Q: I'm inquiring for a friend about chronic obstructive pulmonary disease. I'd like to know what to look for in the last stages of COPD. We're in prison, and my friend is having a hard time physically. He is 60. I want to help him.
A: The chronic in COPD indicates that it's permanent; obstructive, that there's a blockage of air passing into the lungs and oxygen into the blood; and pulmonary, that the lungs are affected.
The two main COPD illnesses are emphysema and chronic bronchitis; usually, both are seen together. Cigarette smoking is the most common cause.
Emphysema indicates destruction of the lung's air sacs -- the millions of tiny, delicate, 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 during activity and a cough that won't stop.
The stages of COPD are best defined by lung tests. Symptoms are only a rough guide to the stages. In the advanced stages of COPD, a person struggles for air when taking just a few steps, and the coughing is constant.
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.
Two maneuvers that your friend can do might help him breathe more easily.
One is to exhale through his mouth with his lips pursed in the whistling position. This helps keep airways open.
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.
Q: Is there really a "triangle of death" on the face in which a popped acne pimple can cause death?
A: The "triangle of death" is formed by the bridge of the nose and the corners of the mouth. Facial veins there 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've heard about the triangle of death since grade school. Seldom have I heard it discussed in medical meetings.
I can't tell you whether anyone has died as a result of squeezing pimples in this section of the face.
All the same, one shouldn't squeeze pimples at any site. The bacteria in a pimple are pushed into the adjacent skin and can set up another site of infection.
Dr. Donohue answers letters only in his North America Syndicate column but provides an order form of available health newsletters. Write him at P.O. Box 536475, Orlando, Fla. 32853-6475.