What is emphysema?

What is emphysema?

John (Gold)
Joined: 18 Dec 2008, 23:57

11 Nov 2000, 03:31 #1

The following article is from the ALA's web site at the below link and is an excellent basic primer on emphysema. I know that some of our members do have breathing disorders and maybe they shed a bit more light on this important topic. Maybe Joel or one of you can help answer my pretty basic questions. As stated below, emphysema results from the destruction of our alveoloi. The explanations that I keep reading, including this one, make it sound like that except for an extremely small portion of victims who may inherit a specific gene, that the damage to our alveoloi is caused by external substances that enter the lung and eventually lead to permanent damage. My questions are: (1) Is emphysema a true disease in the traditional sense; and, (2) although the alveoli once damaged can't repair themselves, does additional harm and damage immediately cease once we quit smoking? Thanks, Zep

From the American Lung Association
What Is Emphysema?Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the walls of the alveoli, which causes a decrease in respiratory function (the way the lungs work) and often, breathlessness. Early symptoms of emphysema include shortness of breath and cough.

How Serious Is Emphysema?Emphysema is a widespread disease of the lungs. In 1993, 1.9 million people in the U.S. had emphysema.

It is estimated that 50,000 to 100,000 Americans living today were born with a deficiency of a protein known as alpha 1-antitrypsin (AAT) which can lead to an inherited form of emphysema.

Emphysema ranks 15th among chronic conditions that contribute to activity limitations: over 43 percent of individuals with emphysema report that their daily activities have been limited by the disease.

Many of the people with emphysema are older men, but the condition is increasing among women. Males with emphysema outnumber females by 22 percent.

Causes Of EmphysemaThe lung has a system of elastic fibers. The fibers allow the lungs to expand and contract. It is known from scientific research that the normal lung has a remarkable balance between two classes of chemicals with opposing action.

When the chemical balance is altered, the lungs lose the ability to protect themselves against the destruction of these elastic fibers. This is what happens in emphysema.

There are a number of reasons this chemical imbalance occurs. Smoking is responsible for 82 percent of chronic lung disease, including emphysema. Exposure to air pollution is one suspected cause. Irritating fumes and dusts on the job also are thought to be a factor.

A small number of people with emphysema have a rare inherited form of the disease called alpha 1-antitrypsin (AAT) deficiency-related emphysema, or early onset emphysema. This form of disease is caused by an inherited lack of a protective protein called alpha 1-antitrypsin (AAT).

How Does Emphysema Develop?Emphysema begins with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile. Damage to the air sacs is irreversible and results in permanent "holes" in the tissues of the lower lungs.

As air sacs are destroyed, the lungs are able to transfer less and less oxygen to the bloodstream, causing shortness of breath. The lungs also lose their elasticity. The patient experiences great difficulty exhaling.

Emphysema doesn't develop suddenly, it comes on very gradually. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema.

A person may initially visit the doctor because he or she has begun to feel short of breath during activity or exercise. As the disease progresses, a brief walk can be enough to bring on difficulty in breathing. Some people may have had chronic bronchitis before developing emphysema.

Treatment For Emphysema Doctors can help persons with emphysema live more comfortably with their disease. The goal of treatment is to provide relief of symptoms and prevent progression of the disease with a minimum of side effects. The doctor's advice and treatment may include:

Quitting smoking: the single most important factor for maintaining healthy lungs. Bronchodilator drugs (prescription drugs that relax and open air passages in the lungs): may be prescribed to treat emphysema if there is a tendency toward airway constriction or tightening. These drugs may be inhaled as aerosol sprays or taken orally. Antibiotics: if you have a bacterial infection, such as pneumococcal pneumonia. Exercise: including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary* rehabilitation program to condition the rest of the body.
*The term "pulmonary" refers to the lungs.
Treatment: with Alpha 1-Proteinase Inhibitor (A1PI) only if a person has AAT deficiency-related emphysema. A1PI is not recommended for those who develop emphysema as a result of cigarette smoking or other environmental factors. Lung transplantation: most recent reports have been encouraging and the success rate continues to increase. Lung reduction surgery: this new technique shows promise. Experience at this time is limited. Emphysema ResearchContinuing research is being done to find answers to many questions about emphysema, especially about the best ways to prevent the disease.

Researchers know that quitting smoking can prevent the occurrence and decrease the progression of emphysema. Other environmental controls can also help prevent the disease.

If an individual has emphysema, the doctor will work hard to prevent the disease from getting worse by keeping the patient healthy and clear of any infection. The patient can participate in this prevention effort by following these general health guidelines:

Emphysema is a serious disease. It damages your lungs, and it can damage your heart. See your doctor at the first sign of symptoms. DON'T SMOKE. A majority of those who get emphysema are smokers. Continued smoking makes emphysema worse, especially for those who have AAT deficiency, the inherited form of emphysema. Maintain overall good health habits, which include proper nutrition, adequate sleep, and regular exercise to build up your stamina and resistance to infections. Reduce your exposure to air pollution, which may aggravate symptoms of emphysema. Refer to radio or television weather reports or your local newspaper for information about air quality. On days when the ozone (smog) level is unhealthy, restrict your activity to early morning or evening. When pollution levels are dangerous, remain indoors and stay as comfortable as possible. Consult your doctor at the start of any cold or respiratory infection because infection can make your emphysema symptoms worse. Ask about getting vaccinated against influenza and pneumococcal pneumonia. COPD: A Growing ProblemChronic obstructive pulmonary disease (COPD), a term that generally applies to chronic bronchitis and/or emphysema, has increased by a dramatic 57 percent between 1982 and 1993.

Today, chronic bronchitis and emphysema combined constitute the most common chronic lung disease, affecting 15.8 million people in the U.S.

The number of lives claimed by chronic lung disease has increased sharply, too. In 1979, it accounted for about 50,000 deaths. In 1982, the number rose to 59,000 and by 1992, the number of deaths reached 86,974.
Last edited by John (Gold) on 26 Mar 2009, 21:50, edited 1 time in total.

John (Gold)
Joined: 18 Dec 2008, 23:57

11 May 2001, 03:22 #2

Last edited by John (Gold) on 26 Mar 2009, 21:51, edited 1 time in total.

Joined: 07 Jan 2009, 18:59

11 May 2001, 03:39 #3

Zep thanks. Good to read more. Spending some time cruising around here to keep reading. The Tiggers Article was good, and the one on medical issues regarding lungs. Lots here, especially all those awful pictures. Can't answer either of you questions ... would be interesting to ask my doctor. I'm pretty sure it takes some months for them to heal. Actually, this IS what my Dr. told me on Monday, because I was having trouble with my lungs (lots more than usual). He said to be patient. It would take a few months. Whew. And the pictures on the ciggerettes packs (alot of them) have been out here in Ontario, Canada. Consiously, I don't think they made much of an impact on me ... and most serious smokers that I know... until I/we get sick. The "It won't happen to me sydrome. Thanks
sunshineray 14th and counting again.

Triin (GOLD)
Joined: 18 Dec 2008, 23:59

11 May 2001, 05:52 #4

Thanks again Zep for the information Image You have sure worked hard to provide us with the best education and information about smoking as possible. About your questions...I think it's a language barrier, because I can't quite understand what you mean by the first question "Is emphysema a true disease in the traditional sense". Could I interpret it like this "Would there be emphysema if there wouldn't be smoking in the world? (without counting the hereditary form of it)". I find the second question very interesting, too.

I have been Quit for: 2M 2W 5D 23h 51m 22s. I have NOT smoked 1619, for a savings of $111.37. Life Saved: 5D 14h 55m.

John (Gold)
Joined: 18 Dec 2008, 23:57

11 May 2001, 09:22 #5

I guess I didn't make that question very clear or maybe only my mind sees disease in such a light but let me try again. In my mind a disease is something that continues to spread once you develop it. Sort of like a cancer. Sometimes medicine uses the word disease in situations where the condition doesn't spread at all. For example, you may at some point in your life hear the phrase "degenerative disc disease" in reference to the spine. It sounds pretty bad and I've seen it scare lots of folks with back problems. In reality it's nothing more than the discs in our spine losing their moisture and drying out as we age. Just like most of us experience more skin wrinkles as we age and gradually seeing our hair thin, it's a natural part of the aging process for most of us - yet it is still called a disease.

With emphysema, my question about it really being a disease is along the same lines. Although just like our spine our lungs certainly age with time, if we quit smoking and quit putting other harmful things into our lungs does the progression of the disease stop or slow tremendously, or is it more like a cancer that continues to spread? From what I've read (since first posting this article) I now believe that the damage is never correctable but, aside from normal aging, that quitting really does help almost stop further damage. Anyway, that's what I want to think Image I guess we all do!

Sewquilts (GOLD)
Joined: 19 Dec 2008, 00:00

11 May 2001, 10:16 #6

Zep, being a nurse who works with the elderly patients, a lot of them with COPD which includes emphysema and asthma, who continually need respiratory treatments. I see respiratory techs all the time...and after I was told that I had beginning emphysema, I have questioned all of the techs...this is what they tell me in short... the parts of the lungs that are dead will never recover...but the tissue in the lungs that is a sleep, (meaning coated) will wake up when the damaging sorce is stopped being put into the lungs....this is not a progressive disease unless you continue to put into the lungs the sorce that is doing the damage...sorces include smoking, chemicals, etc.....

And after seeing so many of those patients struggle for something that we all take for granted (a breath) you would think that I should have been able to quit smoking long ago...that is how powerful addicting nicotine is...
Patients tell me that their breathing is like breathing with a pillow over their face all the time...try that out..put a pillow over your face and breath....difficult...and they breath like that all the time...they also have times when they are in a crisis...like humidity increases, catching a cold.....man or man how these patients STRUGGLE for their next breath...

mitch (Gold)
Joined: 19 Dec 2008, 00:29

15 Aug 2001, 11:02 #7

Thanks Zep and Joel... Mitch here. Twas I who asked to learn more about emphysema. Since I quit over 3 months ago, I've had bronchial asthma (had that when I was a kid), hay fever and recently a shortness of breath. I attribute it all to...smoking had masked these symptoms.

But... I find that I'm stressed out lately and hoving hyper tension...you know...hyperventilating...not being able to get enought oxygen...then it goes away...poof...everythings fine.

After reading and talking to others, I was a little paranoid about the possibility of having emphysema. It's just that the quit had made my lungs, smell and attention so acute...every little thing is noticed.

I'm fine...nothing like a little flyfishing to relieve the stress. I'm breathing like a champ today, deep breaths...no worries.

One thing that's really came home to me is that breath is the connection to life. How fragile it is. I'm really loving breathing lately.

Thanks yall for everything. I'm 4 months into my quit. Mitch

John (Gold)
Joined: 18 Dec 2008, 23:57

15 Aug 2001, 19:51 #8

As you've already know, Mitch, the most important thing is that you've stopped the destruction of healthy lung tissue. My mother had emphysema and spent the last year and a half of her life on oxygen, my younger sister Pat (who started smoking at age 12) has it, and yes, even I was told that I had very eary signs, as well. I'd had pneumonia for two Januarys in a row, my cough, constant throat clearing and wheezing sounds were chronic, and still I sucked down three packs a day. Two years + later, I feel great! I have more energy then I've had in years! The noises are all gone too! I have not had a single breathing illness, flu or cold either!

Oh, I'm not kidding myself! I know that later in life I'll probably pay a price but I know I've lowered it bit by quitting now, and so have you! Mitch, I found this article on emphysema surgery, that was published yesterday, which only makes this new life we've gifted to ourselves all the more important.

Enjoy the fishing and listen to your doctors! I hope you're feeling better soon. YQB Zep : )

Study: Emphysema Surgery DangerousBy Jeff Donn
[/size]Associated Press Writer
[/size]Tuesday, Aug. 14, 2001; 6:42 p.m. EDT[/size]BOSTON -- An increasingly common operation for emphysema that involves cutting away part of the lungs is dangerous - and even deadly - for many patients in advanced stages of the disease, researchers say. Sixteen percent of the very ill patients who had the surgery were dead within a month, according to the latest findings from an ongoing national study of the procedure coordinated by the National Institutes of Health.

Those who survived showed limited benefit from the procedure.

Researchers immediately halted more surgery on patients with the same characteristics of advanced illness. They are now confining their testing to more than 1,000 other emphysema patients because the surgery may still help them.

The investigators will publish the findings Oct. 11 in The New England Journal of Medicine but released them Tuesday to alert doctors and patients immediately. The disease, which is tied largely to smoking, strikes about 2 million Americans each year.

The surgery has stirred much excitement over the last five years, and some studies have suggested it can give at least a reprieve to many patients.

"There has been a prevailing view - that I think unfortunately surgeons have contributed to - that this operation may be a temporary cure for your disease, and it's clear that it's not for this subset of patients," said one of the researchers, Dr. Steven Piantadosi of Johns Hopkins University.

A pioneer in the surgery, Dr. Joel Cooper, downplayed the findings. He said they were predictable because patients reported in the latest findings suffered from disease that was widely spread around their lungs. He said they were bad candidates for the surgery in the first place.

Cooper said his team dropped out of the five-year study in 1997 over this and other disagreements, including a condition that all participating surgeons stop doing the surgery outside the study.

He also said administrators at the federal Medicare program for the elderly, which is funding the study, are seeking justification to limit, delay or deny coverage for the surgery, which typically costs from $25,000 to $40,000.

"Medicare has used the trial for its own purposes," said Cooper, a lung surgeon at Washington University in St. Louis.

An official at the Centers for Medicare and Medicaid Services said the agency didn't interfere with the scientific decision-making. The official spoke on condition of anonymity, which is agency policy.

Dr. Gail Weinmann, project officer for the study at the National Institutes of Health's Heart, Lung and Blood Institute, said surgeons agreed to forgo surgery outside the study because they saw a need for systematic research.

"There was a concern about the spread of the procedure so quickly, and that it could be doing harm," she said.

The surgery was first tried more than 30 years ago with disastrous results. Improvements in anesthesia, surgical methods and postoperative care revived it in the 1990s. It is based on the idea that smaller, but healthier lungs can work better after the operation.

The technique became so widespread in recent years, with around 8,000 operations now performed, that researchers had trouble finding patients for the study. They said some candidates feared they would be assigned to comparison groups taking normal treatment, which includes diet, exercise and drugs.

In the latest findings, though, none of the 70 patients in the normal treatment group died within a month. The surgery left 11 of 69 patients dead.

Over three years, surgery patients were four times more likely to die than the others. Also, surgery survivors gained only limited benefit in better breathing or quality of life.

Weinmann defended the decision to operate on patients included in the latest findings, saying they were an important group to study and there is little medicine can do for them.

Lung specialists outside the study said patients with broadly spread disease were suspected to be relatively poor candidates for the surgery. However, they said the findings are valuable because they underscore the potential danger for some patients who may be overly eager for the surgery.

"In these patients ... someone needs to have a serious talk with them," said Dr. Jeffrey Drazen, a lung specialist who is also editor-in-chief of the journal.

"My guess is that most physicians will heed this warning," added Dr. Norman Edelman, scientific consultant for the American Lung Association.

Joined: 07 Jan 2009, 19:34

15 Aug 2001, 21:41 #9

Hello Joel, Zep and everyone..

Here is a link I found concerning copd and emphysema.


btw, I am doing ok, but this disease is a killer for sure. I have gotten to the point I have trouble breathing when we travel to large cities with a bad smog level. People really need to understand how horrid it is. Slow suffocation is all it is... and its terrible.

Six months, two weeks, five days, 8 hours, 41 minutes and 12 seconds. 12021 cigarettes not smoked, saving $1,442.30. Life saved: 5 weeks, 6 days, 17 hours, 45 minutes.

mitch (Gold)
Joined: 19 Dec 2008, 00:29

16 Aug 2001, 02:46 #10

Thanks yall...Mitch here. Wow...that's some nasty %$#@ emphysema. Really don't like the operation route...really glad I don't smoke anymore...AND...really glad I just have hypertension, something I can do something about.

The definition of hypertension...picture a cat in a room full of rocking chairs during an earthquake. Anyway...all I needed was more rigorous exercise...and to stop worrying about imaginary things that I make up and can do nothing about anyway...no worries.

Geez Zep...3 packs a day...****...that's one smoke every 18 minutes. Boy am I glad you cancelled that habit...and thanks for the support and concern.

Yeah lungs are precious. Deep breaths are a gift...no more abuse ever again. 4 months now. I never even knew some Dahlias have a fragrance and I'm a Dahlia freak. Wow...life is awesome.