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The Star Online: Lifestyle: Health

Posted: 29 May 2013 05:06 AM PDT

Emphysema is included in the spectrum of diseases known as chronic obstructive pulmonary disease (COPD), and its mainly due to long term cigarette smoking.

MY father is a heavy smoker. He smokes two packs of cigarettes a day. We keep telling him to quit smoking, but he says he is addicted. Lately, he has been having difficulty breathing. I can hear him wheeze. I was worried he had asthma, so I brought him to the doctor and he was diagnosed as having 'emphysema'. What is this condition?

Emphysema refers to a condition in your lungs where the alveoli or air sacs are gradually destroyed. This causes you to have shortness of breath, which becomes gradually worse.

Emphysema is included in the spectrum of diseases known as Chronic Obstructive Pulmonary Disease (COPD).

It is caused by long-term smoking.

The cigarette smoke slowly destroys the lung tissue in the alveoli – distorting their usually bunched grape-like shapes and causing holes to form in their inner walls.

This reduces the surface area afforded to your lungs to breathe, and therefore, the amount of oxygen that can diffuse through and reach your bloodstream.

Cigarette smoke also damages the elastic fibres that hold the small airways open, leading to collapse of these little tubes.

The result is that you can draw breath in, but the little airways will collapse when you try to expel air. This causes the air to be trapped in your lungs.

Emphysema is, sadly, irreversible.

COPD is the fourth leading cause of death in the United States.

Emphysema is irreversible? That is scary! What are the symptoms of emphysema?

It is important to note that COPD is not often purely emphysema or the other common condition, chronic bronchitis, but varying combinations of both diseases.

Look out for the following:

·Shortness of breath

·Cough

·Wheezing

·Decreased tolerance for exercise over time and slow deterioration of breathing ability.

·Pursed lip breathing, meaning the patient having emphysema struggles to completely exhale a breath.

This is due to the aforementioned "trapped air" as the smaller airways collapse upon each other as you attempt to let out your breath, effectively "trapping" air in your lungs.

·The development of a "barrel chest", meaning your chest becomes more pronounced in the ribcage. This is caused by the trapping of air.

How do I tell the difference between emphysema and asthma? Both present with shortness of breath and wheezing, yes?

It can be difficult for you to differentiate between the two if you have no experience. But generally, asthma affects younger people and emphysema affects those who are older. Emphysema always comes with a history of heavy smoking.

Some experts recommend that anyone who is a heavy smoker with a cough be screened for emphysema.

In the clinic, the doctor will give you a peak flow meter challenge. He will give you a tube to blow into and measure how much you can blow. Then he will give you a bronchodilator to puff.

With asthma, your ability to blow into this tube improves after the bronchodilator.

It is possible to have both asthma and emphysema.

How does the doctor diagnose emphysema?

This involves measuring pulmonary function with a test called spirometry. Spirometry measures the volume and force of air as you exhale it from your lungs.

You have to inhale and exhale forcefully into this instrument for several times. Then the force of your exhalation is measured and calibrated against the norm.

Your doctor will measure a few indices:

·Forced Vital Capacity (FVC), which is the maximum volume of air that can be exhaled out through your lungs. This indicates your lung size, capacity and elasticity.

·Forced Expiratory Volume in one second (FEV1). This is the maximum volume of air that you can exhale in ONE second. This can measure the severity of your COPD.

If you have severe COPD, your FEV1 is only 30 to 50% of the normal value.

Is there any treatment for emphysema?

Emphysema cannot be cured, unless you get a lung transplant. But you can certainly stop it from getting worse.

Stop smoking immediately. This will "stop the rot" in your lungs. It can even improve your lung function over time.

Bronchodilators may open up your airways for episodes of shortness of breath, but will not cure emphysema.

Steroids and other drugs which are prescribed for asthma can help with symptoms.

And if your shortness of breath is so bad, home oxygen can help.

If all else fails, you can opt for surgery. Other than lung transplant, there is lung volume reduction surgery, which removes the upper lobes of both your lungs to allow the lower parts of your lungs to have better expansion.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment.

For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Kredit: www.thestar.com.my

Rabu, 29 Mei 2013

The Star Online: Lifestyle: Health

The Star Online: Lifestyle: Health

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