Breathing Lessons: A Doctor's Guide to Lung Health

by MeiLan K. Han M. D.

An authoritative, accessible guide to how our lungs work and how to protect them. Every day, our lungs circulate 11,000 liters of air, provide us with life-sustaining oxygen, and allow us to speak, sing, and smell. It’s no secret that our lungs are one of our most vital organs, and yet most of us pay them little attention. The COVID-19 pandemic, however, has reminded us of the importance of our lungs, and sparked interest in their function and the risks they face. In Breathing Lessons , leading pulmonologist and national spokesperson for the American Lung Association Dr. MeiLan K. Han takes readers on a fascinating tour of this neglected yet crucial organ. Han explains the wonder of breathing and reveals how the lungs serve as the body’s first line of defense. She provides a timely overview of the latest scientific thinking about the leading respiratory risks―including indoor and outdoor pollution, smoking and vaping, wildfire smoke, and viruses like SARS-CoV-2―and offers practical advice on how to protect the lungs at each stage of our lives, beginning in the womb. She outlines the major categories of chronic lung disease and demystifies the process lung doctors go through in making a diagnosis and recommending treatments. With authority as both practitioner and medical researcher, Han argues powerfully for social policies that make preserving lung health a national priority. Breathing Lessons is a rallying cry for lung health and an urgent call to start giving our lungs the attention they deserve. 5 illustrations

Genres: Nonfiction, Health, Science, Medical, Audiobook, Medicine

192 pages, Hardcover

Published November 2, 2021

Reviews

[Barbara (The Bibliophage) · Rating 3 out of 5]

Originally published on my book blog, TheBibliophage.com.

Dr. MeiLan Han transfers years of knowledge as a lung doctor, or pulmonologist, to the printed word in her upcoming book Breathing Lessons: A Doctor’s Guide to Lung Health. With this book, she offers explanations of many lung-related conditions including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, and many others.

Dr. Han discusses how doctors both observe and test their patients to diagnose lung conditions. Additionally, she explains a variety of treatments. But most importantly, her goal is to explain how to keep our lungs healthy. By breaking it down over the decades of life, Dr. Han shows that lung health truly begins in childhood.

And this isn’t how the medical community traditionally addresses it. Therefore, she seeks to inform patients in the hopes that they will take the reins and request lung-related follow-up.

Paying attention to our lungs throughout our lives also helps us gain better overall health and function as we age. But Dr. Han also realizes many people reading her book need help in the latter decades of their lives. So she addresses that as well.

My conclusions
Dr. Han is clearly a compassionate physician who cares about the state of people’s lungs. She recognizes that lung health is crucial to life, a fact that COVID-19 brought to the forefront. Our breathing capabilities are a vital sign of health or illness. Unfortunately, they’re often minimized or ignored until it’s too late.

She articulates complicated medical conditions with ease and finds a balance between medical jargon and typical layperson terminology. But from a writing perspective, Breathing Lessons felt dry as a bone to me.

I appreciated her historical perspectives on pulmonology. But more patient stories or other illustrations of the medical concepts would help lighten the academic nature of the content. Still, if you need a general lung-related reference with a focus on Western, allopathic medicine, this is a strong entry.

Pair with Breath: The New Science of a Lost Art by journalist James Nestor, which offers complementary perspectives on the breath.

Acknowledgments
Many thanks to NetGalley, W.W. Norton & Company, and the author for a digital advance readers copy of this book in exchange for my honest review.

[Steve Dustcircle · Rating 2 out of 5]

Lots of info on how the lungs and cardio systems work, and how you can mess them up (smoking, pandemics, pollution, birth defects), and how the medical system and Big Pharma can repair damage done. There is very little on what one can do from home to repair asthma, COPD and other breathing issues. One has to rely on other sources (other books and websites) and common sense (exercise, diet, quit bad habits) that are barely mentioned in this not-a-How-to book.

[Ashlee Bree · Rating 4 out of 5]

Did you know the average person takes over 600 million breaths in their lifetime?

Seeing as how respiration is a largely unconscious process that is regulated in the medulla oblongata, one of the most primitive parts of the brain, you probably didn't. The reason for that is because breathing with ease isn't something many people have to think about. It's a vital biological operation that occurs in the background without anyone having to focus on it, so people tend to take the seemingly "effortless" vitality of the lungs for granted as a result.

That is...until they experience problems that effect their ability to breathe well themselves and panic.

As someone who has lived with moderate asthma for much of my life, and has suffered from both chronic and acute lung exacerbations over the years, I've been there. It sucks. Nobody wants to know what it feels like to choke on air they can't seem to catch. To wheeze. To cough and cough and cough. To have their chest fill with sharp, restrictive fire every time their body encounters another allergen or sneaky little pathogen it doesn't like. No one wants to experience the physiological terrors that are involved in breathing difficulties, no one.

Lung problems and disease are a lot more prevalent nationwide than we may know let alone realize, however. On the whole they remain poorly understood. They can be left undiagnosed or unrecognized until the late stages, too. One of the reasons for this is because doctor's offices don't measure lung function regularly like they do blood pressure or heart rate - which seems insane, almost negligent, when you consider that being able to breathe is imperative to staying alive, right? - and also because the money that is invested in lung research isn't proportionate to the number of patients who are living with lung disease. That means there isn't enough data out there yet to tell a cohesive story or pattern about those who already are or someday could be afflicted. There's so much more out there still to be discovered, studied, experimented, and used for treatment.

I appreciated how this book provided insight into the importance of lung function, lung diagnostics, and overall lung health. It was informative and absorbing. Easily comprehensible for those of us who are neither medical practitioners nor pulmonologists.

The author started off by taking readers through a brief overview of how the lungs work and why. Then she discussed how things like smoking, pollution, vaping, and viruses like influenza or Covid-19 can pose severe respiratory risks. After that, she offered practical suggestions for how to keep the lungs healthy (even if they're diseased) and proposed a kind social intervention that will make the preservation of lung health a priority in medicine.

Breathing is vital to life, to living, so really...why isn't it one already? Better yet, how come it hasn't been one long before now?

Asthma suffer or not, I've never stopped to ask myself those questions before reading this book, but I'm asking them now. I'm encouraging you to ask them, too. What more can I say? I'm with Dr. Han, I think it's time we all knew more about the in's and out's of breathing.

Thank you to NetGalley and W.W. Norton and Company for the ARC in exchange for my review.

BOOK BLOG

[Zoe]

I got this for free at a dymocks damaged book stall. It was fine? Basic overview of the pathophysiology, aetiology, and anatomy of the lungs and lung disease. Not groundbreaking advice, e.g. don’t smoke, eat well, avoid air pollution, exercise. More than anything it was a refresher and extension of knowledge of things learnt in university anatomy courses. Would have liked some more extension on this topic. Maybe good for someone who knew nothing about how the lungs worked or lung diseases but unfortunately that person is not me.

The irony of finishing the last chapter on chronic lung diseases via audiobook while on my run is not lost on me.

[Kat Todd · Rating 4 out of 5]

As a respiratory therapy student I loved this book as a very basic review of some things I’ve been studying. Very easy to read and you learn a lot!

[Jack Strunk-Schwartz · Rating 2 out of 5]

this boon was very dense and informative, almost textbook like, yet marketed to the layman, it's framed as though it will be gently prescriptive, which it is not.

this makes sense, because a responsible medical professional would not market broad health advise apart from the obvious of "don't smoke. exercise regularly. avoid pollution if possible. talk to a doctor if you're concerned."

everything else is some variation of "eh, the science is out on this"

while this makes perfect sense from the standpoint of responsible reporting, but it begs the question, why did you write a book if you didn't have anything to say?

this book is good for someone who is interested in pulmonology, but isn't far enough into their schooling to start taking specialized classes, or maybe someone who has a family member with lung disease and feels better when armed with knowledge? I just don't feel like I took anything away from a very dense and fast paced delivery of information. 3 months from now if you asked me any questions about lung anatomy or health, I'll have nothing. I won't have learned anything from this book.

[Bethany · Rating 5 out of 5]

This was incredibly interesting. Especially in the times of COVID. Understanding how the lungs work and how to keep them functioning well is something that should be taught to everyone. As someone who had long-hauler COVID symptoms and still struggles occasionally this book offered real solutions for improving lung function instead of vague recommendations. I absolutely recommend this book to those who have had COVID or have a family member who has or if you're interested your biology and how it works.

[Cath · Rating 4 out of 5]

A good introductory overview, for the layman, to the physiology of the lungs and the field of pulmonology.

[Beth Savage]

I feel like it’s not fair for me to rate this since it took me so long to finish it :) super informative read, though. Gotta take care of those lungs!

[Patina Malinalli · Rating 5 out of 5]

As a woman with no medical training, I found this book to be very thorough and comprehensible. Dr. Han gives an intensely detailed description of multiple common medical conditions related to the lung. 5/5 stars!

- "The beginnings of the lungs are first detectable around week 3 in the human embryo. This is known as the embryonic period. By week 5, two lung buds are evident. By week 8, the lung lobes begin to form, and by week 16, the airways complete their seemingly infinite branching. Between weeks 16 and 25 is when the alveoli, our gas exchange units, begin to form. Amniotic fluid is essential for normal lung development at this stage. In the womb, the fetus 'breathes' amniotic fluid, which mechanically stretches the developing lung. Very low levels of amniotic fluid can disrupt fetal lung growth. It is not around week 20 of gestation that the alveolar cells begin to manufacture surfactant, a substance crucial for proper lung function and lung defense. However, the fully formed alveoli in their adult configuration are not present until roughy 5 weeks [i/] after [/i] delivery and the alveoli continue to subdivide after birth. Recent data may suggest that alveoli may continue to develop during childhood and adolescence." (p.59)

- "Vitamin D helps to maintain immune function and plays a role in lung development... To many, there seem to be more and more children with allergies of all kinds than there used to be. The types of bacteria that children are exposed to early in life may play a role. The 'hygene hypothesis' was originally generated as a potential explanation for why children raised in West Germany were found to have significantly higher rates of asthma than those raised in Communist Eat Germany, despite higher air pollution in the east. Children who lived on farms in particular had lower rates of asthma and allergic diseases... For instance, long-term exposure to animal stables until the age of 5 has been associated with very low rates of asthma. While there is no clear link to personal cleanliness and allergic diseases, it may be that early exposures to a wide variety of microbes blunts the arm of the immune system responsible for allergic reactions. Incidentally, there is currently no strong evidence to suggest that probiotics reduce development or severity of allergic diseases." (p.67-68)

- "An often overlooked source of indoor air pollution is residential wood-burning stoves. Solid fuels, including wood and coal used for cooking and heating in developing countries, are known to cause significant lung damage and predispose women and children, in particular, to the development of COPD." (p.71)

- "We also have ways of forcing air into the lungs using 'non-invasive' equipment that involves a mask being strapped to a patient's face and air being blown into the lungs. This is referred to as [/i] non-invasive ventilation (NIV).[i/]

I would recommend this book to anyone without deep knowledge of the medical world who is interested in learning more about the lungs. I would not recommend this book to anyone who does have a deeper knowledge of the medical world. You would likely find this book too basic and perhaps a bit boring, because you may feel it does not delve deeply enough into detail.

[Nicole Westen · Rating 3 out of 5]

What humanity doesn't know about lung function could fill a book, and this is that book. Considering that the lungs are just as important as the heart for keeping us alive, we way too little about them. Han notes that even though we have been able to measure someone's lung capacity for far longer than we have been able to measure blood pressure (and in modern times far more accurately than blood pressure too), we really haven't used the tools available to us. What is considered the healthy lung capacity of an adult male or female? We don't know. What is considered health lung capacity through out a child's growth? We don't know. Han also delves into the fact that we often don't notice lung disease until it's in it's later stages, but what if there actually were ways to test this? Han has mentioned small studies that have show a noticeable decrease in lung capacity/effectiveness even before the onset of common symptoms of lung disease. It honestly just makes me think about ovarian cancer, we usually don't notice something is wrong until it's practically too late to do anything. Even though breast cancer kills more women than ovarian cancer, the survival rate for breast cancer five years out is over 75%, while the survival rate for ovarian cancer five years out is in the 40% range at the highest. What's kind of nice (as in thin silver lining) is that, as Han states in the beginning, COVID has made everyone painfully aware of how little we actually know about how the lungs work, and hopefully this will spur more research organizations and charities to pour more money into lung research.

[Pamela · Rating 4 out of 5]

Although this book is for a lay person, it is solidly from a doctor’s perspective and medical terms are used. Han will state what it is more commonly understood, term or condition, then use the medical term going forward. While the sub-title implies a how-to for improving lung heath, it is a bit misleading, as much more is covered.

We start out with the function of the lungs. There’s a chapter on how the lungs develop, which surprisingly isn’t fully established until young adulthood. The bulk of the book is describing the lungs as we understand them, some diseases, and how we don’t have good ways of measuring good lung health. Instead we measure when something is presenting as a problem. There is advice as well.

For good lungs, follow what is often said: don’t smoke, eat a healthy diet with lots of fruits and vegetables, and get exercise. One additional advice that isn’t as commonly mentioned is pay attention to air quality, outside and inside the home. Some chemicals or products can off-gas leaving an unhealthy home.

For the detailed information about the lungs, I found the book informative. I got the sense that research into the lungs is lacing compared to some other aspects to our bodies, and more studies need to be conducted for increased understanding. This isn’t a long book and can be a quick read.


Thanks to W.W. Norton and NetGalley for an uncorrected electronic advance review copy of this book.

[Janice · Rating 5 out of 5]

The author claims that every doctor's office should have a spirometer in order to determine lung function. Lungs do so much to protect us. Lungs can suffer much damage before even noticed. We need to know more than just not to smoke or vape and avoid pollution dust and mold. Lower respiratory infections, mainly caused by bacteria, are the leading cause of death in children world-wide. COPD is the third leading cause of death in the world! Yet the amount of money for research and attention in this area are quite low. There is much useful information to learn about the lungs. For example, breathing slowly reduces blood pressure, cortisol levels and pain. Very small blood clots can cause strokes and heart attacks. Lungs can protect us to a certain degree, since small clots can lodge in veins of blood vessels of the pulmonary circulation. When they become incredibly smaller, they can be absorbed by the body. Clots released from the left side of the heart have potential problems, like stroke. But clots released from the right side of the heart can be filtered by the lungs before they can do any damage. However, the lungs cannot stop all clots. Pulmonary emboli can develop from patients who are recovering from recent surgery or are immobile and cause trouble. Prone positioning, on the stomach, helps when the patient remains on their back too long, to redirect blood flow. This issue comes up with patients with covid or pneumonia. Avoid the chemical smells of cleaners and hairdressers need to beware of the chemical smells, too. Some occupations are at risk for lung hazards. Excess moisture and lack of ventilation can lead to mold. Wear a N95 respirators to clean it, or get professional cleaners. Light exercise, aerobics and walking can improve lung function! "It is never too late!" Eating fruits and vegetables help. "Hot tub lung" can be improved by removing the hot tub or moving it outdoors.

[Shanna Klutts · Rating 4 out of 5]

I learned many things about my lungs that I did not know before, and because of this book, I am making some life adjustments to have a better lung life. I have been battling asthma my entire life, and thought I had been managing it well, until I had an anxiety attack brought on by relying to much on my rescue inhaler. I thought I was having a heart attack. So…life changes happened, and I am now on a steroid for life. And now I have a better understanding of what is going on, and will continue to make better changes.

The book mentioned COVID, but really only said that if you are put on a respirator, you have a 70% chance of dying. That number was shocking, but when you think about it, because of all the bacteria that is accumulated in the tubes, it makes sense.

It also said that there is so much more we don’t know about the lungs than what we do…so if you are passionate about lung health, this is a growing and expanding field!

[Ashley · Rating 2 out of 5]

An interesting book by a pulmonologist that's timely in the COVID era. I had already started it before I realized what it was exactly (thanks to Libby's suggestions!). A lot of this was common sense (don't smoke, stay inside when air quality is bad, wear a mask if you work around strong fumes or fine particulates), but I found the deep dives into how the lungs work and the various diseases to be the most interesting. The lungs' sole jobs are to move air into the body and rid the body of carbon dioxide. They can (often) take a fair amount of abuse before their owner realizes damage has been done. The intricate structures of the alveoli and branching network to exchange gases was explained well. The explanation of the diseases affecting the lung were very interesting, as I had only a cursory knowledge of things like COPD, asthma, and pulmonary emboli.

The author narrated the book and had such a soothing voice, so this was a nice audiobook. 2.5 stars.

[Jan Peregrine · Rating 3 out of 5]

This little book was still too long to keep my interest after the first half. I didn't pick it up because I wanted to know how to treat lung diseases, but only how to keep my lungs strong. It was interesting to know how lung health begins in the womb and determines how strong lungs will become and why lungs will be vulnerable to decline. A fully functioning pair of lungs isn't going to happen if poorly developed or until age 25.

I had hoped, from the title, it would be more about the importance of breathing slowly and nasally, but that's only given a paragraph.

She did discuss COVID-19 quite a bit and that her highest recommendation, without hesitation, is for people to get vaccinated. She doesn't discuss which vaccine is best, but I'm waiting the plant-based one approved in Canada.

[Leonard · Rating 5 out of 5]

This 2022 publication is the book to read if you want to find out about your lungs and about breathing without having to tackle a lot of medical terms over volumes of pages. In about 150 pages this pulmonologist from my home state of Idaho, now working in Michigan, explains how your lungs work, what can happen to them, the major threats they face, and how you can take care of them. It's easy reading and the author rightfully emphasizes the increasing threats to lung health including efforts to cut regulations controlling air pollution by some political extremes. Also climate change, large fires, and pandemics like Covid, combine with the ongoing threats to lung health from smoking and vaping remind us that we have to continually care for our lungs.

[Rena · Rating 4 out of 5]

Rounded for 3.75 stars. This book is a good resource for someone interested in learning everything about pulmonary anatomy, physiology, lung diseases and treatment with help of prescription medications. I was more interested in alternative methods of treating breathing problems, such as breathing techniques, exercises to improve lung function and disease prevention. Unfortunately author did not include any of that in her book. The book is well written and easy to understand, so even though it did not include subjects I was interested in, I learned some new information, such as damage vaping and e-cigarettes cause and more. Overall this was a good read.

[Kim · Rating 5 out of 5]

If you or a loved one struggles with asthma or other lung diseases, this is a great resource. The author is a Pulmonologist, a Professor of Medicine in the Pulmonology and Critical Care Division at University of Michigan, and a national spokesperson for the American Lung Association.

The book explains lung function and health, and discusses lung disorders and ways to increase lung health in utero and beyond.

I’ve battled severe chronic allergic and non-allergic asthma for the past decade, and am a mom to several children who struggled with childhood asthma. I’ve read about asthma extensively, and learned much from this book.

[Michelle]

I have no business rating this book as I'm not sure what the author's intentions were. The reader can hear the author-doctor's passion around advocacy and prevention and her many observations around how the healthcare system has changed and can do better. However, if she was attempting to educate the average person, she chose too academic a style to make it easily consumable and interesting. There is also much time spent on smoking and vaping when talking about environmental factors and choices and not nearly enough on the many other issues that she skims over.

I wish the author had consulted a different editor.

[Katie · Rating 3 out of 5]

The author is clearly knowledgeable about the subject and presented a lot of information that we really should know. Unfortunately, for me, this was a hard read because of all of the biology and science involved. I was also hoping to find a few more alternative methods to help my breathing, which were not covered. This being said, I think that people need to have a better understanding of their lungs and how they work, and this book is perfect for that.

Thanks to NetGalley for an advanced copy in exchange for my honest opinion.

[Matt · Rating 4 out of 5]

An information look into what we do know about our lungs, and what we don't. A passionate plea frrom a top-class pulmonologist to increase funding to increase our understanding of the vital process that makes all our other systems function. If you're looking for breathing exercises, this isn't the place to be, but if you're looking to understand the systems of the body, and stumped by why the science seems to be light years behind our understanding of other bodily systems, this is the place to be!

[Riann · Rating 5 out of 5]

A fascinating look at how the lungs work, lung disorders, treatments, and the importance of lung health. I loved that this book was written by a pulmonologist who offered insight into how pulmonologists go about diagnosing their patients. As an asthmatic I especially appreciated the steps one can take in order to preserve lung health. This book was very accessible to the average person so I never felt bogged down by medical jargon. This book was very well done.

[Karen · Rating 4 out of 5]

This book is a well-written guide to our lungs. Just the right level of science for me - clear explanations and helpful analogies to make the information accessible. I hoped for more guidance on maintaining lung health, but admit that just knowing the ways one’s lung health can be compromised is useful. Hearing how much the scientists don’t know, compared to some other health issues, came as a surprise. This book is a very approachable 150ish pages, well worth a reading.

[Sharon · Rating 4 out of 5]

This was a very good rundown on lung disease and the causes and treatments. It also covered what an appointment with a pulmonologist should look like and the way they reach a diagnosis. It discusses lung health as well as factors that may contribute to lung disease. Very informative although definitely, (perhaps necessarily) quite technical. It may have been improved by citing more case studies of various conditions, or at least more so than is done here.

[Jake · Rating 4 out of 5]

It's a good book, but I wish the author dumbed it down more for me. I wish there were more anecdotes or individual prototypical case discussion. The writing felt kind of like a journal article at other points. The title is a bit misleading; not sure if the author or publisher made that happen. I did learn some cool things though and it gave me a better sense of the lungs. I should run more and I guess I should figure out what VOCs are around my apartment...

[Kathleen Warnick · Rating 4 out of 5]

A whole education on the lungs: development, diseases and contriving factors, diagnosis, treatment and much more including funding, or lack there of, for research to better understand and manage this third leading cause of death. I was glad to have had some medical background (RN) to read this very readable book.

[Taren Young · Rating 3 out of 5]

Wow are lungs are amazing!

This book gave a gentle run through of the functions, problems and treatments of our lungs.

Our lungs are so strong and resilient that problems can go so long undetected it actually is a downfall.

I love that we are still learning new things about this part of every human's body that has been around since the beginning of time.

[Mitzi Moore · Rating 2 out of 5]

I was expecting something different when I pulled this off the New Books shelf. I’m not a doctor, and I don’t have lung disease, so learning about the specifics of it was a bit more than I needed to know.

I wonder what the author would think of the best-selling book Breathe, which I also read this year.

[Essie (Sarah) · Rating 3 out of 5]

I thought I would be the perfect audience for this. I was not the audience for this.

A doctor’s guide is right. This book reads like a textbook and is not very approachable, unfortunately. Because it was so over my head, the info I took away from this read was limited. If you are science-minded though, this would likely be great.