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Publié par
Date de parution
21 avril 2008
Nombre de lectures
0
EAN13
9780470306796
Langue
English
Poids de l'ouvrage
1 Mo
Publié par
Date de parution
21 avril 2008
Nombre de lectures
0
EAN13
9780470306796
Langue
English
Poids de l'ouvrage
1 Mo
The
Chronic Bronchitis and Emphysema Handbook
R EVISED AND E XPANDED E DITION
Dr. Fran ois Haas
Dr. Sheila Sperber Haas
with Illustrations by Kenneth Axen
John Wiley Sons, Inc.
New York Chichester Weinheim Brisbane Singapore Toronto
This book is printed on acid-free paper.
Copyright 2000 by Francois Haas and Sheila Sperber Haas. All rights reserved
Published by John Wiley Sons, Inc.
Published simultaneously in Canada
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 750-4744. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley Sons, Inc., 605 Third Avenue, New York, NY 10158-0012, (212) 850-6011, fax (212) 850-6008, email: PERMREQ@WILEY.COM.
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional person should be sought.
Library of Congress Cataloging-in-Publication Data:
Haas, Fran ois.
The chronic bronchitis and emphysema handbook / Fran ois Haas, Sheila Sperber Haas.-Rev. and expanded ed.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-23995-X
1. Lungs-Diseases, Obstructive-Handbooks, manuals, etc. 2. Lungs-Diseases, Obstructive-Popular works. I. Haas, Sheila Sperber. II. Title.
RC776.03 H33 2000
616.2 4-dc21 00-023916
Printed in the United States of America
10 9 8 7 6 5 4
This book is dedicated to people everywhere who are struggling to reclaim their lives from COPD, to the family and friends who support them in this battle, to the health care professionals who really listen to them and give them the best edge possible in this fight, and to patient advocates who fight for better weapons and a more fair advantage in this lifelong struggle.
Contents
Preface
1. You and COPD: An Introduction
What Is COPD?
How to Use This Guide
The Downward Spiral
Minimizing the Limitations
Some COPD Facts
How Serious Is COPD?
Questionnaire
2. The Respiratory System: What It Is, How It Works, and What Goes Wrong in COPD
Our Breathing Machinery
What Controls Your Respiratory Muscles?
Microscopic Anatomy: The Acinus and Emphysema
Physical Properties of the Respiratory System
Breathing Is Work, Especially in COPD
What Controls the Airway Opening?
Gas Exchange
3. COPD: The Damage, the Symptoms, the Progression
The Evils of Tobacco
Emphysema
Chronic Bronchitis
COPD s Natural History
Modifying This Natural History
4. Inherited Emphysema: Alpha 1 -Antitrypsin Deficiency
The Dynamics of Disease
Screening
Treatment
Prognosis
Resources
5. Seeking Help
Finding the Right Doctor
Who Is Responsible for What?
6. How Do I Know I Have COPD?
History Taking
The Physical Examination
Laboratory Studies
The Formal Diagnosis
7. COPD and
Cardiovascular Disease
Diabetes
Surgery
8. Stop Smoking!
The Cigarette Cycle: The Path to Addiction
Giving Up Cigarettes
Conclusion
One Ex-smoker s Story
Another Ex-smoker s Story
9. Bronchodilators
History of Medication for Respiratory Diseases
Modern Medication
Drugs That Stimulate Beta-Receptors
Anticholinergic Drugs
Use and Care of Metered-Dose Inhalers
Theophylline
10. The Rest of the COPD Drugs
Corticosteroids
Antibiotics and Airway Infections
Antiviral Drugs and Airway Infections
Anticough Medication
Coping with Mucus
Experimental Emphysema Treatment
Stress and Anxiety Requiring Medication
11. Complementary Therapies for COPD: Old Treatments Have New Life
The Plant Advantage
Herbal Formulations
Coping with Mucus
Preventing Infection
Coping with Cough
Vitamins and Minerals for COPD
Miscellaneous Supplements
Anxiety
Depression
Miscellaneous
Resources
12. Oxygen Therapy
Understanding Oxygen
Modern Use
Using Oxygen at Home
Oxygen Equipment for Home Use
13. Physical Therapies for COPD
Goal Setting
Relaxation Techniques
Breathing Exercises
Postural Drainage
Relearning to Cough
Respiratory Muscle Strengthening
Physical Fitness
One Exercisers Experience
Medicare Coverage
14. Conquering the Emotional and Psychological Consequences of COPD
What Can You Do?
Neuropsychological Changes in COPD
Emotional Effects
Emotional Recovery
Group or Individual Psychotherapy
15. Daily Living
Minimizing Airway Infections
Environment
Nutrition
Energy-Saving Strategies
How One Patient Manages
Improving Your Sleep
16. Work and Play
Restoring Your Ability to Work for a Living
The Initial Decision
What Am I Going to Be?
Putting It into Action
Impairment vs. Disability
Recreation
17. COPD and Sex
COPD Often Produces Sexual Problems
How Do I Start?
Sex Is More Than Intercourse
Important Things to Know
Extending Your Limits
Summary
18. COPD and Successful Travel
Your Medical Needs Away from Home
Where to Go; When to Travel
Final Words
19. Surgical Options
Lung Transplantation
The Ideal Candidate
Transplant Procedure
Lung Volume Reduction Surgery
In Their Own Words
20. The Final Phase
When Will That Point Be?
Final Stage Care Is Moving from Hospital to Home
When Death Is Finally Imminent
Euthanasia
Final Thoughts
21. Reflections: Taking the Measure
Medical Optimism
Economic Pressures Call the Shots in Health Care
How Can We Help Ourselves?
Appendix
Additional Sources of Information
Further Readings
Drug Information
Medical Dictionary
Glossary
Index
Preface
It has been nearly 10 years since the publication of our initial handbook for patients with COPD-chronic bronchitis and emphysema. Until recently we saw no significant changes in treatment or outlook for COPD patients-and thus no reason for doing a second edition. In the last two years, however, three important issues have emerged.
First is the development of lung reduction surgery Second is the dramatic increase in awareness of complementary-or alternative-therapies, along with progress in understanding what they can accomplish and greater acceptance by mainstream medicine. Third is the even greater need for patient advocacy. Since we wrote the first edition, we are more convinced than ever that changing health care management is increasingly forcing COPD patients to go to bat for themselves. And this book now includes more of the tools and ammunition that you ll need.
COPD can be an exhausting and overwhelming burden to live with. Patients who constantly fear running out of air, who watch their capacities dwindle prematurely, struggle with a grossly heightened sense of their fragility. They and those close to them are usually frightened, depressed, and angry. Doctors treating COPD patients do the best they know how to do. The problem is that so many were taught only to treat the medical aspects of COPD-and many have never learned since to appreciate the importance of rehabilitating these patients.
The word rehabilitate comes from the Latin rehabilitate, which means to restore. Restoration to a happier, healthier lifestyle should be the goal of any treatment program-and it is certainly our aim in educating you. This book s guiding principle regards rehabilitation as synonymous with comprehensive care -rehabilitation in its broadest and truest sense. It should not be merely an adjunct to the treatment of COPD, but ideally encompasses medical management and is itself the treatment. It is the means for reversing the downward spiral that begins with impaired pulmonary function and ends in near-total impairment of the patient and, all too frequently, his or her family.
The most basic premise of all rehabilitation-including pulmonary-is that positive change can be achieved under even the most dreadful circumstances imaginable, and thus no effect of illness, save for death, is absolute. The concept of pulmonary rehabilitation actually first emerged after World War I. Then in 1942, during World War II, the Council on Rehabilitation stated that, rehabilitation is the restoration of the individual to the fullest medical, mental, emotional, social and vocational potential for which he/she is capable.
The Council added that in addressing both the physical and mental aspects of any chronic illness, rehabilitation must be tailored to maximize improvement and minimize the impact of illness or progressive deterioration for both patient and family, The next decade-the 1950s-saw the pioneers of pulmonary rehabilitation establish successful techniques for meeting these goals, techniques that now allow COPD patients to resume useful and satisfying lives.
Although the medical literature is filled with reports verifying the solid benefits of comprehensive pulmonary rehabilitation, the medical establishment still views it with at best benign neglect, and at worst-outright hostility. They brand it a waste of time and money rehabilitating patients with a disease that can only get worse. Skepticism and a lack of enthusiasm persist among many physicians, including pulmonologists. The reasons for this skepticism are not surprising.
1. Many programs that call themselves comprehensive in truth provide only fragmented care, and thus produce only fragmented benefits.
2. Because most programs fail to incorporate follow-up in their design, alleged benefits remain anecdotal.
3. Many programs use physiological parameters-s