What is emphysema?

Crawdad (The Silver)
Joined: 19 Dec 2008, 00:29

13 Nov 2002, 13:08 #21

It was my doctor telling me I have emphysema that finally got me off my butt and quitting. My paternal grandfather died of E in his early fifties. My dad was scared to death that he had E and would die like his dad did, and quit when he was 35.

It was rather cold the way they told me I had it. After a yearly physical including blood work and chest X-rays the doc's nurse calls me up a few days later. "your cholesterol is high. your red blood cell count is high - thats from smoking. your liver enzymes are good. Oh, and by the way, the radiologist reading your Xrays has determined you have emphysema."

Well. From the way the message was delivered one would think "Ah, no big deal. Hemmoroihds, tonsillitis." Well, no. A bit of research on the web brings up word like irreversible, progressive, and fatal.

So I called my doc back and said "Tell me about this diagnosis" He says "It's really no surprise, given that you've smoked 2 packs a day for 30 years." I say "What now ?" He says "Well, you can keep smoking and in 5-8 years you'll be on oxygen 24-7, or you can quit now and it won't get any worse."

I'm not in that bad shape now. I can charge around our oversized block, with fairly significant hills, with my wife who has never smoked and not be any more out of breath than she is.

We had an extended damp period a week or so ago, and I noticed the slightest shortness of breath at rest then. That scared the ****** out of me. The weather dried out and things returned to normal.

Last week I had an appointment and "bragged" to my doc that I had quit for six weeks and was planning on staying that way forever and what could I/he/we do to keep the E from getting worse ? So he gave me Advair, which is a combination bronchodialator and steroid in inhalable powder form. My research on the web indicates that it is typically prescribed for asthma sufferers, but it can certainly help with E as well.

So far, so good. As the weather has stayed dry since getting the script I can't say for sure that the advair is for sure the thing that is doing the trick, but it has been better.

What I've found from researching E on the web : Bottom line : if you live long enough you will get emphysema. It's part of the natural deterioration of the body with age.

Smoking causes onset at a much earlier age. Much earlier. And once you have onset continued smoking accelerates the progress.

If you have onset and quit, it is my understanding that progress of the disease continues from there at the normal aging rate. That's what my doc tells me, and that's what I'm banking on.

Joined: 07 Jan 2009, 20:16

26 Nov 2002, 07:46 #22

This is part of message number 9 pasted. I have a question that I hope somebody can answer for me. I spent quite a bit of time last night cruusing the internet looking for more information on COPD. I didn't find anything that specifically addresses this part. And I do admit I did get a bit sidetracked looking at other aspects. The part I am curious about is the part I bolded. Does this mean that with emphysema you can get more lung function back?

Thank you for any answers.

"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....."

Joined: 18 Dec 2008, 23:57

26 Nov 2002, 22:40 #23

Hello Anastazia:

The underlying lung tissue which is destroyed cannot regenerate. In a sense then, the loss of lung elasticity cannot come back. But the lining tissue of the wind pipe does regenerate. This tissue, primarily the Cilia is key to sweeping out the lungs, keeping the airways open and making breathing easier. So by this tissue being repaired, even though you don't get back the lungs elasticity, it keeps the airways cleaner and makes it easier for the remaining lung tissue to work without small airway obstructions. Added to this is the bonus of the blood's ability to carry much larger amounts of oxygen than when poisoned by carbon monoxide from tobacco smoke. Again, the lungs as well as the heart's workload is decreased when the blood carries the extra oxygen.

See articles:
Smoking's Impact on the Lungs
Smoking and Circulation

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

27 Nov 2002, 01:46 #24

Anastazia, I saw this post yesterday and spent a bit of time before bed exploring the question you raised in the highlighted portion. I think you have the same question that I've had all along with the subject of emphysema. As Joel says, clearly those alveoli (air sacs), among that 300 million that we started with in each lung, that have been destroyed will remain destroyed. But, in talking about emphysema being a "progressive" disease, does it remain progressive even after we quit smoking?

Although you'll find some research in the area of regeneration, I don't think you'll find any info at those sites suggesting that there is any hope of ever regenerating any dead alveolus - the research appears aimed at generating (growing) new alveoli.

As for the progressive nature of the disease, most literature I've been able to locate makes statements like this -
"Those patients who smoke should stop smoking immediately; this is the most important step patients can take to stabilize their disease and guard against further lung damage." 

Creighton University Medical Center

"The emphysematous patient must stop smoking to retard progression of the disease."

Canadian Lung Association

This is the portion of the above post you highlighted ..."but the tissue in the lungs that is a sleep, (meaning coated) will wake up when the damaging source is stopped being put into the lungs...."

Anastazia, I have yet to read anything contrary to above statement and much of Joel's wonderful post about the beauty of cilia healing I'm sure applies to all still living cells coated knee-deep beneath any chemical build-up.

What I would like to think is that because I stopped pumping the 4,000+ chemicals delivered into my lungs with each puff, that my emphysema will never ever grow any worse than it is right now, so long as I never take another puff. I wish it was true. Clearly I've brought an abrupt halt to smoking's intentional destruction of my remaining capacities but those remaining capacities are still subject to both the normal aging process, other environmental agents aside from cigarette smoke, and any genetic susceptibilities to emphysema that my deceased mother (advanced emphysema), my sister (moderate) and I (light) have already demonstrated exist in our family.

Will quitting smoking help substantially increase overall lung function for every person with emphysema? I'd love to hear an emphysema expert's answer to that question as it would seem to me that to one degree or another the elasticity and performance of every still living alveolus must be enhanced by not having to fight the 3,500+ particles and 500+ gases arriving with each puff. I can't speak for everyone but I can for my sister and I and in our cases we've noticed tremendous improvement in both breathing capacities and endurance.

Last edited by John (Gold) on 22 Jul 2010, 20:49, edited 3 times in total.

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

27 Nov 2002, 23:04 #25

Yesterday I emailed a friend at the American Lung Assocation posing the following two questions. The response I just received follows:
How much does quitting smoking halt the progression of the disease?

Does every person with emphysema experience an overall increase in their remaining lung function capacities when quitting?
John - this was from the pathologist. One thing to add into the mix is the
degeneration due to ageing.

> In most cases, the progression of the disease stops when the smoking
> stops. In the rest of the cases, it usually slows down. However, there
> is no repair of the lung that has dissolved.
> Large and small airways diseases are also caused by smoking and
> contribute to the symptoms. Much of this is reversible. Cough and
> phlegm usually intensify for a few days to a few weeks, then get better
> and go away. Along with this, the larger airways open up some and
> airflow gets better. There's a lot of variation from person to
> person.

OBob Gold
Joined: 18 Dec 2008, 23:58

02 Feb 2003, 05:32 #26

Added the following after noticing the use of bronchodilators for the treatment of emphysema above. My question, would it be reasonable to expect that symptoms of emphysema could be masked by the bronchodilators in cigarette smoke?... would it also, then, be reasonable to conclude that the symptoms of emphysema could seem worse after quitting, due to the lack of those bronchodilators?

Not looking for medical advice, of course, but I think it's a worthy discussion issue given the potential for someone to blame their quit for a worsening of their pulmonary function.

From: GrumpyOMrsS (Gold) Sent: 3/2/2002 6:10 AM

Just a note to John concerning the additives in your Vantage cigarettes and all other brands as well.....the first two you mentioned, licorice and cocoa are the vehicles put in the cigarettes not only to enhance the taste and smell, but they are actually the bronchodialors in cigarettes. those are the two ingredients added to cigarettes to make sure that our bronchii are open and able to accept the nicotine for faster delivery to the brain. Cocoa contains theopholine, the chemical used in inhalers for asmatatics and others suffering from COPD, as well as the licorice which contains, Glycyrrhizin. This explains in part why many people reach for chocolate or black licorice after quitting smoking. By the way, besides many calories for both chocolate and licorice, the glycyrrhizin in licorice, if ingested in larger than normal quatities, has the ability to raise one's blood pressure according to my pulmonologist. So this must be watched too.

below the findings in the tobacco hearings:

3.4.3 Cocoa and theobromine

Widely used as an additive, cocoa contains alkaloids, which may modify the effects of nicotine and have a pharmacological effect in themselves. Cocoa also contains about 1% theobromine, a 'bronchodilator' - encouraging expansion of the airways and facilitating increased smoke and nicotine intake.

The following quotes are from scientific and medical papers held by Philip Morris:

"Theobromine: The principal alkaloid of the cocoa bean which contains 1.5-3% of the base... bronchodilation effect in asthma."51

"The bronchodilator effect of a 10mg dose of theobromine was compared with that of 5mg of theophylline in young patients with asthma.... In this single dose study the bronchodilatory effect produced by theobromine was clinically and statistically significant.... improvement in all pulmonary function tests was noted after the ingestion of theobromine or theophylline."52 The addiction of these chemicals, in many cases, may mask an underlying problem when smoking. Stop smoking and take away these additives and a person who does not know he has asthma or emphsema or other symptoms of COPD is at once faced with a difficulty breathing from lack of broncodiators. This is how I found out I had asthma. Of course keep on smoking and you're liable to end up with much, much worse.

3.4.4 Glycyrrhizin

An ingredient of liquorice - another commonly used additive, glycyrrhizin also acts as a bronchodilator.

"What does a bronchodilator do? The bronchodilator makes it easier for you to inhale, so obviously if you are having difficulty putting smoke in your lungs, it's good to have a bronchodilator in there. Now I was asked recently whether I knew whether the glycerizon being delivered is delivered in adequate concentration to cause that to happen. I do not know the answer to that question. It would be interesting to know whether that has been studied by the industry. If they have studied it, it would seem that that is the kind of information that should be shared with regard to ingredients. The point is, however, that we know it can happen, it is a bronchodilator. The probability that it happens is very high, but that would be related to studies that should be done."53 (Farone WA 1997)


2 years free
Last edited by OBob Gold on 22 Jul 2010, 20:52, edited 1 time in total.

MareBear GOLD
Joined: 18 Dec 2008, 23:59

07 Mar 2003, 22:52 #27

Thanks for bringing up this thread, Joanne. I had never read it because I didn't think it applied to my life. Unfortunately I think we are all affected one way or another by smoking-related conditions.

There is a very dear, sweet lady whose office is next door to mine, and she was a heavy smoker for over 30 years. She has emphysema, asthma and chronic bronchitis, yet she continued to smoke until about a month before I quit. She quietly quit (didn't tell a soul until people started noticing) with a nicotine patch and was still on it for about a month after I had quit. Once she withdrew from the patch she was OK and seemed to understand the concept of the Law of Addiction. I guess I just assumed she was listening to me talk about Freedom, since we had something in common. It was wonderful not to hear that constant racking, phlegm-y cough and I often asked her how she was feeling since she'd quit, and she'd answer that she hadn't felt this good in years.

However, over the last few weeks I've caught her smoking twice (she doesn't know this). I printed out a few articles and left them around where she'd see them, and found them in the trash. Now, that horrible cough is back, and she's back to calling in sick once or twice a week. Sometimes she's just too weak to get in her car and drive to work. It breaks my heart that she's relapsed, that she's killing herself again. As I type this I can hear her struggling to breathe. I don't guess there's much else I can do, but it sure felt good to get this off my chest. Thanks for listening.


9 months, 1 week, 1 day

Joined: 19 Dec 2008, 00:06

04 Feb 2006, 09:44 #28

My dad suffered from this disease for 20 years before he was diagnosed with lung cancer and 14 months later died from that. I am not afraid of picking up a nicotine delivery device again and DYING.....I'm afraid that I'd pick it up and live the way he did for 20 years. His whole life was compromised by the disease. And still he smoked until 4 days before he died. If that isn't addiction, I don't know what is! And sadly, I smoked with him and continued for 10 years after he died.

I am now quit for 28 days (and the rest of my life, one day at a time) and my sister is quit for 8 days. I think my dad has interferred with our lifes and, somehow, gave us the insight to be able to break this chain. I am 58, my sister 50 and it's taken us this long to get the message!! But got it we did and we are on our way to living happy, joyous and free of any substance. All we have to do is NTAP!!!

sandy -a nicotine addict who hasn't used nicotine for Twenty Eight Days, 23 Hours and 15 Minutes, while extending my life expectancy 1 Day and 12 Hours, by avoiding the use of 435 nicotine delivery devices that would have cost me $65.26.

Joined: 19 Dec 2008, 00:06

04 Feb 2006, 12:27 #29

Such scary stuff. I need to read it, to remember it, to reject the drug that causes it. Thanks to Freedom

Joined: 19 Dec 2008, 00:06

17 Apr 2006, 23:58 #30

I have a brilliant friend -- a writer, actor, and teacher -- who is maybe 62 years old, and I find myself avoiding her because it is soo painful to be in her house, where it's so hard to breathe through all the cigarette smoke, and then, through a cloud of smoke, watch her labored breathing. A couple of years ago, I took a walk with her and was stunned with fear and sadness at how much lung capacity she was losing to emphysema. Thank you for bringing this thread back, Sal.Image
I thank my lungs every day for supporting my life, and now, I can only hope that all of us have quit in time.

best, joanne, free for 97 days