What’s wrong with your lungs?

For the past several years, you’ve noticed that you get short of breath when you do certain activities. No big deal, you just stopped doing them. Now, it seems like you’re short of breath all the time. What’s happening? Can it be treated? Is there a way to prevent it?

Definition

Emphysema is one of the conditions that contribute to chronic obstructive pulmonary disease (COPD). The other is chronic bronchitis, which causes inflammation of the tubes (bronchioles) that carry air to and from your lungs. Emphysema is when the air sacs of your lungs (alveoli) become damaged. This happens over time, and the inner walls of the alveoli weaken, resulting in them rupturing and creating larger spaces. The outcome is a decrease in the surface area within your lungs, which means less oxygen can be absorbed into your bloodstream. The other issue is that when you exhale, the alveoli you have left can’t function correctly, causing air to become trapped inside your lungs, so you can’t get fresh air into them.

The cause of emphysema is long-term exposure to airborne irritants, such as air pollution and chemical fumes/dust. However, the primary cause for most people is tobacco smoke, with the severity of the condition directly tied to the number of years and amount of tobacco you’ve smoked. Besides smoking, several other things can increase your risk of developing emphysema. Not surprisingly, one of these is being exposed to secondhand smoke. Air pollution is also a significant risk factor. It can come from both indoors and outdoors. Certain occupations where you’re exposed to chemicals or dust from grain, cotton, wood, or mining products also increase your risk, especially if you smoke too.

Emphysema increases your risk of developing certain complications that people without it have a less likely chance of acquiring. One such complication is a collapsed lung (pneumothorax), which is uncommon but can be life-threatening for those with emphysema. Another complication called bullae are empty spaces that form in your lung and can be as large as half a lung, reducing the amount of space your lung has to expand. It also increases your risk of developing a pneumothorax. Emphysema often results in increased pressure in the arteries that connect your lungs to your heart, called cor pulmonale, and causes parts of your heart to expand and weaken.

Symptoms often appear between the ages of 40 – 60. Since symptoms appear gradually, most people don’t realize they have a problem until it starts affecting daily tasks. The most common symptom is shortness of breath. Typically, that starts with activities that require exertion. Most likely, you cut back on these activities until you don’t do them anymore. Eventually, you’ll start feeling short of breath even while resting. If you ever feel short of breath when going upstairs, your lips/fingernails turn blue/gray with exertion, or your mentation is altered, seek medical care immediately.

Treatment

Unfortunately, emphysema can’t be cured. When treating it, the goal is to relieve symptoms and slow the progression. The intensity of treatment is dependent on the severity of your condition. Typically, you’ll need to take some medications. One type, bronchodilators, are designed to relieve coughing and shortness of breath by relaxing your constricted airways. Another type, inhaled steroids, are used to decrease shortness of breath by reducing inflammation. You’ll need to take antibiotics if you have an infection, like pneumonia or acute bronchitis (which is different from chronic bronchitis).

Other important aspects of treatment include various therapies. The primary one is pulmonary rehabilitation, where you learn breathing exercises and techniques to decrease your breathlessness and increase your ability to exercise. Nutrition therapy is also vital to being healthy since most people in the early stages of emphysema need to lose weight, and those in later stages often need to gain weight. Supplemental oxygen therapy is often required when your condition becomes severe enough that you have low blood oxygen levels. Usually, you need it around the clock, and it’s delivered via a narrow tube that fits into your nose.

If you have severe emphysema, your doctor may recommend removing small sections of damaged lung tissue to help the remaining tissue expand and work more efficiently. If you have severe lung damage and all other options have failed, your doctor may recommend a lung transplant. Since many people become increasingly limited in what they can do, they often feel depressed and withdrawn. It can be beneficial to talk with family and friends about your feelings or join a support group. If it feels like it’s too much to handle at any point, talking to a mental health professional can help.

Prevention

The most important thing you can do to prevent emphysema is not to smoke. If you do, quit because this helps limit the damage to your lungs. Also, avoid secondhand smoke whenever possible. If you work in a job where you’re exposed to chemical fumes and dust, wear a mask to avoid inhaling it. The same thing applies to air pollution. In addition, replacing the filters of your furnace and air conditioner regularly can help reduce how much air pollution enters your home.

If you already have emphysema, there are things that you can do to get relief from your symptoms and slow its progression. Regular exercise can help increase your lung capacity; check with your doctor before starting a new routine. Since cold air can cause bronchial passages to spasm, protect yourself by wearing a soft scarf or cold-air mask during colder months. Make sure you get the flu and pneumonia vaccinations yearly because getting either of these illnesses can significantly impact your lungs. Do everything you can to prevent respiratory infections by avoiding people you know are ill, washing your hands frequently, or using alcohol-based hand sanitizer when necessary.

Emphysema can definitely affect your life in negative ways, so by doing all that you can to prevent it, you’ll decrease your risk of developing it and experiencing these impacts. If you have any questions or concerns about emphysema, please speak with your doctor. If you would like more information, please visit the American Lung Association’s Emphysema page at https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/emphysema/