Emphysema

What is emphysema?

Emphysema is an ongoing (chronic) disease that gradually destroys the lungs. The damage makes it hard to breathe. You have trouble breathing out carbon dioxide, and eventually you become unable to breathe in enough oxygen.

How does it occur?

Emphysema is one of the 2 main types of chronic obstructive pulmonary disease (COPD). Chronic bronchitis (inflamed airways) is the other type. Chronic bronchitis and emphysema result from irritation of your airways over a long time, usually from smoking and sometimes from air pollution. Other causes are on-the-job exposure to irritants such as dust or chemicals, or frequent lung infections.

Cigarette smoking is the main cause of emphysema. The smoke damages the cells in your lungs. As the air sacs (alveoli) in your lungs become damaged, it gets harder for you to breathe out carbon dioxide after you breathe in. This means more carbon dioxide stays in your lungs and you have less room for oxygen when you breathe in. The damage to the lungs does not go away. Eventually you cannot breathe in enough oxygen to meet the needs of your body. About 15 to 20% of smokers (1 in every 5 or 6) develop emphysema. Unfortunately, you will not start having symptoms until serious damage has been done already.

An inherited disorder (passed down from parents) called alpha-1 antitrypsin deficiency (also called A1AD) can also cause emphysema. Alpha-1 antitrypsin (also called A1AT, AAT or alpha-1 proteinase inhibitor) is a substance made in the liver. The liver releases this substance into the bloodstream. A1AT helps protect the lungs against damage from other chemicals in the blood. Having alpha-1 antitrypsin deficiency means that you don’t have enough A1AT and your lungs can be damaged more easily. If you are a smoker AND have this genetic disorder, the lungs are damaged more quickly. Smokers with A1AD can develop emphysema in their 30s or 40s.

What are the symptoms?

The most common symptom of emphysema is a feeling of shortness of breath. At first this occurs with mild exercise or normal daily activities. After a while, you have trouble breathing all the time, even when you are resting. Another symptom is frequent coughing.

Sometimes the first obvious symptom of emphysema is wheezing, which can also be a symptom of asthma. These two medical problems can be confused with each other.

How is it diagnosed?

Your Reddy Urgent Care healthcare provider will ask about your medical history, including your smoking history and family medical history. Your provider will examine your heart and lungs. Then he or she will examine your hands and feet to look for signs that your body is not getting enough oxygen.

Your provider will check for other problems that could cause your symptoms, such as asthma.

Spirometry, a breathing test also called a PFT or pulmonary function test, is the most helpful test for emphysema. It checks how well your lungs are working.

You may have blood tests and chest X-rays. Early in the disease, you may not have any physical symptoms, and lab tests of your blood and X-rays of your chest may be normal. However, once you begin to have symptoms, blood tests may show that you have more red blood cells than normal. (Red blood cells are the cells that carry oxygen in your blood.) Other blood tests may show that too much carbon dioxide is staying in your body. As damage to your lungs gets worse, chest X-rays will start to show changes that suggest emphysema. (In the early stages of emphysema, chest X-rays are normal.)

If you are young or a nonsmoker and have symptoms of emphysema, your healthcare provider will do a blood test to check the level of alpha-1 antitrypsin.

How is it treated?

There is no cure for emphysema, but treatment can help control the disease. The treatment goals for emphysema are to:

  • Relieve symptoms and keep you as active as possible, based on your ability and lifestyle.  

  • Avoid things that make emphysema or its symptoms worse, such as smoking and lung infections.  

The most important part of treatment is to stop smoking. Talk to your Reddy Urgent Care healthcare provider about ways to stop smoking. You might find it helpful to join a quit-smoking program or to use nicotine patches or gum. If you are exposed to secondhand smoke at home or work, it is just as important to stop that exposure.

Asthma medicines can make it easier for you to breathe. Ipratropium (Atrovent) can help open up the airways so you can breathe better. Other asthma medicines may also be prescribed.

For times when you are feeling especially bad, other medicines such as antibiotics or steroids may be given for a short time. Steroids are available in forms that may be inhaled or taken by mouth as a pill. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.

Emphysema caused or worsened by A1AT deficiency (A1AD) may be treated with medicine that gives you more A1AT (A1AT replacement therapy). The medicine will not cure the emphysema, but it will help you have more A1AT in your body. It may slow down damage to your lungs caused by the lack of A1AT.

Ask your Reddy Urgent Care healthcare provider if you would benefit from:

  • regular exercise, such as walking or riding a stationary bicycle  

  • a humidifier to add moisture to the air  

  • changes in your work environment to reduce exposure to irritants  

At some point it is likely that you will need oxygen therapy. At first you may need oxygen only in some situations, but later you may need continuous oxygen.

How long will the effects last?

There is no cure for emphysema. It gradually worsens over many years until the lungs can no longer function. You may be able to slow the progress of the disease by not smoking and avoiding lung irritants such as secondhand smoke, harsh chemical fumes and air pollutants.

How can I take care of myself?

  • Do not smoke. If you stop smoking before much of your lungs have been damaged, the disease may progress more slowly. Also, if you stop smoking you are less likely to have problems with frequent bronchial infections. Ask your healthcare provider for help to stop smoking.  

  • Follow Reddy Urgent Care‘s recommended treatment.  

  • Ask your provider how often you need follow-up appointments.  

  • If you are able to exercise, get regular exercise according to your healthcare provider’s recommendations. Exercise will help keep your heart and other muscles healthy. Do not start an exercise program without your provider’s approval.  

  • Eat healthy foods.  

  • Eat high-calorie snacks between meals if you are underweight.  

  • Take vitamin and mineral supplements if recommended by your healthcare provider.  

  • Drink more liquids (water or tea) every day to help you cough up mucus more easily unless your provider says you need to limit fluids.  

  • If you use a humidifier, be sure to keep the humidifier clean, as recommended in the manufacturer’s instructions. It’s important to keep bacteria and fungi from growing in the water container.  

  • Do the breathing exercises recommended by your provider. They can help strengthen the muscles used for breathing. You may need a physical therapist to help you learn to do them properly.  

  • Take good care of your heart: Keep your blood pressure and cholesterol levels normal. Emphysema damages the heart over time, so work to keep the heart healthy.  

  • Get plenty of rest and sleep.  

  • If you think you are getting a cold or the flu, contact your healthcare provider right away. You need prompt treatment for any possible lung infections. Symptoms of emphysema often worsen during an infection.  

  • To help avoid lung infections, you should have a Pneumovax shot. This is a shot that protects against a common type of pneumonia. You should have no more than 2 shots of the pneumonia vaccine in your lifetime. The shots should be given at least 5 years apart.  

  • Get a flu shot every October to prevent flu.  

  • If you live in an area where smog or air pollution is a problem, be sure to ask your provider how you should take care of yourself when the air is bad.  

  • If you plan to travel, discuss your plans with your healthcare provider. It’s good to make sure there will be no problems with high altitude, humidity, temperature, pressurized airplane cabins, or smoggy cities, especially if you are using oxygen.  

  • Call your healthcare provider if you have:  

    • o.worsening shortness of breath  

    • o.shortness of breath even when you are resting  

    • o.chest pain  

    • o.fever  

    • o.phlegm that thickens or changes in color  

    • o.blood in the phlegm 

How can I prevent emphysema?

The best way to prevent emphysema is never to smoke. If you are a smoker, quit now. The fewer years you smoke, the less likely it is that you will develop emphysema