Lung Disease Affecting Many Americans.

¶ … lung disease affecting many Americans. Specifically it will discuss emphysema, including what it is, what causes it, what are some preventions, clinical features, diagnosis, and treatments. Chronic Obstructive Pulmonary Diseases (COPD) is the name for several lung diseases that affect millions of Americans, and one of the many COPD is emphysema. Emphysema is a lung disease that affects breathing, and eventually physical activity. It is a serious disease that some experts say has reached epidemic proportions in America today. Emphysema can be treated, it can be prevented, but it cannot be cured.

What exactly is a COPD? A COPD is a disease characterized by decreased lung function, chronic cough, shortness of breath, and wheezing. COPD affect millions of people every year worldwide. If COPD are left untreated, they can lead to heart failure, infection, pneumonia, and ultimately -- death. COPD are usually detected in adults between the ages of 40 and 50. Many people are unaware of their illness until it is too late and the doctors are unable to undo its consequences. The most common cause of COPD is cigarette smoking -- fortunately, only 10 to 15% of moderate to heavy smokers develop COPD. Other causes of COPD are environmental factors, and even a genetic defect, and other forms of COPD include asthma and chronic bronchitis. COPD are treatable but are not curable, because once the lungs are damaged, there is simply no way to regenerate their tissue. Emphysema is probably one of the most well-known forms of COPD, and it can be one of the most debilitating, too.

Emphysema is a chronic lung disease that is most often caused by cigarette smoking. The American Lung Association (ALA) describes the disease as a situation where "the walls between the alveoli or air sacs within the lung lose their ability to stretch and recoil. The air sacs become weakened and break. Elasticity of the lung tissue is lost, causing air to be trapped in the air sacs and impairing the exchange of oxygen and carbon dioxide. Also, the support of the airways is lost, allowing for airflow obstruction" ("Emphysema," 2004). Another writer continues, "As a result, the lungs lose their elasticity, and exhaling becomes difficult as the damaged lungs trap air and cannot effectively exchange it with fresh air. As the damage progresses, the effort needed to breathe increases and, ultimately, each breath becomes labored" (Lewis, 1999, p. 9). Finally, another writer notes, "With fewer channels through which blood can reach the lungs, the flow resistance rises, raising the pulmonary artery pressure and increasing the load on the heart" (Honish, 1982, p. 91). Thus, emphysema affects the lungs, but it can also affect other organs and even the heart. Oxygen therapy can help the body cope with less oxygen, but ultimately, when the lungs deteriorate enough, even oxygen therapy is not enough to fully provide the body with the oxygen it needs.

In addition, those who suffer from emphysema, because of their weakened lung condition, can also frequently suffer from chronic bronchitis. The worst thing about the disease is that it cannot be cured, it can only be treated, and it can get progressively worse. Lack of oxygen to other vital body organs can also reduce their effectiveness, and eventually lead to death. The ALA estimates that over 3.1 million Americans have been diagnosed with emphysema. Men suffer from the disease more than women, and it, combined with other COPD disorders, is the fourth leading cause of death in the United States ("Emphysema," 2004).

What are the symptoms and clinical features of emphysema? Initially, most emphysema patients simply feel shortness of breath (or dyspnea), especially when exercising or during physical exertion, and this is the main clinical feature of the disease. Some other common symptoms are coughing, wheezing, and constant mucus production in the lungs (Lewis, 1999, p. 9). As the disease progresses, some or all of these symptoms may be present continually. A physician cannot make a diagnosis only based on these symptoms, however.

Since about 80 to 90% of emphysema deaths each year are initially caused by smoking ("Emphysema," 2004), the physician will first determine if the patient smokes or smoked in the past. If the patient did not smoke, the physician may ask about their employment, as in some cases, emphysema can be caused by environmental factors, such as continual dust or bacteria in the air. Most emphysema is caused by external factors such as smoking or continued irritants in the air, but a few cases come from genetic inheritance from family members who have a deficiency in a lung protein, as the ALA notes here,

In addition, it is estimated that 100,000 Americans living today were born with a deficiency of a "lung protector" protein known as alpha 1-antitrypsin (AAT). Another 25 million Americans carry a single deficient gene that could be passed on to their children. In the absence of AAT, an inherited form of emphysema called alpha 1-antitrypsin deficiency related emphysema is almost inevitable. Symptoms of AAT deficiency emphysema usually begin between 32 and 41 years of age. Smoking significantly increases the severity of emphysema in AAT-deficient individuals ("Emphysema," 2004).

The physician will complete a chest examination and listen to the lungs to determine how over-inflated the lungs are, and how the air flows through the lungs. The physician may order one of a number of tests, including x-rays or a CAT scan, to determine the condition of the lungs and how much of the lungs are affected by the disease.

There are several other tests the physician may use, too, including: a spirometry test, which measures the amount of air a patient can force out in one second and the total amount of air they can exhale, which is one of the best ways to establish the amount of airways obstruction. An arterial blood gas (ABG) test, which analyzes blood from an artery for amounts of carbon dioxide and oxygen. Often, physicians use this test to find more advanced stages of emphysema and to decide whether or not a patient needs extra oxygen. Finally, a pulse oximetry test may be used to indirectly measure the amount of oxygen in the blood (Lewis, 1999, p. 9). All of these tests will confirm emphysema in the patient and give the physician an idea of the best way to treat the disease.

What are the treatment options for emphysema? First, if the patient smokes, their first action should be to quit smoking. There are also several treatment options, including bronchodilator medicines that help relax muscles around the airways in the lungs, anti-inflammatories (corticosteroids), which can help to soothe and heal air passageways, oxygen therapy, which adds additional oxygen to the blood and can prolong the life of long-term suffers. Doctor may also prescribe antibiotics and/or steroids during times of acute suffering or other infections. Doctors may also prescribe drugs to help reduce or break down the mucus in the lungs. Exercise is also a key to managing the disease, and most physicians will prescribe breathing exercises in addition to exercise. There are also two surgical treatments that can be used in some acute cases. Lung reduction surgery removes or blocks off the affected portion of the lung, making the lung smaller but more functional, and it can help those who need oxygen for their disease. Lung transplants can also be done in extreme cases, but it is very rare because of the risks involved with transplant surgery ("Emphysema," 2004) and (Lewis, 1999, p. 9). While there are many treatment options for emphysema that can help control the disease, there is no cure for emphysema, and it continues to progress as the patient ages.