BREATH TAKING – a book review

We take 7.5 million breaths a year and some 600 million in our lifetime. Breath Taking is an exhaustive review of why and how our lungs work, and what happens to our lives when they are attacked and injured by disease.

Usually when we call something “breathtaking”- a sunset, a painting, a song, a mountain- we mean it is awe-inspiring, wondrous, beautiful, or astonishing. But in his book Breath Taking, Dr. Michael Stephen describes conditions that literally cause us to lose our breath- the multiple and serious diseases that affect the human lung.

Prologue: Lungs =Life

Michael J. Stephen, M.D.

BREATH TAKING

by Michael J. Stephen, M.D.

The Power, Fragility, and Future of Our Extraordinary Lungs

I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. Some of the links in this post are affiliate links which may help support this blog financially.

image of God and Adam on the Sistine Chapel by Michelangelo
“The Lord God formed man, and breathed into his nostrils the BREATH of life, and he became a living being.” Genesis chapter 2, mentioned in the prologue.

the breath can be used to heal the body

from the prologue

Part i-THE PAST

the lungs shaped our beginnings, physically and spiritually

We take 7.5 million breaths a year and some 600 million in our lifetime. Yet humans have not always understood breathing, how the lungs work, or even what oxygen is. In Part 1 Dr. Stephens steps into the past to relate the story of how we came to understand this critical part of our physiology.

The human respiratory system diagram- the throat, trachea, bronchi, and lungs
The human Respiratory Tract from the nose all the way down to the lungs and alveoli . (photo complimentary from Pixabay)

For years physicians tried to understand why premature babies have breathing problems, known as neonatal respiratory distress syndrome. It took a determined young woman physician, Dr. Mary Ellen Avery, to discover the cause and rename it hyaline membrane disease, descriptive of the underlying disease.

a tiny baby lying in a bed with a breathing tube
phots by Alex Workman, from the LIGHTSTOCK.COM collection, an affiliate link

part ii: the present

our lungs-and us-against the world

In this section Dr. Stephen introduces us to the interactions between the immune system and the lungs. Ideally we expect our immune system to protect our lungs from threat of infections due to pathogens like viruses-influenza and coronaviruses- and bacteria that cause pneumonia. In all of human history, including today, tuberculosis has caused more disease and death than the others combined.

But the immune system can go awry, and cause disease rather than protect us from it. Such is the case with asthma in which inflammation out of control can lead to first shortness of breath and progress into respiratory failure.

Published early in 2021, the book does not cover the COVID-19 pandemic extensively. Dr. Stephen did say this,

“The coronavirus story is one illustration of how our air is communal, that the world is interconnected, and warnings about potential global health threats need to be taken seriously. ”
WHY WE NEED TO VACCINATE THE WORLD
graphic from the Johns Hopkins Bloomberg School of Public Health Facebook page

Next Dr. Stephen devotes a large section to the “seduction of nicotine”, explaining why we should not start smoking cigarettes and why we should stop if we do.

I was intrigued by the story of a man named Buck who came from a modest background but was quite an entrepreneur. In the early 20th century smoking was becoming more and more popular, enabling Buck to make a fortune by creating and marketing a machine that rolled cigarettes.

He became so rich that he donated $100 million to a small college. The college administration was so grateful they renamed the school after him, James Buchanan “Buck” Duke. The college, now Duke University, ranks among the top universities in the United States, including the medical school. The men’s basketball program is one of the country’s most successful.

I wonder if Mr. Duke knew how addictive his fortune making product was, thus assuring his company of success?

from the Facebook page of WHO, the World Health Organization

part iii-the future

the lungs provide a vision of what’s to come

Next to the infections-pneumonia, bronchitis, influenza, COVID-19, tuberculosis -the lung disease most people know and fear most is lung cancer.

A diagnosis of lung cancer strikes fear in the hearts of its victims and their families, and for good reason. “80% of patients come ..with stage III or IV disease, both very advanced.” Compare the average five year survival rates for

  • breast cancer-90%
  • colorectal cancer-65%
  • lung cancer-18%.

Lung cancer causes more deaths per year than colon, breast, and prostate combined.

chapter 11

Lung cancer is treated with a combination of surgery, radiation, and/or chemotherapy. However, a small percentage of cancers are due to a genetic mutation that can function as a “kill switch” if found. For those who qualify, about 4%, such treatment can extend life much longer than the conventional treatment.

Another option is harnessing the immune system to attack cancer cells, and a new drug, pembrolizumab has recently been approved by the FDA.

Most important now is prevention, by decreasing cigarette smoking, reducing other inhaled carcinogens such as radon, and toxins from air pollution .

2 preserved human lungs, one normal, one damaged
Two preserved human lungs, one normal,-left, one damaged from disease-right. Photo by Dr. Aletha at the Denver Science Museum

part iv

life, love, and the lungs

Dr. Stephen introduces this section by reiterating the three main themes of his book-

  • the central importance of the lungs
  • the courage of patients afflicted by a devastating illness
  • the importance of hard work, intelligent observation, and collaboration in the advancement of medical science

He illustrates these themes by telling the story of the discovery , and advances in treatment of cystic fibrosis (CF), “the Most Heartbreaking Lung Disease”.

Again, it was a woman physician, Dr. Dorothy Anderson, who did the groundbreaking work which described the pathologic changes caused by CF, established the genetic origin of CF (a defective autosomal recessive gene), and developed the first test for CF.

My final thoughts

Breath Taking is an exhaustive review of why and how our lungs work, and what happens to our lives when they are attacked and injured, sometimes fatally .

Dr.Stephen achieves this by weaving stories of real people afflicted with lung diseases together with the scientists who studied those diseases, and the physicians who treat them.

He believes it is imperative for us to protect and improve the enivironment, especially the air we breath and challenges us to choose lifestyles that can save not only our own lungs but of everyone else on this planet. He discussed this in a piece written for Each Breath, a blog by the American Lung Association.

2020:The Year We Lost Our Breath

tops of skyscrapers obscured by smog
photo by Brandon at Lightstock.com

“The Clean Air Act (1970) was designed to protect public health and welfare from different types of air pollution caused by a diverse array of sources, and passage of this landmark legislation has saved countless lives. While we enjoy healthier air thanks to the Clean Air Act, climate change poses new risks to our air quality. We know air pollution harms health and can be deadly, and new research suggests that exposure to particle pollution can even increase the death toll from COVID-19.” (continue reading at the link)

Conclusion

  • Acknowledgments
  • Notes- more of an exhaustive bibliography
  • Image Credits
  • Index
  • Author bio on the inside back cover

The author- Michael J. Stephen, M.D.

Michael J. Stephen, MD, is an associate professor at Thomas Jefferson University in Philadelphia, and director of the Adult Cystic Fibrosis Center.

He has led numerous clinical trials and has cared for COVID-19 patients. Over the past two decades he has studied advanced end-stage lung diseases and worked with patients at diverse locales, including a Massachusetts prison hospital and a pediatric HIV clinic in Cape Town, South Africa.

A graduate of Brown University and Boston University Medical School, he lives in New Jersey with his wife and two children.

About this post

This review is for information only, is not intended for medical advice, and does imply endorsement of the author or his views, unless stated.

I chose all of the photos and graphics in this post, they are not from or affiliated with the book.

I took the photo of the lungs which were part of the Expedition Health exhibit at the Denver Museum of Nature and Science.

The two graphics were shared on Facebook by the organizations identified and I thank them.

The photo illustrating Genesis 2 is of course the ceiling of the Sistine Chapel at the Vatican, painted by Michaelangelo from 1508 to 1512. The photo,available on Lightstock.com (affiliate link), was shot by Rob Birkbeck.

exploring the HEART of breathing

Dr. Aletha

This graphic is from SundaySocial.tv
cheesy-free faith-focused stock photos

Lightstock-quality photos and graphics site- here. 

(This is an affiliate link)

How common meds can hurt your skin

Medications, both prescription and over the counter, can relieve symptoms, hasten healing, and save lives. Even so, adverse reactions are always a risk with any drug. Some of these adverse reactions can involve the skin.

In a previous post I told you how smoking and sunlight affect our skin- premature aging, dryness, and increased risk of skin cancer. Here is a link for you to review or read if you missed it.

How smoking and sun affect your skin’s look and feel

Layers of the Skin diagram

Here is a review of the skin’s layers

Medications and skin -help and harm

In this post I’ll talk about ways medications can adversely affect skin health.

Medications, both prescription and over the counter, can relieve symptoms, hasten healing, and save lives. Even so, adverse reactions are always a risk with any drug. Some of these adverse reactions can involve the skin.

So it is vital that patients and doctors avoid unnecessary or inappropriate use of medications.

Sun sensitivity due to medication

As mentioned in the previous post , some medications can make your skin more sensitive to sun exposure, called drug-induced photosensitivity.

Any drug can cause a reaction, even if you have taken it before without a problem. Some of the more common “skin reaction drugs” include

  • Anti-inflammatory medications, the NSAIDs
  • Psychiatric medications
  • Chemotherapy drugs
  • Blood pressure lowering meds
  • Antibiotics
  • Statins-cholesterol lowering drugs

Reactions can vary from scaly rashes, blisters, redness, dryness, itching, to severe eruptions all over the body that can be painful and occasionally life threatening.

This is what your skin looks like under a powerful microscope.

Melasma-drug induced skin color change

Melasma (muh-LAZ-muh) is a common skin problem. It causes brown to gray-brown patches, usually on the face. It is much more common in women, probably because it is triggered by female hormones, so it often starts in pregnancy. Women of color are also more susceptible.

Photo by Pixabay on Pexels.com

Melasma can be caused by

  • Sun exposure
  • Hormone medications-birth control pills, post -menopause hormonal therapy

Here is an excellent discussion and photos of melasma from the American Academy of Dermatology

Use antibiotics wisely for your skin’s sake

Probably the most common drugs that cause a rash or other adverse effects are antibiotics, probably because they are used so often. A

Antibiotics such as penicillin, amoxicillin, sulfa, tetracycline, and ciprofloxacin can cause several skin reactions .

  • urticaria, also known as hives
  • photosensitivity, mentioned above
  • a scaley rash that may peel off
  • a measles-like rash, called morbiliform
  • blisters

So doctors prescribe antibiotics only for infections that are serious enough that the risk of adverse reaction is worth the possible benefit.

Colds,  flu, and bronchitis are caused by viruses and don’t respond to antibiotics. Even sinus and ear infections don’t always need an antibiotic to resolve. Please don’t pressure your doctor for an antibiotic when you don’t need it. Read more about antibiotic misuse at my previous post

How to navigate the antibiotic highway

6 smart facts about antibiotic use
graphic created by the Centers for Disease Control, http://www.cdc.gov

The American Academy of Dermatology shares

10 skin care secrets for healthier skin

What you should and shouldn’t do now

Please understand I am not saying we should never use these medications as sometimes they are the best choice for our overall health. You should be aware of the potential for reactions and report them promptly to your doctor if they occur.

If you are taking any of the drugs listed here, do not stop without talking to your doctor.

exploring the HEART of healthy skin

Thanks for joining me to explore skin problems and the HEART of health. Even if it’s winter where you live, don’t forgo sunscreen; the sun doesn’t take a holiday from damaging skin.

Dr Aletha

a cute monkey checks out his face in a mirrow
We all care about our appearance, including this cute monkey. Photo by Andre Mouton on Pexels.com

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