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Life and Breath FREE TO VIEW

Suzanne C. Lareau, RN, MS
Chest. 2004;125(4):1597-1598. doi:10.1378/chest.125.4.1597
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By Neil Schachter, MD. New York, NY: Broadway Books, 2003; 346 pp; $24.95

Life and Breath is a book on lung disease written for the layperson, and its publication is timely in a number of ways: the prevalence of lung disease is increasing; individuals have become more interested in learning about their health; and providers are advocating patient participation in management of their disease through action plans. While this book does not actually describe action plans, it does provide information that should help patients implement such a plan.

The style of Life and Breath combines anecdotes with scientific content. Generally, the content of a given chapter is introduced with anecdotes from the author’s experience as a pulmonologist, which are followed by a discussion of the relevant topic. The book is divided into multiple chapters mainly focusing on the lung conditions COPD and asthma. Following an introductory chapter describing why Dr. Schachter authored the book, Chapter 2 describes the anatomy and function of the lungs. Chapter 3 is entitled “What Is COPD?” and may be confusing to the reader since COPD is never actually defined, although descriptions are given of chronic bronchitis as “a form of COPD” and emphysema as “one of the most serious forms of COPD.” Chapter 4 covers “The Causes of COPD” and provides a good description of factors involved in the genesis of COPD (and asthma), with the relationship between smoking and these lung conditions detailed, as well as other causes of COPD. Chapter 5, the “Complete Chest Workup,” should be enlightening to most patients. The author reviews his approach to the examination of individuals presenting with a pulmonary problem and the significance of questions usually posed during the taking of medical histories. Chapter 6, “Eat Right, Breathe Easy,” explains the basis behind reports of the value of, for example, vitamins and antioxidants in the diets of pulmonary patients. There is no discussion, however, about the still prevalent (but inaccurate) belief that a high-protein, low-carbohydrate diet is preferred for COPD patients. Chapter 7 encourages exercise for patients with COPD and asthma. This is not a particularly strong chapter on exercise and has rather little in the way of detailed instructions for COPD patients, who generally are in great need of such advice. Chapter 8, “It’s Never Too Late to Quit,” encourages smokers to stop smoking and describes strategies to do so. Chapter 9 reviews the treatment of COPD and asthma, including the common pharmaceutical forms of treatment (eg, bronchodilators, steroids, and antibiotics), as well as alternative approaches to treatment, such as yoga and acupuncture. The 11th and 12th chapters deal with indoor pollution and the means to reduce exposure, and the last chapter poses hypothetical questions and answers, the equivalent of “frequently asked questions” found on a web site.

There is a glossary of terms at the end of the book, but it is unclear why some terms were chosen and others not. There is also a bibliography associated with each chapter. While this is a useful complement to the chapters, the references are not linked to specific content.

Life and Breath is a more complex read than most lay material on the subject. There are several books and Internet resources available for the public to read on lung conditions. In order to reach the widest audience, historically these resources provide information designed for limited levels of education and comprehension, usually meaning that the vocabulary is based on what a seventh grader could read and understand. Life and Breath is not written at a seventh grade reading level. Such terms as exponential, surface area, and remodeling clearly are directed at a more sophisticated consumer. Consequently, the health-care provider should take into consideration the reading level of the individual patient when recommending this book.




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