by Kimberly Allen RN
Emphysema is one of the diseases belonging to a group of diseases known as COPD or chronic obstructive pulmonary disease. It is a long term progressive disease affecting your ability to breathe. Emphysema as well as other diseases of COPD are a major health issue. It is estimated that there are over 24 million adults in the US with some degree of emphysema. Because the diseases in COPD including emphysema are under diagnosed it is difficult to know just how many American’s are suffering with emphysema. However, of the diagnosed cases emphysema is responsible for approximately 8 million out patient and Dr office visits as well as at least 1 1/2 million ER visits. There are over 750,000 hospitalizations for emphysema every year with approximately 120,000 deaths every year as well. Emphysema affects both men and women though the incidence in women has been increasing over the past few years, in fact the death rate in women now exceeds that of men.
In emphysema the tiny air sacs known as aveoli that expand to receive oxygen begin to lose their elasticity. Then when you inhale the aveoli expand from the force of air entering the lungs but are unable to collapse after the oxygen has been transferred to the bloodstream forcing the unoxygenated air to leave when you exhale. If you are unable to exhale then there is no room for you to take in fresh oxygenated air. As more and more of your aveoli lose heir elasticity there are less and less to take in oxygen. As more of the aveoli are destroyed the lungs are unable to maintain sufficient oxygenlevels in your bloodstream. As the disease progresses you’ll begin to hyperventilate in an attempt to compensate and increase oxygen levels in the bloodstream. As your oxygen levels drop the blood vessels in your lungs begin to narrow. This causes your heart to have to work harder pushing the blood through the narrower blood vessels. In turn this increases the pressure in your lungs a condition known as pulmonary hypertension which over time can eventually lead to heart failure.
The most common cause of emphysema is smoking though exposure to other airborne irritants like air pollution, coal and silica dust and manufacturing fumes. There is also a rare type of emphysema that is caused by a genetic mutation.
The most common symptom of emphysema is shortness of breath. Usually you first notice being short of breath with activity like going up the stairs or trying to run or jog. Eventually you’ll become short of breath doing minimal activity like getting dressed or trying to eat. As you have more and more difficulty breathing you’ll begin to use accessory muscles to help you expand your lungs in an attempt to take in more air. This can lead to soreness in your chest and shoulder muscles. As the disease progresses most people develop whats called a “barrel chest” as a result of using your accessory muscles.
There is no cure for emphysema however there are medications available to help relieve your symptoms. The main goal of treatment is to prevent further destruction of the lungs and preserve it’s function. If you have emphysema it’s important to remember treatment focuses on improving and maintaining quality of life while limiting the effects of the disease on your daily life. There are several new medications available that have been effective in relieving the shortness of breath including spiriva which is a long acting bronchodialator that is used to control the symptoms of emphysema in maintenance therapy. With the long acting bronchodialator usually a short acting one is also used for sudden flare ups called rescue therapy. Many people with emphysema also used inhaled corticosteroids in combination with the bronchodialators as the steroids reduce inflammation in the lungs.
Prevention is the best way to avoid serious illness. the first and most important factor in preventing emphysema is to not smoke and if you do smoke it’s important to quit. Avoid breathing in second hand smoke and if your work where there are chemical fumes or lots of dust wear a mask to protect your lungs.