PERF, The Pulmonary Education and Research Foundation, is a small but vigorous non-profit foundation.  We are dedicated to providing help, and general information for those with chronic respiratory disease through education, research, and information.  This publication is one of the ways we do that.  The Second Wind is not intended to be used for, or relied upon, as specific advice in any given case.  Prior to initiating or changing any course of treatment based on the information you find here, it is essential that you consult with your physician.  We hope you find this newsletter of interest and of help

We Got Mail

Leonard writes, 
"Thank you very much for your research on COPD.

My mother has COPD and uses O2, hence my interest in COPD research. I am trying to find out what the conclusions were from:
1. Testosterone supplementation in men
2. Testosterone supplementation in women
3. Research to find out what the optimum O2 saturation should be for a patient who is on O2 continuously (24 hrs). In other words, when we set the O2 flow rate, what O2 saturation should we aim for, in order to have the optimum benefits? I am told that 100% O2 saturation should not be the aim. My question is, what would be the optimum setting? 

Dr. Casaburi answered, 
Dear Leonard,
I'm sorry that your mother has COPD. It is a miserable disease. I'll provide brief answers .

• Testosterone supplementation in COPD (men or women) is considered experimental therapy. We used testosterone in COPD men in modest doses and found increased muscle mass and strength, and little in the way of side effects. Testosterone therapy for women is problematic in that doses we use in men will cause virilization (e.g., growing beards). We are in the middle of a 3-year study to see if a lower dose of testosterone will have beneficial effects in women with COPD. 
• It is generally agreed that a target oxygen saturation should be roughly in the 92-95% range. In general, when a patient ambulates, the oxygen flow rate must be increased to maintain an adequate saturation. Thus the flow rate of oxygen necessary to obtain adequate oxygen saturation should be determined at rest and during exercise.
• Tiotropium (Spiriva) is a new drug that is available for sale in the Europe and Canada, but not in the US yet. I think it is a good drug and an advance in therapy, but not a miracle drug. 
  I hope this is of help.

Rich Casaburi

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Sarah wrote to ask if emphysema is hereditary since her mother has it and she is concerned about herself. 

Mary responded:
There is a form of emphysema called Alpha One Antitrypsin Deficiency, which is hereditary and can be diagnosed early in life with a simple blood test. However, this is a very rare condition and perhaps accounts for only 1% to 3% of all cases of emphysema. COPD and emphysema are usually due to smoking though the susceptibility to lung damage from smoking seems to run in some families. Only 15% to 20% of people who smoke get emphysema. The question is not so much why do some people who smoke get COPD as why doesn't EVERYONE who smokes get it? Avoiding smoking and second hand smoke is good advice for everyone for many reasons. 

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Do you have a question about respiratory disease that has been bothering you? 
If so, feel free to write and ask us, either through our web site or by mail.
We answer all of your letters.

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