DEAR DR. DONOHUE: I have COPD – chronic obstructive pulmonary disease – specifically, chronic bronchitis. I’d appreciate knowing why the impaired lungs are unable to thin the thick congestion. – R.L.

ANSWER: COPD, or chronic obstructive pulmonary disease, consists of two lung illnesses – emphysema and chronic bronchitis. A person with COPD usually has a touch of both illnesses. Both give rise to breathing troubles.

With chronic bronchitis, cough and the production of thick mucus are principal symptoms. Inflamed bronchi – air passages – are responsible for both. In this condition, the mucus glands of the bronchi increase in number and in size. That’s why the thick mucus occurs. The mucus can be so thick that it obstructs air flow into the lungs.

Inhaled medicines – not inhaled from a machine but from a handheld spray – can dilate the clogged airways and help people cough up mucus. Two examples are Spiriva and Atrovent. Inhaled cortisone sprays ease airway irritation and decrease mucus production.

Do you take advantage of pulmonary rehabilitation offered by many local hospitals? Therapists teach COPD patients proper breathing techniques, safe exercise and the ways to drain mucus out of the lungs.

The booklet on chronic obstructive pulmonary diseases provides more information on these two common illnesses. 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 and many others are confused about osteoporosis, osteopenia and spondylolisthesis. It would be helpful if you showed a list of the three and their treatments. – I.W.

ANSWER: Osteoporosis is the loss of bone calcium and bone inner support. Bones become brittle and break easily. Osteoporosis comes about in women from an abrupt cessation of estrogen production at menopause, and in both men and women from age-related changes. Proof of osteoporosis is obtained from a bone-density test called DEXA – dual-energy X-ray absorptiometry. Calcium and vitamin D both prevent and treat osteoporosis. Medicines such as Fosamax, Forteo, Evista, Miacalcin and others are also available.

Osteopenia is a step on the road to osteoporosis. The bones haven’t lost enough calcium to be classified as osteoporotic, but they are on the way to becoming osteoporotic. The same things that treat osteoporosis work for osteopenia.

Spondylolisthesis (SPAWN-duh-low-lis-THEE-siss) is the slipping forward of one backbone over the one beneath it, like a roof shingle slipping over the shingle below it. It can come with age or from arthritis of the spine. If it produces no symptoms, no treatment is needed. If it does, physical therapy and medicines like ibuprofen often can be useful. In severe cases, surgery is the answer. There is a form of spondylolisthesis that is present from birth, but that’s a special case with special problems.

DEAR DR. DONOHUE: I have high blood pressure and also an abdominal aortic aneurysm. My last ultrasound measured it at 3 cm. What doctor should monitor me? A vascular surgeon, a cardiologist or a primary care doctor? I am 83. – E.H.

ANSWER: An abdominal aneurysm is a bulge of an artery, and it is a weak spot in that artery. The abdominal aorta is often a site for aneurysms. The normal diameter of the aorta is 2 cm (4/5 inch). Yours is only slightly larger than normal. When an aneurysm attains a diameter of 5 cm (about 2 inches), it is repaired to prevent it from bursting. Aneurysms grow slowly. You might never face the prospect of surgery.

You do have to keep your blood pressure controlled. High blood pressure fosters aneurysm expansion.

Your primary care doctor can take care of following you for high blood pressure and the aneurysm. If the aneurysm reaches a size that calls for surgery, the doctor will refer you to a vascular surgeon.

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