Emphysema

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Emphysema

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Overview
Emphysema is a type of chronic obstructive
pulmonary disease (COPD) involving damage to
the air sacs (alveoli) in
the lungs. As a result, your body does not get the
oxygen it needs. Emphysema
makes it hard to catch your breath. You may also
have a chronic cough and have

http://www.fitango.com/categories.php?id=152 1

Overview
trouble breathing during exercise.
The most common cause is cigarette smoking.
If you smoke, quitting can
help prevent you from getting the disease. If you
already have emphysema, not smoking


Overview
might keep it from getting worse. Treatment is
based on whether your symptoms
are mild, moderate or severe. Treatments include
inhalers, oxygen, medications
and sometimes surgery to relieve symptoms and
prevent complications.


Symptoms
At first, COPD may cause no symptoms or only mild
symptoms. As the
disease gets worse, symptoms usually become
more severe. Common signs
and symptoms of COPD include:


Symptoms
-- An ongoing cough or a cough that produces a lot
of mucus (often called "smoker's cough")
-- Shortness of breath, especially with physical
activity
-- Wheezing (a whistling or squeaky sound when
you breathe)
-- Chest tightness


Symptoms
If you have COPD, you also may have colds or the
flu (influenza) often.
Not
everyone who has the symptoms above has COPD.
Likewise, not everyone
who has COPD has these symptoms. Some of the
symptoms of COPD are


Symptoms
similar to the symptoms of other diseases and
conditions. Your doctor
can find out whether you have COPD.
If your symptoms are mild, you
may not notice them, or you may adjust your
lifestyle to make breathing


Symptoms
easier. For example, you may take the elevator
instead of the stairs.
Over time, symptoms may become severe enough
to see a doctor. For example, you may get short of
breath during physical exertion.
The
severity of your symptoms will depend on how
much lung damage you have.


Symptoms
If you keep smoking, the damage will occur faster
than if you stop
smoking.
Severe COPD can cause other symptoms, such as
swelling in your ankles, feet, or legs; weight loss;
and lower muscle endurance.
Some


Symptoms
severe symptoms may require treatment in a
hospital. You—with the help
of family members or friends, if you're unable—
should seek emergency
care if:
-- You're having a hard time catching your breath
or talking.


Symptoms
-- Your lips or fingernails turn blue or gray. (This is a
sign of a low oxygen level in your blood.)
-- You're not mentally alert.
-- Your heartbeat is very fast.
-- The recommended treatment for symptoms that
are getting worse isn't working.


Diagnosis
Your doctor will diagnose COPD based on your
signs and symptoms, your medical and family
histories, and test results.
Your
doctor may ask whether you smoke or have had
contact with lung


Diagnosis
irritants, such as secondhand smoke, air
pollution, chemical fumes, or
dust.
If you have an ongoing cough,
let your doctor know how long you've had it, how
much you cough, and


Diagnosis
how much mucus comes up when you cough.
Also, let your doctor know
whether you have a family history of COPD.
Your doctor will
examine you and use a stethoscope to listen for
wheezing or other


Diagnosis
abnormal chest sounds. He or she also may
recommend one or more tests to
diagnose COPD.
Lung Function TestsLung function tests
measure how much air you can breathe in and
out, how fast you can


Diagnosis
breathe air out, and how well your lungs deliver
oxygen to your blood.
The
main test for COPD is spirometry (spi-ROM-eh-tre).
Other lung function
tests, such as a lung diffusion capacity test, also
might be used. (For


Diagnosis
more information, go to the Health Topics Lung
Function Tests article.)
SpirometryDuring
this painless test, a technician will ask you to take a
deep breath in.
Then, you'll blow as hard as you can into a tube
connected to a small


Diagnosis
machine. The machine is called a spirometer.
The machine measures how much air you breathe
out. It also measures how fast you can blow air
out.
Other TestsYour doctor may recommend other
tests, such as:
-- A chest x ray or chest CT scan.


Diagnosis
These tests create pictures of the structures inside
your chest, such
as your heart, lungs, and blood vessels. The
pictures can show signs of
COPD. They also may show whether another
condition, such as heart
failure, is causing your symptoms.


Diagnosis
-- An arterial blood gas test.
This blood test measures the oxygen level in your
blood using a sample
of blood taken from an artery. The results from this
test can show how
severe your COPD is and whether you need oxygen
therapy.


Treatment
COPD has no cure yet. However, lifestyle changes
and treatments can
help you feel better, stay more active, and slow the
progress of the
disease.
The goals of COPD treatment include:


Treatment
-- Relieving your symptoms
-- Slowing the progress of the disease
-- Improving your exercise tolerance (your ability to
stay active)
-- Preventing and treating complications


Treatment
-- Improving your overall health
To
assist with your treatment, your family doctor may
advise you to see a
pulmonologist. This is a doctor who specializes in
treating lung
disorders.


Treatment
Lifestyle ChangesQuit Smoking and Avoid Lung
IrritantsQuitting
smoking is the most important step you can take to
treat COPD. Talk
with your doctor about programs and products
that can help you quit.
If


Treatment
you have trouble quitting smoking on your
own, consider joining a
support group. Many hospitals, workplaces, and
community groups offer
classes to help people quit smoking. Ask your
family members and friends
to support you in your efforts to quit.


Treatment
Also, try to avoid secondhand smoke and places
with dust, fumes, or other toxic substances that
you may inhale.
For more information about how to quit
smoking, go to the Health Topics Smoking and Your
Heart article and the National Heart, Lung, and
Blood Institute's "Your Guide to a Healthy Heart."
Although these resources focus on heart
health, they include basic information about how
to quit smoking.

Treatment
Other Lifestyle ChangesIf
you have COPD, you may have trouble eating
enough because of your
symptoms, such as shortness of breath and
fatigue. (This issue is more
common with severe disease.)


Treatment
As a result, you may not get all of
the calories and nutrients you need, which can
worsen your symptoms and
raise your risk for infections.
Talk with your doctor about


Treatment
following an eating plan that will meet your
nutritional needs. Your
doctor may suggest eating smaller, more frequent
meals; resting before
eating; and taking vitamins or nutritional
supplements.
Also, talk


Treatment
with your doctor about what types of activity are
safe for you. You may
find it hard to be active with your symptoms.
However, physical
activity can strengthen the muscles that help you
breathe and improve
your overall wellness.


Treatment
MedicinesBronchodilatorsBronchodilators relax
the muscles around your airways. This helps open
your airways and makes breathing easier.
Depending
on the severity of your COPD, your doctor may
prescribe short-acting or


Treatment
long-acting bronchodilators. Short-acting
bronchodilators last about
4–6 hours and should be used only when needed.
Long-acting
bronchodilators last about 12 hours or more and
are used every day.
Most


Treatment
bronchodilators are taken using a device called an
inhaler. This device
allows the medicine to go straight to your lungs.
Not all inhalers are
used the same way. Ask your health care team to
show you the correct way
to use your inhaler.


Treatment
If your COPD is mild, your doctor may only
prescribe a short-acting inhaled bronchodilator. In
this case, you may
use the medicine only when symptoms occur.


Treatment
If your COPD is moderate or severe, your doctor
may prescribe regular treatment with short- and
long-acting bronchodilators.
Inhaled Glucocorticosteroids (Steroids)Doctors
use inhaled steroids to treat people whose COPD
symptoms flare up or


Treatment
worsen. These medicines help reduce airway
inflammation.
Your
doctor may ask you to try inhaled steroids for a
trial period of 6 weeks
to 3 months to see whether the medicine helps
relieve your breathing


Treatment
problems.
VaccinesFlu ShotsThe flu (influenza)
can cause serious problems for people who have
COPD. Flu shots can
reduce your risk of getting the flu. Talk with your
doctor about getting


Treatment
a yearly flu shot.
Pneumococcal VaccineThis vaccine lowers your risk
for pneumococcal pneumonia
(NU-mo-KOK-al nu-MO-ne-ah) and its
complications. People who have COPD
are at higher risk for pneumonia than people who
don't have COPD. Talk


Treatment
with your doctor about whether you should get
this vaccine.
Pulmonary RehabilitationPulmonary rehabilitation
(rehab) is a broad program that helps improve the
well-being of people who have chronic (ongoing)
breathing problems.
Rehab


Treatment
may include an exercise program, disease
management training, and
nutritional and psychological counseling. The
program's goal is to help
you stay active and carry out your daily activities.
Your rehab


Treatment
team may include doctors, nurses, physical
therapists, respiratory
therapists, exercise specialists, and dietitians.
These health
professionals will create a program that meets
your needs.


Treatment
Oxygen TherapyIf you have severe COPD and low
levels of oxygen in your blood, oxygen therapy can
help you breathe better. For this treatment, you're
given oxygen through nasal prongs or a mask.
You
may need extra oxygen all the time or only at
certain times. For some


Treatment
people who have severe COPD, using extra oxygen
for most of the day can
help them:
-- Do tasks or activities, while having fewer
symptoms
-- Protect their hearts and other organs from
damage


Treatment
-- Sleep more during the night and improve
alertness during the day
-- Live longer
SurgerySurgery
may benefit some people who have COPD. Surgery
usually is a last resort


Treatment
for people who have severe symptoms that have
not improved from taking
medicines.
Surgeries for people who have COPD that's mainly
related to emphysema include bullectomy (bul-EK-
toe-me) and lung volume reduction surgery (LVRS).
A lung transplant might be an option for people
who have very severe COPD.


Treatment
BullectomyWhen
the walls of the air sacs are destroyed, larger air
spaces called
bullae (BUL-e) form. These air spaces can become
so large that they
interfere with breathing. In a bullectomy, doctors
remove one or more


Treatment
very large bullae from the lungs.
Lung Volume Reduction SurgeryIn
LVRS, surgeons remove damaged tissue from the
lungs. This helps the
lungs work better. In carefully selected
patients, LVRS can improve


Treatment
breathing and quality of life.
Lung TransplantDuring a lung transplant, your
damaged lung is removed and replaced with a
healthy lung from a deceased donor.
A
lung transplant can improve your lung function and
quality of life.


Treatment
However, lung transplants have many risks, such as
infections. The
surgery can cause death if the body rejects the
transplanted lung.
If
you have very severe COPD, talk with your doctor
about whether a lung


Treatment
transplant is an option. Ask your doctor about the
benefits and risks of
this type of surgery.


Causes
Long-term exposure to lung irritants that damage
the lungs and the airways usually is the cause of
COPD.
In
the United States, the most common irritant that
causes COPD is


Causes
cigarette smoke. Pipe, cigar, and other types of
tobacco smoke also can
cause COPD, especially if the smoke is inhaled.
Breathing in
secondhand smoke, air pollution, or chemical
fumes or dust from the


Causes
environment or workplace also can contribute to
COPD. (Secondhand smoke
is smoke in the air from other people smoking.)
Rarely, a genetic condition called alpha-1
antitrypsin deficiency
may play a role in causing COPD. People who have
this condition have


Causes
low levels of alpha-1 antitrypsin (AAT)—a protein
made in the liver.
Having
a low level of the AAT protein can lead to lung
damage and COPD if
you're exposed to smoke or other lung irritants. If
you have this


Causes
condition and smoke, COPD can worsen very
quickly.
Although uncommon, some people who have
asthma
can develop COPD. Asthma is a chronic (long-term)
lung disease that
inflames and narrows the airways. Treatment
usually can reverse the


Causes
inflammation and narrowing. However, if
not, COPD can develop.


Prevention
You can take steps to prevent COPD before it
starts. If you already
have COPD, you can take steps to prevent
complications and slow the
progress of the disease.
Prevent COPD Before It StartsThe


Prevention
best way to prevent COPD is to not start smoking
or to quit smoking.
Smoking is the leading cause of COPD. If you
smoke, talk with your
doctor about programs and products that can help
you quit.
If you


Prevention
have trouble quitting smoking on your
own, consider joining a support
group. Many hospitals, workplaces, and
community groups offer classes to
help people quit smoking. Ask your family
members and friends to
support you in your efforts to quit.


Prevention
Also, try to avoid lung
irritants that can contribute to COPD. Examples
include secondhand
smoke, air pollution, chemical fumes, and dust.
(Secondhand smoke is
smoke in the air from other people smoking.)


Prevention
For more information about how to quit
smoking, go to the Health Topics Smoking and Your
Heart article and the National Heart, Lung, and
Blood Institute's "Your Guide to a Healthy Heart."
Although these resources focus on heart
health, they include basic information about how
to quit smoking.
Prevent Complications and Slow the Progress of
COPDIf


Prevention
you have COPD, the most important step you can
take is to quit smoking.
Quitting can help prevent complications and slow
the progress of the
disease. You also should avoid exposure to the lung
irritants mentioned
above.


Prevention
Follow your treatments for COPD exactly as your
doctor
prescribes. They can help you breathe easier, stay
more active, and
avoid or manage severe symptoms.
Talk with your doctor about whether and when
you should get flu (influenza) and


Prevention
vaccines. These vaccines can lower your chances of
getting these
illnesses, which are major health risks for people
who have COPD.


Emphysema

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