Emphysema

Emphysema is a type of COPD that is an irreversible degenerative condition resulting from inflammation of the alveoli, the small air sacs in the lungs. When these sacs loose their natural elasticity to expand and deflate for holding and releasing oxygen, then air becomes trapped in the lungs and the patient experiences shortness of breath and coughing. Smoking is the most common cause of emphysema.

Emphysema Symptoms

Emphysema takes years to develop and comes on very gradually. Initial symptoms include:

Difficulty in catching your breath
Shortness of breath during activity or exercise
Chronic bronchitis
Chronic cough

Emphysema Treatment

Treatment for emphysema is based upon the patient’s symptoms as being mild, moderate or severe. Relief is the top priority in treatment, along with slowing or preventing the progression of the disease with a minimum of side effects.The most important measure to slow its progression is for the patient to stop smoking and avoid all exposure to cigarette smoke and lung irritants. Forms of treatment include:

Pulmonary Rehabilitation is helpful in optimizing the patient’s quality of life and teaching them how to actively manage their daily care. Patients with emphysema and chronic bronchitis can do more for themselves than patients with any other disabling disease. Exercise is a critical component of this rehab that not only conditions the entire body but includes breathing exercises to strengthen the muscles used in breathing.
Oxygen Therapy used as prescribed usually more than 20 hours per day) is the only non-surgical treatment which has been shown to prolong life in emphysema patients.
Bronchodilators help emphysema patients if they have a tendency toward airway constriction or tightening. They open the patient’s airways and enable them to breathe easier by relaxing the muscles around the airways. These medications are provided in an inhaler and are either short-acting to use before an activity or long-acting to use on a regular basis.
Inhaled Steroids are used to treat emphysema patients who have relapses or “acute exacerbations.” They reduce airway inflammation and help patients breathe better.
Lung Volume Reduction Surgery (LVRS) can improve the quality of life for certain carefully selected patients. It can be done by different methods, some of which are minimally invasive. The most severely diseased portions of the lung are removed to allow the remaining lung and breathing muscles to work better.
Lung Transplant is the only known “cure” for emphysema, but few patients are strong enough physically to survive the surgery. The combination of a patient’s age, oxygen deprivation and the side-effects of the medications used to treat emphysema cause damage to the kidneys, heart and other organs. Transplants also require the patient to take an anti-rejection drug regimen which suppresses the immune system, and so can lead to microbial infection of the patient.

Smoking Cessation

Emphysema patients who smoke need to stop smoking in order to treat the disease and slow its progression. Options for quitting smoking include:

Cold Turkey: Some people are able to quit all at once by simply making the decision to quit. If smoking is simply a habit that you can take or leave, then cold turkey might work for you. Select a date, decide upon a reward for yourself, and then enlist friends and family to give you support.
Nicotine Replacement Therapy: Nicotine replacement therapy (NRT) gives you nicotine without the other harmful chemicals that are in tobacco and is especially helpful for smokers who are physically addicted to nicotine. When you use the nicotine gum, patch, spray, inhaler or lozenges, the nicotine enters your bloodstream in a controlled amount and you are able to gradually taper off from the physical addiction without suffering from the majority of withdrawal symptoms.

Almost 90 percent of smokers cite the nicotine withdrawal symptoms and cravings as their only reason for not quitting. Smokers usually quit several times before they are able to quit for good, and this lack of success is directly related to the onset of withdrawal symptoms. Nicotine replacement therapy gives smokers a better chance of quitting for good by reducing their withdrawal symptoms.

NOTE: Smokers need to utilize cessation methods that focus on the emotional and mental aspects of smoking as well as the physical. Nicotine replacement therapy only counteracts the physical addiction of nicotine. Studies have documented that combining NRT with a group support smoking cessation program can double your chances of quitting and remaining an ex-smoker.
FDA-Approved Medications:
1. Bupropion (Zyban®) is a prescription anti-depressant in an extended-release form that reduces symptoms of nicotine withdrawal. It does not contain nicotine. This drug acts on chemicals in the brain that are related to nicotine craving.
2. Varenicline (Chantix™) is a newer drug developed to help people stop smoking. It works by interfering with nicotine receptors in the brain and has two effects. First, it lessens the pleasurable physical effects a person gets from smoking, and second, it reduces the symptoms of nicotine withdrawal.
Hypnosis: Hypnosis does help some people quit smoking. This process works by helping you avoid the triggers that lead you to smoke.
Acupuncture: Acupuncture does help some smokers lose their craving for smoking. Acupuncture works for smoking cessation by inserting fine needles into parts of your ears.

Emphysema Products

Oxygen benefits emphysema patients with severe lung impairment. This therapy relieves low blood oxygen levels (hypoxia) and improves mental functioning. Oxygen can be supplied as:
Concentrators take room air and remove most of the other gases present to supply the respiratory-diseases patient with 90 to 95 percent pure oxygen. The concentrators can be set to deliver a specific oxygen flow ranging from 1 to 6 LPM (liters per minute).
Portable Oxygen Concentrators (POD’s) enable oxygen patients to maintain their mobility and independence. These high-tech concentrators are lightweight and unobtrusive, and easy to carry with you wherever you go, be it work or travel.
Compressor Nebulizers (Pulmo-Aide) are table-top units that force compressed air through a nebulization chamber to aerosolize medication for inhalation.
Smoking Cessation Products

Resources on Emphysema

American Lung Association
800 586-4872
www.lungusa.org

MedlinePlus
The National Library of Medicine/National Institutes of Health
www.nlm.nih.gov/medlineplus