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Defeating disease: pneumonia DEFEATING DISEASE: PNEUMONIA
Pneumonia's a bully. It picks on the very young, the old, and the weak. But like most bullies, it'll back off if you stand up to it.
Taking it seriously is a good first step. If you've written off pneumonia as a has-been of a disease, write it back on. Granted, the advent of antibiotics dethroned it from its pre-1936 status as the nation's top cause of death. But there's a lot of fight left in this old killer. Teaming up with influenza, it's still the sixth leading cause of death in the United States. And the number of pneumonia-caused deaths has actually been on the rise, from less than 55,000 in 1980 to more than 80,000 in 1995.
Pneumonia usually swoops in for the kill after some other disease-say, diabetes, chemotherapy-treated cancer, or heart disease-has weakened you. "Even many who die from 'old age' really die of pneumonia," says Ronald Greeno, M.D., co-director of respiratory therapy and pulmonary function at Good Samaritan Hospital in Los Angeles.
Pneumonia is what they call an infectious pulmonary disease, caused usually either by viruses or (much more seriously) bacteria that overpower your lung's defenses and take over. Pretty soon, oxygen isn't getting to your blood the way it should and your cells aren't working right. That can be fatal.
And while the majority of deaths from flu-derived pneumonia in our antibiotic era are in people over 65, that's by no means all of them. "The most common bacterial pneumonia- pneumococcal pneumonia, also known as Streptococcus pneumoniae - very often follows a bout of influenza at any age," says Alfred Munzer, M.D., a pulmonologist at Washington Adventist Hospital in Takoma Park, Maryland, and past president of the American Lung Association. "It is much more likely to be fatal in people who are debilitated or elderly, but it certainly can also be fatal in younger people."
What hits younger and middle-age men a lot more often than bacterial pneumonia is either viral pneumonia or pneumonia caused by mycoplasmas, which are bugs falling somewhere in between a virus and bacterium. Since these types are rarely lethal and usually won't land you in the hospital, you hear them referred to as walking pneumonia. Walking is about as much as you'll feel like doing if you have it.
"You can recognize somebody with viral pneumonia because they usually have a dry, hacking, nonproductive cough combined with a fever," says Dr. Munzer.
So if you don't want to be the guy doing the coughing, do your best to follow these tips.
Know the symptoms. Doctors can usually knock out bacterial pneumonia with antibiotics, but hot if you don't seek treatment. The problem is that the symptoms are often a lot like flu symptoms-fever, cough, chest pains, phlegm.
Another red flag is a cough that comes in violent attacks, which can signal mycoplasma pneumonia. And, says Dr. Munzer, "if you're bringing up a lot of phlegm and you have a fever, with chest pains that are aggravated by breathing, then you have to start thinking seriously about pneumonia."
Seek treatment pronto. As with most diseases, early diagnosis and treatment speed your recovery of pneumonia. Getting doctor-shy because you simply assume that you have a bad flu-or the more common and less dangerous viral pneumonia-is a dubious piece of self-diagnosis, according to Dr. Greeno.
Besides, adds Steven Mostow, M.D., professor of medicine at the University of Colorado in Denver and chairman of the American Thoracic Society's Committee on the Prevention of Pneumonia and Influenza, in New York City, "there are therapies with any number of compounds that will shorten mycoplasma disease dramatically. And you'll feel a hell of a lot better much more quickly."
Get vaccinated. Yes, there's a pneumonia vaccine. And while it won't fend off every type of pneumonia in existence, it will protect you from the most common bacterial pneumonia, pneumococcal. It's relatively cheap, it's covered by Medicare, it's side effect-free, and it will last you at least 10 years, perhaps a lifetime. And still, sighs Dr. Munzer, "it's probably the most underutilized of all the vaccines."
Dr. Munzer adds: "There's no harm in anybody who's interested in preventive medicine asking his doctor about taking the vaccine. If you want to take it, you should be encouraged to do so."
Get a flu shot. The logic is simple. Influenza can lead to pneumonia. So don't get influenza. "There's one way to avoid the flu, and that's to get an annual flu shot," Dr. Mostow says. "I recommend it even for young, healthy men."
Take your time. If you rush your recovery, you run the risk of a relapse. Remember, it takes longer to recover at age 45 than it does at age 25. And some walking pneumonias, such as mycoplasma, leave you weak for many weeks. Rest, after all, is the cure for walking pneumonia, says Dr. Munzer. So stop walking. Take a load off.
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