Learning to Cope With COPD

Living Well With Emphysema and Bronchitis: A Handbook for Everyone With Chronic Obstructive Pulmonary Disease by Myra B. Shayevitz MD and Berton R. Shayevitz MD (Doubleday: $15.95).

It comes as a sobering surprise to learn that the fastest-growing disease in the United States is not cancer or heart disease, but chronic obstructive pulmonary disease (COPD), a term that covers emphysema, chronic bronchitis and asthma. The causes of COPD, affecting an estimated 25 million Americans, seem to include increased air pollution and cigarette smoking, which has been directly linked to 120,000 deaths in 1984 alone.

Myra and Berton Shayevitz, a husband-wife medical team working in the fields of pulmonary rehabilitation and intensive-care medicine respectively, offer new hope for COPD patients. They begin by explaining the physiology of this condition, comparing a patient's weakened, narrowed lungs to "plugged plumbing," and by similar analogy, the alveoli, or air sacs, become pitted like "sinkholes."

And it's just those pits of inactivity, fearfulness and depression this upbeat book attempts to rescue people from, using a rehabilitation plan consisting of specific exercises, improved diet and recreational activities, including some forthright advice on how to improve one's sex life.

As for that "assassin," smoking, the authors, in an excellent chapter on how to kick the habit, do not equivocate: "Make no mistake about it, if you smoke, cigarettes are killing you." They cite studies showing damage to the lungs of children who live with smokers, give new evidence that passive smoking affects the non-smoker and quote the U.S. surgeon general to the effect that smoking is the "single greatest preventable cause of disability and death in the United States today."

People with COPD are urged to take responsibility for their own welfare, establish an honest doctor-patient relationship and understand various kinds of treatment when hospitalization is indicated. The authors also advise about pets (cats never, but possibly tight-haired, poodle-type dogs or perhaps a snake or iguana) and conclude with an alluring description of an Alaskan cruise that offers ideal conditions for easing this disorder.

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