Emphysema

As you may know from reading my blog, my focus in life is disease prevention of all types, but mu current job deals primarily with tobacco education and cessation. I am well of aware of the many diseases that can be attributed to the use of tobacco, most often cigarette smoking. In fact, the top 4 leading causing of death in our country can be caused by smoking alone - though there are other things that cause them as well. They are;
Heart Disease
Cancer
Stroke
Lung Disease

I have educated people on COPD - Chronic Obstructive Pulmonary (lung) Disease - which includes chronic bronchitis and emphysema. Today I understand them both a little bit better because two things led me to investigate the diseases further. First, someone that I know, a former smoker, has COPD and her condition has worsened significantly though she stopped smoking some years ago, and second, I made a statement that quitting smoking can stop the progression of emphysema and was told that I was incorrect.

The two diseases affect different parts of the lung with different end results. The toxic chemicals and gases in smoke destroy lung tissue. The first response to the TAR is inflammation. Our bodies respond to invasions by trying to clean up the damage (free radicals), but some of that clean up (antioxidant activity) is itself impaired by the toxins in the smoke. Scarring can also occur on the lungs. Chronic bronchitis has to do with the larger airways and mucus buildup which obstructs airflow by narrowing the passages. Emphysema is a disease of the much smaller air sacs, the alveoli.

Lungs are often said to be like sponges with many little holes in them. If you think of a sponge and how it absorbs water and how you wring out the water, you get the idea of how important those small holes are. And think about a good sponge vs a cheap one - without small holes, the water doesn't stay in the sponge, the sponge doesn't inflate with it. So in emphysema, where alveoli are destroyed, the lungs begin to lose their shape and a person cannot fully expire air. This means that oxygen cannot be delivered efficiently and carbon dioxide can not be expelled. This process can lead to other disease conditions. Emphysema is almost always (80-90%) caused by cigarette smoking and if a person does not quit smoking, the prognosis is swift and poor.

In many cases, stopping smoking CAN slow if not halt progression to other air sacs, but there are types of emphysema that trigger an autoimmune response which causes continued damage regardless of smoking status.

Treatment includes, but is not limited to, oxygen and inhalers. The absolute first thing and most important thing a person can do is quit smoking. It is also said that persons who are under or overweight have worse outcomes. It is important to exercise and eat well so that the lungs and body can be conditioned.

The longer one smokes the greater the risk for this disease. I have come to believe that this is the far bigger threat to a smoker than lung cancer. There is just no way to breathe in smoke every day and not damage your lungs. Not all lung damage is COPD, however. In other words, you can impair your breathing without contracting this incurable disease. It is also possible that COPD may be genetically inspired, but the gene may not be expressed unless one smokes. BTW, people often have both chronic bronchitis and emphysema.

In one of my classes today a person talked of seeing a smoker's lungs during an autopsy. The lungs were black like coal and much smaller than non smokers' lungs. My "student" said that he could not imagine how the person had been able to breathe.