A fraction of patients respond to cortisone or prednisone, and although long term use can have serious side effects, this drug can also be helpful. Training of the patient in pulmonary exercises and other techniques can enhance adaptation to the handicap. A small minority of patients will benefit from chronic oxygen use, although most do not, and this is an expensive modality. Prompt treatment of any worsenings is important. The importance of pneumonia and influenza immunizations are clear.
Emotional counseling is important for others.
Obviously, avoidance of smoking is advised. It is very important for severely ill patients to avoid sedating drugs, as these may precipitate respiratory failure. Experimental treatments such as x-ray therapy and surgery have found little acceptance, as their benefit has been disappointing. I work with an R.T. who performs the initial patient eval and works with the aerobic portion of the treatment on the bike or treadmill. I would like to know the role the P.T. plays in the rehab process and specific relaxation, stretching and strengthening exercises which have proven successful with these patients.