can’t tell you if anyone has ever died as a result of squeezing pimples in this triangular section of the face. All the same, it’s a smart idea not to squeeze pimples at any site. The bacteria in a pimple are pushed into the adjacent skin and can set up another site of infection.
DEAR DR. DONOHUE: I have taken Cardizem, Tenormin, hydrochlorothiazide and Micro-K for years. My insurance company will now pay for the only generic equivalent of these medicines. Is there any difference between the brand-name drugs and their generic equivalent? — C.C.
ANSWER: None of the medicines you take is on the list of medicines for which a generic switch might cause trouble. Those medicines are seizure-control drugs, some thyroid medicines, Lanoxin (a digitalis medicine), theophylline (an asthma medicine) and the blood thinner Coumadin. Most people do well with generic substitutes. The only way to know for sure is to try 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 www.rbmamall.com.