Eradicating Emphysema
Breathing is a nightmare for you. You used to smoke at least a pack a day. Now, stairclimbing is scary. You were just diagnosed with emphysema.
Emphysema is an irreversible lung disorder. It is very common among smokers. Approximately 14 million people have emphysema. It is more common among men than women. It is also more common among whites than Blacks.
It occurs when smoking or some other factor aggravates a destructive enzyme that damages air sacs (alveoli) in the lungs. Over the years, as air continually becomes trapped in the lungs, these air sacs stretch and rupture. That can cause the lungs to grow considerably beyond their normal size. As a result, some people with emphysema develop barrel-shaped chests.
To know what it is like breathing with emphysema, take a finger and close one nostril. Try breathing through the open nostril only. It can be a strenuous effort.
Most people with emphysema have been heavy smokers—typically two packs a day for 20 or more years. The rest either have an inherited form of emphysema or developed a tendency toward getting it after childhood respiratory infections or exposure to damage in such jobs as coal mining and cotton milling. It is not known whether exposure to others’ tobacco causes emphysema.
People with emphysema have low levels of the enzyme alpha-antitrypsin (AAT). A deficiency of AAT is a fairly common inherited disorder with an increased tendency to develop emphysema. Emphysema is caused by destruction of the small air sacs and loss of elasticity in the lungs. As a result, the small air passages tend to collapse and obstruct the flow of air, especially when breathing out.
Although the cause of emphysema is not fully understood, it is believed that enzymes that break down proteins damage the elastic tissue in the lungs by destroying its main protein, elastin. White blood cells in the lower respiratory tract release the enzyme that breaks down elastin, called elastase, and its destructive action is normally blocked by AAT.
AAT deficiency leaves the elastin in air sacs unprotected from damage. And continued loss of elastic tissue over many years eventually leads to emphysema.
The Global Initiative for Chronic Obstructive Lung Disease categorizes COPD in four stages. While emphysema is a cause of COPD, not all patients with emphysema have COPD. Doctors use the four stages to describe emphysema. The stages are:
· Stage 1. This is the mildest form of emphysema. Your lungs operate at least 80 percent as well as the healthy lungs of someone who’s the same age, height and sex.
· Stage 2. Moderate emphysema, where your lungs operate between 50 percent and 79 percent as well as the healthy lungs of someone who’s the same age, height and sex.
· Stage 3. Severe emphysema, where your lungs operate between 30 percent and 49 percent as well as the healthy lungs of someone who’s the same age, height and sex.
· Stage 4. Very severe emphysema, where your lungs operate less than 30 percent as well as the healthy lungs of someone who’s the same age, height and sex.
The life expectancy of someone with emphysema varies according to your age and what stage you’re at. In addition, whether you used to smoke or not factors into your life expectancy. Smoking may reduce your life expectancy by 3.5 years.
Some common symptoms of emphysema are:
· Gradual shortness of breath.
· Tiredness (fatigue).
· Long-term coughing.
· Wheezing.
· Constant feeling of not getting enough air.
· Tightness in the chest.
· Increased mucus production.
· Abnormal mucus color (yellow or green).
· Heart problems.
· Trouble sleeping.
· Anxiety.
· Depression.
· Weight Loss.
Keep in mind, if you have emphysema, you are at increased risk for developing other conditions like pneumonia, bronchitis and other lung infections.
Your doctor may conduct a physical exam to diagnose you with emphysema. Some other tests that might be performed are chest X-ray, CT scan, pulmonary function testing, arterial blood gas, electrocardiogram, blood tests and genetic tests.
Treatment options may include:
· Quitting smoking. Perhaps the most important step you can take to protect remaining lung function.
· Bronchodilators. These medicines relax the muscles around your airways.
· Inhaled corticosteroids. These medicines reduce swelling in the airways and mucus production.
· Oral corticosteroids. Often prescribed when you are exacerbated or experiencing a “flare” of your emphysema.
· Antibiotics. Helps to treat bacterial infections like pneumonia, bronchitis, and other lung infections.
· Anti-inflammatory medications. Helps to reduce inflammation in the airways.
· Oxygen therapy. This can help when your lungs aren’t getting enough oxygen to your blood. A machine will deliver oxygen to you through a nasal catheter or a face mask.
· Lung volume reduction surgery. During this procedure, your doctor removes a portion of the diseased lung tissue and joins the remaining tissue together. But not all patients with emphysema are eligible for this surgery.
· Bronchoscopic lung volume reduction. During this procedure, a doctor places a one-way valve into your airways. The valve allows air to leave this section of your lungs but not enter it. Not all patients with emphysema are able to have this surgery.
· Lung transplant. If you have severe emphysema and your lungs don’t respond to other treatment options, a lung transplant where you replace your damaged lungs with a donor’s healthy ones may be a solution.
There is no cure for emphysema. But the earlier you are diagnosed, the greater the quality of life you can achieve. Perhaps the most important thing you can do is quit smoking immediately.
Some other lifestyle choices are to wash your hands, brush and floss daily, keep your house dust free, keep up to date with vaccinations and avoid irritants like smoke, car exhaust fumes, pollen and pet dander.
While you can’t undo the damage that leads to emphysema, you can slow down the progression of this disease. If you suspect you may have emphysema, talk to your health care provider right away.
