How our Lungs Work
Our lungs are responsible for providing our body with oxygen and expelling the carbon dioxide that's left over once our body has used the oxygen. The lungs do this through a series of clusters of small air sacs called, alveoli. These clusters are separated by a very thin membrane that allows the exchange of oxygen and carbon dioxide through the tiny blood vessels that travel through the membrane.
Air enters the alveoli through the the "bronchial tree. The trachea splits into the right and left mainstem bronchi, which branch further into bronchioles and finally ends in the alveolar air sacs" (www.medicinenet.com). As we breathe in, the alveoli expand, and the oxygen is transferraed to the hemoglobin in the red blood cells to be distributed to the rest of the body. During this transfer, carbon dioxide transfers from the bloodstream to the alveoli to be expelled.
What is Emphysema?
Emphysema is the name given to the condition where the alveolar walls have been destroyed along with the tiny (capillary) blood vessels that run within them. The loss of these membranes means that there is less total area in the lungs for the oxygen/carbon dioxide exchange to happen. In some cases, there is only inflammation of the bronchioles (airways) which limits the amount of air traveling through the alveoli. In severe cases, the bronchioles and alveoli collapse making it hard to expel and take in air.
With the oxygen intake of the body impaired, oxygen concentrations in the bloodstream are also compromised which leads to an increased breathing rate. The heart has to work harder to push blood through blood vessels which have narrowed due to lack of oxygen resulting in pulmonary hypertension - the increase of blood pressure within the lungs. Over time, this can lead to heart failure.
Emphysema is considered part of the group of diseases called chronic obstructive pulmonary disease (COPD). It is a chronic condition that worsens over time.
- One in every 135 Canadians has emphysema
- Over 2 million Americans have emphysema
- Emphysema is the 15th most common condition that forces people to limit their activities
- Cigarette smoking is the primary cause of emphysema
- Most emphysema sufferers are older men, but the incidence is increasing among women; emphysema rates are highest for men aged 65 and up.
- Emphysema develops gradually over time due to exposure to inhaled irritants
- Symptoms only appear only after 30 to 50 percent of the lung tissue has already been lost
- Emphysema is not reversible. It can be slowed, but not stopped.
The Causes of Emphysema
Cigarette smoke causes the alveoli to produce defensive cells and causes the inflammation of lung tissues. Smoking also activates enzymes that attack and destroy lung tissue.
Alpha-1 antitrypsin deficiency
Alpha-1 antitrypsin is a naturally occurring protein that protects the lung from attacking enzymes. When there is a deficiency of this protein, the lung tissues are more susceptible to the destructive enzymes.
As we age, our lungs also age and the lung lose their elasticity - their ability to expand and contract effectively.
The Symptoms of Emphysema
As with most conditions, the onset and severity of symptoms vary from patient to patient. This is particularly the case with those patients who have alpha-1 antitrypsin deficiency. Initially, those with emphysema will experience shortness of breath and wheezing during physical exertion. Over time, these symptoms will worsen until they appear when the person is resting, as well.
Other symptoms include:
- losing weight without trying
- coughing with or without phlegm
- production of excess phlegm (mucus)
- a bluish tint to the skin (cyanosis)
- grumpiness, irritability, impaired mental capacity, headaches, and sleeplessness due to lack of oxygen to the brain and increased levels of carbon dioxide in the blood.
*Note: If wheezing happens while breathing in that is usually due to emphysema or COPD. If wheezing happens while breathing out that is usually due to asthma
Treatments for Emphysema
Once emphysema has been determined through clinical and radiographic examination, a treatment regimen will be established with a goal of slowing the development of the symptoms. Part of that regimen will be the cessation of smoking. Following that, the treatment plan will include medication, breathing retraining, and possibly surgery, which may involve the removal of damaged lung tissue or a lung transplant.
Treatment may also include:
Bronchodilators which are meant to relieve coughing, shortness of breath, and general breathing difficulties due to constricted airways.
Corticosteroids are usually used in conjunction with bronchiodilators because sufferers of emphysema often have other lung issues. Corticosteroids help reduce the inflammation of the bronchial passages.
Supplemental oxygen is often reserved for those patients who are in the advanced stages of emphysema
Regular vaccinations against flu and pneumonia
The Mayo Clinic website (cited below) has a great list of at-home breathing remedies that can help you keep your oxygen levels up and your lungs functioning well.
How to Prevent Emphysema
Sources: www.medicinenet.com; www.lung.ca (Canadian Lung Association); www.ehealthmd.com; www.cureresearch.com; www.mayoclinic.com