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Thursday, November 29, 2007

She has broken two ribs from coughing: C.O.P.D. and prednisone side effects

For many, trying to control chronic obstructive pulmonary disease (COPD), rather than be controlled by it, is a daily struggle. Diane Williams Hymons, 57, a social service consultant and therapist in Silver Spring, Maryland, has had lifelong problems with bronchitis, allergies and asthma. In the last five or ten years her breathing difficulties have worsened, but she was told only three years ago that she had COPD. It motivated her to give up cigarettes, after smoking for more than 30 years.

"I have good days, and days that aren’t as great," she said. "I sometimes have trouble walking up steps. I have to stop and catch my breath."

She is "usually fine" when sitting, she says.

Her mother, also a former smoker with chronic lung disease, has been in a pulmonary rehabilitation program. Diane's doctor has not recommended such a program for her, but she has no idea why. They have discussed surgery to remove part of her lungs, which helps some people with emphysema, but she said no decision had been made yet because it is not clear whether her main problem is emphysema, or asthma. She is not sure what her prognosis is.

She has been taking prednisone for years, something both she and her doctor know is risky. But when she tries to cut back, the disease flares up. She has many side effects from the drug.

"My bone density is not looking real good," she said. "I have cramps in my hands and feet, weight gain and bloating, the moon face, excess facial hair, fat deposits between my shoulder blades."

She has broken two ribs just from coughing, probably because the prednisone has thinned her bones, she said. She went to a hospital for the rib pain last year and was given so much asthma medication to stop the coughing that it caused an abnormal heart rhythm. She wound up in the cardiac unit for five days, and now says "never again" to being hospitalized.

Her doctor orders regular bone density tests.

"I know he's concerned, like I’m concerned," she said, "but we can't seem to kind of get things under control."

Advice to long-time smokers: Ask your doctor if you might have C.O.P.D.

Browse for related stories in the index at the very bottom of this page, or read a C.O.P.D. story.

Thanks to Denise Grady for the source article in today's New York Times.

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