# What to Do for Pneumonia James Hubbard, MD, MPH



## faithmarie

What to Do for Pneumonia

In this X-ray, pneumonia covers most of this child’s left lung (which is on your right when looking at the picture). It looks white because there’s not just air in there; there’s fluid and swollen tissue.
by James Hubbard, MD, MPH

I have a confession. I’m a pneumonia survivor. And it wasn’t walking pneumonia either. I was in the bed for a week.

Yes, a few years ago, The Survival Doctor ended up a whimpering mess, dependent on other people’s care. It took a good month to feel like doing much walking. But I was lucky. Each year millions in the U.S. get pneumonia, and over 50,000 die. In a prolonged disaster situation, that number would be much higher.


Symptoms and severity of pneumonia can vary greatly. Me, I thought I was as healthy as a horse, doing just fine, wasn’t even feeling sick. Then, out of the blue, I had a teeth-chattering chill. I just shook all over. After that, I started feeling weak, my heart beating fast. I wasn’t coughing much, but I took my temperature, and it was over 102 F.

I took a couple of Tylenol and crawled in the bed. Soon my bedclothes were soaked in sweat. After the Tylenol wore off, I had another chill. The cough started next, but I thought I had the flu. Now I wasn’t thinking right because anytime anyone comes to my office, otherwise healthy, and they’re running fever, I ask if they’ve had a shaking-all-over type chill. If they have, my first thought is pneumonia.

Well, luckily, after a couple of days of lying in the bed, my wife made me see a doctor, of all things. I mean, I am a doctor. Although he couldn’t hear much in my chest, a chest X-ray proved the diagnosis. I started on antibiotics, but it took me a good week to feel able to go back to work, and a month before I felt like doing anything like going on a walk.

How Did I Get It?

I came down with pneumonia just before my daughter Leigh Ann’s wedding. Though I didn’t have the walking pneumonia type, I managed to deliriously walk her down the aisle—and promptly get driven home to bed. I couldn’t even stay for the reception, so you know I’m not exaggerating when I say this thing can get bad.
Pneumonia can be divided into two very general types, community acquired and hospital acquired. The first is what will be more prevalent during a disaster—especially if many people are sheltering together.

Community Acquired Pneumonia (CAP)
I expect I got mine from breathing in bacteria left in the air from someone coughing. It could have been in some public place as easy as it could have been in my office.

Walking Pneumonia
There’s really no such official diagnosis as walking pneumonia. If you have pneumonia and you still feel like walking around, you have walking pneumonia. Okay, it is true that usually this milder version is caused by the bacteria called mycoplasma. And it’s usually treated with some sort of erythromycin antibiotic like azithromycin (Z-Pak) or clarithromycin (Biaxin) or some sort of tetracycline, like doxycycline.

Pneumococcal Pneumonia
One of the most common types of CAP, and the kind I probably had, is caused from the bacteria pneumococcus. We usually treat these with erythromycins or quinolones (Cipro, Levaquin, etc.).

Others
Legionnaire’s disease was first diagnosed in 1976 after several people attending an American Legion convention in Philadelphia came down with severe pneumonia. A bacteria now called legionella coming from the air-conditioning vent was isolated as the cause. The pneumonia can be severe but usually responds to erythromycin.

Pneumonia from the klebsiella bacteria is found in chronic smokers. Ciprofloxacin usually kills it.

In addition to bacteria, viruses are a common cause of CAP. Rarely a fungus can cause it.

Now, don’t get me wrong. Community acquired pneumonia can often be treated on an outpatient basis, but it can also be severe. You may need hospitalization, and people die each year from this type.

Hospital Acquired Pneumonia (HAP)
You are classified with this type if you’ve been in the hospital for more than a day or two and you get pneumonia. Many types of germs can cause HAP—things like MRSA from staph, other bacteria such pseudomonas, and fungi. HAP is usually treated with two or three different IV antibiotics. I won’t go into this type any further for the obvious reason that you won’t be seeing it out of the hospital

Pneumonia Diagnosis If You Can’t Get to a Doctor
As with my case, shaking chills and/or sweats is a clue, but high fever for any reason can cause that. Suspect pneumonia in someone who also has fever and a cough. Chest pain or discomfort is another clue, but it’s less common.

Often, if you have a stethoscope or put your ear on the person’s chest and you know what you’re listening for, you can hear crackles in an area of one or both lungs. If your hair is long enough, rub a few strands together next to your ear. That’s what one type of crackles (medical term—rales) sounds like. Sometimes rales can sound coarser.

Many people with pneumonia get short of breath with exertion. Some are short of breath at rest.

How Contagious Is Pneumonia?

Pneumonia is contagious but not highly so. When treating someone who has it, using a mask would be of small benefit. Better would be having fresh air if possible, along with taking the typical disease-prevention precautions such as washing your hands.

Treatment
It’s very hard to get an exact cause for the pneumonia even if you’re in the hospital. Fortunately, any antibiotic in the ciprofloxacin, erythromycin, or tetracycline family usually treats the community acquired type. Rest and fluids help also. Bring down the fever with acetaminophen (Tylenol) or ibuprofen (Advil).

I usually save the ciprofloxacin for smokers or those who appear pretty sick. Of course, the really sick ones—the ones short of breath who don’t respond to an asthma inhaler, the ones who can’t keep down fluids, the confused ones—I usually send to the hospital.

People with chronic diseases, such as heart disease, diabetes, or emphysema, are at higher risk for complications also, as are even healthy people over 65 and under age 2.

Prevention
The most common community acquired pneumonia is caused by pneumococcus bacteria or comes on after a bout of the flu. You already know about the annual flu vaccine, but you may not know that there’s a pneumococcus vaccine you can get every ten years. It doesn’t prevent them all, but it can cut down on your risk considerably. It’s usually recommended for people age 65 and older or who are at high risk for complications.


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## faithmarie

Question:
Would the use of tumeric be helpfull or beneficial if no antibiotics were available fir cases of pneumonia? I know it is used to treat sinus infections. Just not sure about pneumonia.

I don't know but I believe it is very healthy.

Turmeric .Overview
Turmeric (Curcuma longa) has been used for 4,000 years to treat a variety of conditions. Studies show that turmeric may help fight infections and some cancers, reduce inflammation, and treat digestive problems, and it has gotten a lot of press lately.

But remember several facts when you hear news reports about turmeric. First, many studies have taken place in test tubes and animals, and turmeric may not work as well in humans. Second, some studies have used an injectable form of curcumin, the active substance in turmeric. Finally, some of the studies show conflicting evidence.

Turmeric is widely used in cooking and gives Indian curry its flavor and yellow color. It is also used in mustard and to color butter and cheese. Turmeric has been used in both Ayurvedic and Chinese medicine as an anti-inflammatory, to treat digestive and liver problems, skin diseases, and wounds.

Curcumin is also a powerful antioxidant. Antioxidants scavenge molecules in the body known as free radicals, which damage cell membranes, tamper with DNA, and even cause cell death. Antioxidants can fight free radicals and may reduce or even help prevent some of the damage they cause.

In addition, curcumin lowers the levels of two enzymes in the body that cause inflammation. It also stops platelets from clumping together to form blood clots.

Research suggests that turmeric may be helpful for the following conditions:

Indigestion or Dyspepsia

Curcumin stimulates the gallbladder to produce bile, which some people think may help improve digestion. The German Commission E, which determines which herbs can be safely prescribed in Germany, has approved turmeric for digestive problems. And one double-blind, placebo-controlled study found that turmeric reduced symptoms of bloating and gas in people suffering from indigestion.

Ulcerative colitis

Turmeric may help people with ulcerative colitis stay in remission. Ulcerative colitis is a chronic disease of the digestive tract where symptoms tend to come and go. In one double-blind, placebo-controlled study, people whose ulcerative colitis was in remission took either curcumin or placebo, along with conventional medical treatment, for 6 months. Those who took curcumin had a relapse rate much lower than those who took placebo.

Stomach Ulcers

Turmeric does not seem to help treat stomach ulcers. In fact, there is some evidence that it may increase stomach acid, making existing ulcers worse. (See "Precautions" section.)

Osteoarthritis

Because of its ability to reduce inflammation, researchers have wondered if turmeric may help relieve osteoarthritis pain. One study found that people using an Ayurvedic formula of herbs and minerals with turmeric, winter cherry (Withinia somnifera), boswellia (Boswellia serrata), and zinc had less pain and disability. But it' s impossible to know whether it was turmeric or one of the other supplements -- or all of them together -- that was responsible.

Heart Disease

Early studies suggested that turmeric may help prevent atherosclerosis, the buildup of plaque that can block arteries and lead to heart attack or stroke. In animal studies, an extract of turmeric lowered cholesterol levels and kept LDL "bad" cholesterol from building up in blood vessels. Because it stops platelets from clumping together, turmeric may also prevent blood clots from building up along the walls of arteries. But a double-blind, placebo-controlled study found that taking curcumin, the active ingredient in turrmeric, at a dose of up to 4 g per day did not improve cholesterol levels.

Cancer

There has been a great deal of research on turmeric's anti-cancer properties, but results are still very early. Evidence from test tube and animal studies suggests that curcumin may help prevent or treat several types of cancers, including prostate, breast, skin, and colon cancer. Its preventive effects may be because it is a strong antioxidant, protecting cells from damage. More research is needed. Cancer should be treated with conventional medications. Don' t use alternative therapies alone to treat cancer. If you choose to use complementary therapies along with your cancer treatment, make sure you tell all your doctors.

Bacterial and Viral Infections

Test tube and animal studies suggest turmeric may kill bacteria and viruses. But researchers don' t know whether it would work in people.

Uveitis

A preliminary study suggests curcumin may help treat uveitis, an inflammation of the eye' s iris. In one study of 32 people with chronic anterior uveitis, curcumin was effective as corticosteroids, the type of medication usually prescribed. More research is needed.

Plant Description:

A relative of ginger, turmeric is a perennial plant that grows 5 - 6 feet high in the tropical regions of Southern Asia, with trumpet-shaped, dull yellow flowers. Its roots are bulbs that also produce rhizomes, which then produce stems and roots for new plants. Turmeric is fragrant and has a bitter, somewhat sharp taste. Although it grows in many tropical locations, the majority of turmeric is grown in India, where it is used as a main ingredient in curry.

Parts Used:

The roots, or rhizomes and bulbs, are used in medicine and food. They are generally boiled and then dried, turning into the familiar yellow powder. Curcumin, the active ingredient, has antioxidant properties. Other substances in this herb have antioxidant properties as well.

Available Forms:

Turmeric is available in the following forms:

Capsules containing powder
Fluid extract
Tincture
Because bromelain increases the absorption and anti-inflammatory effects of curcumin, it is often combined with turmeric products.

How to Take It:

Pediatric

Turmeric supplements haven' t been studied in children, so there is no recommended dose.

Adult

The following are doses recommended for adults:

Cut root: 1.5 - 3 g per day
Dried, powdered root: 1 - 3 g per day
Standardized powder (curcumin): 400 - 600 mg, 3 times per day
Fluid extract (1:1) 30 - 90 drops a day
Tincture (1:2): 15 - 30 drops, 4 times per day
Precautions:

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and may interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Turmeric in food is considered safe.

Turmeric and curcumin supplements are considered safe when taken at the recommended doses. However, taking large amounts of turmeric for long periods of time may cause stomach upset and, in extreme cases, ulcers. People who have gallstones or obstruction of the bile passages should talk to their doctor before taking turmeric.

If you have diabetes, talk to your doctor before taking turmeric supplements. Turmeric may lower blood sugar levels, and when combined with medications for diabetes could cause hypoglycemia (low blood sugar).

Although it is safe to eat foods with turmeric, pregnant and breastfeeding women should not take turmeric supplements.

Because turmeric may act like a blood-thinner, you should stop taking it at least 2 weeks before surgery. Tell your doctor and surgeon that you have been taking turmeric.

Possible Interactions:

If you are being treated with any of the following medications, you should not use turmeric or curcumin in medicinal forms without first talking to your health care provider.

Blood-thinning Medications -- Turmeric may make the effects of these drugs stronger, raising the risk of bleeding. Blood-thinners include warfarin (Coumadin), clopidogrel (Plavix), and aspirin, among others.

Drugs that reduce stomach acid -- Turmeric may interfere with the action of these drugs, increasing the production of stomach acid:

Cimetidine (Tagamet)
Famotidine (Pepcid)
Ranitidine (Zantac)
Esomeprazole (Nexium)
Omeprazole
Lansoprazole (Prevacid)
Diabetes Medications -- Turmeric may make the effects of these drugs stronger, increasing the risk of hypoglycemia (low blood sugar).

http://www.umm.edu/altmed/articles/turmeric-000277.htm#ixzz2CFlAYH5J


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