WHAT IS EMPHYSEMA

lung allow the lungs to expand and contract. 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 the majority (80% - 90%) of COPD (chronic obstructive pulmonary disease) cases, including emphysema. In addition, 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 called alpha 1-antitrypsin (AAT) deficiency-related emphysema. 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 lowerlungs. 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, which is important to keep airways open. 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:This is a major proceedure, which can be effective. Lung volume reduction surgery is a surgical procedure in which the most severely diseases portions of the lung are removed to allow the remaining lung and breathing muscles to work better. The short term results are promising but those with severe forms are at higher risk of death. PREVENTION OF EMPHYSEMA Continuing 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 inthis 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. The 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.