What can you tell me about pneumonia?
As you probably know, pneumonia can become pretty dangerous for older people, especially for those with other chronic health conditions like heart problems, diabetes or chronic lung disease. Pneumonia is the second-leading cause of hospitalizations among Medicare beneficiaries and the fifth-leading cause of death among Americans ages 65 years and older. So it’s wise to learn about pneumonia symptoms and get on top of it quickly.
Pneumonia infects or inflames the lungs in two ways. Lobar pneumonia is when a lobe of the lung is infected or inflamed (lobes are like pie slices and there are five of them). Bronchial pneumonia is when you have patches affected throughout both lungs.
The first question you want to ask your doctor is whether your pneumonia is viral or bacterial. There are three major culprits linked to pneumonia: viruses, bacteria and mycoplasmas. The latter is another form of bacteria known for its “stealth” quality because it has no cell walls and therefore acts like a tiny jellyfish taking on different shapes. As a result, it becomes tough to identify and is able to travel throughout your body, damaging more than just your lungs.
How does your physician know from your pneumonia symptoms which type you have? Your doctor will listen to your lung sounds and will likely order a chest x-ray, sputum culture and blood tests. He or she will be checking your oxygen saturation rate, which indicates the level of oxygen in your blood. If it is too low, it means your infected lungs aren’t functioning as well as they should and, as a result, your organs won’t be getting the oxygen levels they need to stay healthy. It’s a domino effect you don’t want.
About half of pneumonia cases are believed to be caused by a virus, which tends to be less severe than illnesses caused by bacteria. Pneumonia symptoms are similar to the flu: fever, dry cough, headache, muscle pain, weakness and increased breathlessness. Most viral infections will heal on their own; however your doctor will most likely prescribe medications and care to relieve your symptoms to facilitate your recovery. He or she will also monitor you closely to prevent any other complications from developing, given your weakened state.
If your pneumonia is bacterial, getting the right antibiotic in your system quickly is the name of the game. One major study of more than 18,000 Medicare patients by the Centers for Medicare & Medicaid Services (CMS) found that three out of four patients presenting pneumonia symptoms who received antibiotics within four hours of coming to the hospital experienced reduced risk of death and spent less time in the hospital recovering than those who did not receive antibiotics. But antibiotics aren’t fool-proof since bacteria (especially mycoplasmas) are constantly finding new ways to resist being terminated.
The most common type of bacterial pneumonia acquired outside of the hospital environment is streptococcus or pneumococcal, accounting for about one in three such pneumonias. These nasty bacteria can quickly run amok, attacking the bloodstream, brain or other parts of the body and can potentially cause serious damage to otherwise healthy lungs. More severe symptoms may include shaking or chills, sweats, a cough that produces rust-colored or greenish mucus, bluish lips or nails (signs of deprived oxygen) and chest pain.
Why are older adults more susceptible to pneumonia? Specialized cells lining our airways have hair-like projections that sweep anything that doesn’t belong in the lungs up and out. But as we age, that cleansing system gets less effective, giving bacteria and other bad guys a free pass. Coughing also becomes less vigorous, so sputum gets to hang back and cause infection. Then there’s the standard trouble-maker: a weakened immune system. Your best defense is to get the pneumococcal vaccination which will protect you from 23 types of pneumococcal bacteria. It is generally given once, but if you have heart problems and other risk factors, your doctor may recommend a revaccination within six years. It is also recommended for anyone over the age of 65.
Once you know what type of pneumonia you have, ask your doctor:
- Could you please explain the tests that were done to tell you what kind of pneumonia I have?
- What treatment and/or medications are you recommending?
- How will you know if they are or are not working?
- Are there any complications you’re concerned about that are unique to me?
Once you go home, ask:
- What symptoms should I call you about?
- What are the signs that I should go to an emergency room?
- Is this contagious?
- How long should it take me to feel better?
- What can I do to recover? Is there something I could have done to prevent this or could do in the future?
For more information about pneumonia check out the American Lung Association’s website at lungusa.org
or give them a call at 1.800.586.4872 to receive any of their free publications.