Question: My mother recently nearly died from pneumonia. I know it is a lung infection, but how do you tell if someone is getting pneumonia, what part of the lung is affected and how is it treated?
Pneumonia is an infection of the tiny air bubbles that form the major part of the lung, and enable the oxygen to cross into the bloodstream. The infection is caused by bacteria, miniature microscopic animals that are inhaled with every breath. Normally these bacteria are destroyed by the body’s defense mechanisms, but if the person is tired, run down, overworked, bedridden or suffering from other illnesses the bacteria may be able to get a hold and start multiplying.
The symptoms of pneumonia may be obvious with fever, cough and chest pains, but some bacteria are far more insidious, and cause minimal symptoms for some months. The patient may just feel tired, short of breath and have intermittent sweats. A chest X-ray is always necessary when a doctor suspects pneumonia, as the damaged section of lung can be seen, and the extent of the infection assessed. A sample of sputum is taken before treatment is started, and this is sent to a laboratory where the infecting bacteria can be identified, and the correct antibiotics to destroy it can be determined.
Treatment may be started before the laboratory results are received, but sometimes the antibiotic has to be changed to a more appropriate one at a later date. Medications to open up the airways and loosen the phlegm may also be prescribed. Regular physiotherapy is very important to drain the foul collection of pus out of the chest.
The other important factors in treatment are rest and the cessation of smoking. If you try to keep working, the body cannot gain enough energy to help the antibiotics fight off the infection. Anyone who continues to smoke while they have pneumonia is effectively frustrating every effort of the doctors and therapists to cure him or her.

Question: I have recently been very ill with double pneumonia. Why is double pneumonia different to ordinary pneumonia?
Pneumonia occurs when a bacterium enters the tiny air bubbles that fill your lung, and starts multiplying to cause an infection. Usually only one part of the lungs, often at the bottom of your chest, is affected at first, but the problem soon spreads to other parts of the lung.
If a sample of the sputum you cough up is sent to a laboratory, the specific bacteria causing your pneumonia can be identified. Once one bacterium is in residence, your resistance to further infection is lowered, and it is much easier for a second type of bacteria to infect the lungs as well. When this happens, both types of bacteria can be identified by the laboratory, and you are said to have double pneumonia. It is possible to have triple, and rarely even quadruple pneumonia if you are particularly unlucky!
The laboratory will also be able to tell which antibiotics will kill the various types of bacteria infecting your lungs. The appropriate combination of antibiotics can then be given by the doctor to cure the condition. Expectorants and chest physiotherapy are the other mainstays of treatment in any type of pneumonia.

Question: My son suffers from asthma, but he was recently sent in to hospital with a pneumothorax. Can you explain this?
Our lung is made up of millions of air bubbles that all connect together by means of fine air-filled tubes. The entire lung lies in a sack that has a smooth inner surface, allowing the lung tissue to slide over it as you breathe in and out.
If the lung develops a puncture (ie. one or more of the tiny air bubbles or tubes bursts) air will leak into the sack around the lung, and will be unable to escape. More and more air steadily accumulates in the sack, causing pressure on the lung, shortness of breath and pain. These punctures can occur for no apparent reason, or may be due to lung diseases such as asthma, which put an excessive stress on the lungs. Once diagnosed, urgent medical attention is required. A tube is placed through the chest wall to remove the escaped air, and this allows the lung to expand and refill the sack.
Pneumothorax resembles asthma in that the patient is short of breath, but asthmatics are not normally in pain.

Question: I am 78 years old and my doctor tells me I have emphysema. I would be much obliged if you could tell me what is available to ease this condition.
Emphysema is a degenerative disease of the lungs caused by smoking, recurrent lung infections, or the inhalation of toxic gases. Unfortunately, there is no cure for the condition, but there are many medications (most of which require prescriptions) and techniques that can be used to control the cough and shortness of breath that occur. The treatments available include:
• Medication to prevent any spasm of the air tubes (bronchi) in the lungs, and prevent the excess production of mucus. These are in the form of inhalers such as Flixotide, Becotide, Pulmicort and Aldecin.
• Bronchodilators that open up the airways to allow more air into the lungs. Examples include Ventolin, Respolin, Atrovent, Seretide, Oxis and Bricanyl. They can be taken using either an inhaler or a nebuliser.
• Tablets such as Theo-Dur and Nuelin that open up the airways, but often cause the heart to race as a side effect.
• A tablet or mixture called Bisolvon which liquefies the phlegm in the lungs so that it can clear away more easily.
• Antibiotics that are used to treat any infection at the earliest possible stage.
• Steroid tablets or injections which are used as a last resort to treat severe episodes, or prevent a recurrence if no other medication works.
• Physiotherapy, which is very important to assist in the clearance of excess mucus from the lungs.
By using combinations and permutations of the above treatments, most emphysema victims can lead useful and comfortable lives.