Tuesday, May 29, 2012

MAY 29, 2012 EMPHYSEMA AND VITAMIN D









"Happiness is the rsult of good actions."

"In seeking happiness for others, you find it for yourself." Anonymous

"Happiness lies in the joy of achievement and the thrill of creative effort." Franklin Roosevelt

"The secret of happiness is not in doing what one likes, but in liking what one does." James M Barrie

What is happiness? There is a definition.  Are you happy today? To the world you may be one person, but to one person you may be the world.”  said Bill W. Now that makes me happy to know I might have touched one person in my life during my AA service. I hope and pray I touch many individual lives in my lifetime. If I do this, then I am grateful and this is my happiness in the world. If I contribute just a bit of my knowledge and happienss to another human individual, then my work is done on this Earth . How blessed am I!

Happiness this weekend was relaxing with Rick and family. I love the green of Virginia. I love listening to the birds in the morning. It was especially endearing as all were healthy in Virginia this weekend... more so than in the past few months. We were all blessed to be together.- Nancy, Fred, Rick, Michael and I



What is COPD?  Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It makes it difficult to breathe. There are two main forms of COPD: One is chronic bronchitis, which involves a long-term cough with mucus and the other is emphysema, which involves destruction of the lungs over time. Most people with COPD have a combination of both conditions. The leading cause of  COPD is smoking . A person who smokes two packs per day is more likely to develop COPD than someone who smokes one pack per day.
Other risk factors for COPD are exposure to second hand smoke, air pollution and certain gases/fumes in the workplace.
One of the first symptoms is a cough with or without mucous, fatigue, dyspnea (shortness of breath) and many bouts of respiratory infections. Some other symptoms might be wheezing, and trying to catch one's breath.
The most useful test is for the doctor to listen to the lungs with a stethopscope. I do not think that many doctors have time to listen to their patients lungs. In the last years I am getting more involved in the physical diagnosis aspect of my patients health. I used to sit behind a desk (which I still do) but now I have an examination table in my office to better assess my patients health.

The best test for COPD is a lung function test called spirometry. This involves blowing out as hard as possible into a small machine that tests lung capacity. The results can be checked right away, and the test does not involve exercising, drawing blood, or exposure to radiation.

Many Americans die from emphysema from years of smoking. If not emphysema, then lung cancer. One of those individuals was William Griffith Wilson, also known as Bill W. Last week, Rick and I saw the 2012 biopic film, Bill W. BILL W. is the inspirational story of Bill W, the founder of Alcoholics Anonymous. Young Bill was a hard worker and a quick learner. But there were always reasons to drink, and Bill became an alcoholic at a time when there was no support. Working with Dr. Bob Smith to organize an alcoholics’ support group in Akron, Ohio in 1935, Bill then expanded his ideas into the first 12-step recovery program. An engaging public speaker, his idea was to turn alcoholics’ interests toward others, so they wouldn’t be overwhelmed by their own difficulties. It was a truly inspirational story to watch. I teared up at many situations on the screen espcially the real footage of Bill W. I am in awe of this truly gifted special man. He is one of the most engaging men of the 20th century and should never be forgotten.

In the recent Annals of Internal Medicine (2012;156:105-114) a study was published involving COPD patients and the supplementation of Vitamin D. The supplementation was 100,000 units every 4 weeks which was equivalent to about 3,600 IU/day.

The data concluded that high dose Vitamin D DID NOT decrease the incidence of exacerbations in patients with COPD. Vitamin D supplementation did decrease the exacerbation in patients with severe Vitamin D deficiency. The definition for severe was less than 10. There was a suggestion that high dose Vitamin D may exacerbate COPD in those without a severe deficiency (less than 10)

My conclusion is that the estimated daily dose is not enough. I do not consider 3,600 IU/day to be a high dose. Most of my patients take an average dose of 5,000 or greater.  The results in this article are basically what has been written before, but I feel more studies need to be done on much higher doses of Vitamin D. I prefer to use Vitamin D3 as a liquid. Although this is not readily available in most health food stores, it can be obtained through a physician.

Until tomorrow...

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