Health Care and Emphysema

Emphysema is a disease that affects many people, and it typically will lead to death in some cases. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases, according to the National Institutes for Health (NIH). COPD makes it difficult to breathe.

There are two main forms of COPD, according to the NIH:

•Chronic bronchitis, defined by a long-term cough with mucus.
•Emphysema, defined by destruction of the lungs over time.
Most people with COPD have a combination of both conditions, and smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop COPD although some people smoke for years and never get COPD. In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are:
•Exposure to certain gases or fumes in the workplace.
•Exposure to heavy amounts of secondhand smoke and pollution.
•Frequent use of cooking gas without proper ventilation.
Much more detailed information can also be found on this website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/.

According to eMedicineHealth.com, Emphysema is called an obstructive lung disease because airflow on exhalation is slowed or stopped because over-inflated alveoli do not exchange gases when a person breaths due to little or no movement of gases out of the alveoli. Emphysema changes the anatomy of the lung in several important ways. This is due to in part to the destruction of lung tissue around smaller airways. This tissue normally holds these small airways, called bronchioles, open, allowing air to leave the lungs on exhalation. When this tissue is damaged, these airways collapse, making it difficult for the lungs to empty and the air (gases) becomes trapped in the alveoli.

Normal lung tissue looks like a new sponge, according to eMedicineHealth. Emphysematous lung looks like an old used sponge, with large holes and a dramatic loss of “springy-ness” or elasticity. When the lung is stretched during inflation (inhalation), the nature of the stretched tissue wants to relax to its resting state. In emphysema, this elastic function is impaired, resulting in air trapping in the lungs. Emphysema destroys this spongy tissue of the lung and also severely affects the small blood vessels (capillaries of the lung) and airways that run throughout the lung. Thus, not only is airflow affected but so is blood flow. This has dramatic impact on the ability for the lung not only to empty its air sacs called alveoli (pleural for alveolus) but also for blood to flow through the lungs to receive oxygen.

Emphysema symptoms are mild to begin with but steadily get worse as the disease progresses, according to the Mayo Clinic. The main emphysema symptoms are:

■Shortness of breath.
■Wheezing.
■Chest tightness.
■Reduced capacity for physical activity.
■Chronic coughing, which could also indicate chronic bronchitis.
■Loss of appetite and weight.
■Fatigue.

The Mayo Clinic suggests when to see a doctor if you experience symptoms similar to Emphysema:
■You tire quickly, or you can't easily do the things you used to do.
■You can't breathe well enough to tolerate even moderate exercise.
■Your breathing difficulty worsens when you have a cold.
■Your lips or fingernails are blue or gray, indicating low oxygen in your blood.
■You frequently cough up yellow or greenish sputum.
■You note that bending over to tie your shoes makes you short of breath.
■You are losing weight.

These signs and symptoms don't necessarily mean you have emphysema, but they do indicate that your lungs aren't working properly and should be evaluated by your doctor as soon as possible. Emphysema can increase the severity of other chronic conditions, such as diabetes and heart failure. If you have emphysema, air pollution or a respiratory infection can lead to an acute COPD exacerbation, with extreme shortness of breath and dangerously low oxygen levels. You may need admission to an intensive care unit and temporary support from an artificial breathing machine (ventilator) until the infection clears, according to the Mayo Clinic. More information can be found at http://www.mayoclinic.com/health/emphysema/DS00296.

The single greatest risk factor for emphysema is smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible, and the risk for all types of smokers increases with the number of years and amount of tobacco smoked. Men are affected more often than women are, but this statistic is changing as more women take up smoking. Second-hand smoke can also cause emphysema and lung disease.

Other risk factors, according to Emphysema.org, include:
•Age. Although the lung damage that occurs in emphysema develops gradually over time, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 50 and 60.
•Exposure to secondhand smoke. Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar.
•Occupational exposure to chemical fumes. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. The risk is even greater if you smoke.
•Exposure to indoor and outdoor pollution. Breathing indoor pollutants such as fumes from heating fuel as well as outdoor pollutants — car exhaust, for instance — increases your risk of emphysema.
•Heredity. A rare, inherited deficiency of the protein, alpha-1-antitrypsin (AAt) can cause emphysema, especially before age 50, and even earlier if you smoke.
•HIV infection. Smokers living with HIV are at greater risk of emphysema — and of developing the disease at a relatively young age — than are smokers who don't have HIV infection.
•Connective tissue disorders. Some conditions that affect connective tissue — the fibers which provide the framework and support for your body — are associated with emphysema. These conditions include cutis laxa, a rare disease that causes premature aging, and Marfan syndrome, a disorder affecting many different body organs, especially the heart, eyes, skeleton and lungs.

The most essential step in any treatment plan for smokers with emphysema is to stop smoking immediately; it's the only way to stop the damage to your lungs from becoming progressively worse over time. But quitting smoking is rarely easy, according to Emphysema.org, and people often need the help of a comprehensive smoking cessation plan, which may include:

•A target date to quit.
•Relapse prevention.
•Advice for healthy lifestyle changes.
•Social support systems.
•Nicotine gum, tablets or patches and sometimes use of the antidepressant bupropion hydrochloride (Zyban) to help curb the irritability, depression and sleep problems that can occur in the first few weeks after quitting smoking. Much more information about treatment, self-care, prevention, weather related issues, and more can be found at this site: http://emphysema.org/.

Emphysema is a deadly disease, as is COPD. But it is manageable in less severe cases. Also, your doctor can be a great resource to help you battle it. The key is to avoid smoking in any situation as much as possible. If you are a smoker, you need to quit. And, avoid second hand smoke as much as possible. If you feel that you may be experiencing symptoms, go see your physician immediately for a diagnosis. Much information is available online and through medical and health care facilities about emphysema. And it can be encouraging to be around other people who are meeting the same medical challenges you are. If you're interested in a support group, talk to your doctor. Or contact your local chapter of the American Lung Association. It's your life. Take care of it.


Until next time.