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Emphysema

Seniors with Emphysema

Elderly emphysema is a chronic condition that decreases the air exchange within the lung. It is one of the two conditions that are known as Chronic Obstructive Pulmonary Disease (COPD). This condition ranks in the ten top causes of death in the US and is a major contributor to the disability roles. The other major COPD condition is asthma. Many people have both of these conditions. Frequent infections and irritation within the lung damage the air sacs where oxygen and carbon dioxide are exchanged. Oxygen gets into the sacs but the carbon dioxide has difficulty getting out, thus making it difficult to exhale and to rid the body of waste products. The body slowly begins to build a tolerance for a lower level of oxygen and higher level of carbon dioxide as all body cells are impacted by this imbalance.

Signs and symptoms

Emphysema develops so gradually that until it reaches a critical level, most people ignore the changes they are experiencing. The first symptom may be a cough that begins several years after chronic exposure to irritants such as smoke. Then shortness of breath may occur, especially during strenuous activity. The cough may soon become productive. Sometimes bronchitis is the initial diagnosis. Bronchitis reflects an irritation of the bronchial tubes that carry air in and out of the body. As they become irritated, they secrete more mucous to protect themselves. This extra mucous travels to the lungs where it is ultimately coughed out. As emphysema progresses, the symptoms increase. Coughing becomes severe. There is increased sputum production. Breathing is difficult and is often accompanied by wheezing. Activities become limited. Fainting may occur as well as vomiting and/or stress incontinence may be present. After the age of 50, the symptoms progress more rapidly. For persons who also have osteoporosis, the coughing may be severe enough to cause fractures of the ribs.

Diagnosis

A thorough medical history and physical examination starts the diagnostic process. The health care provider, while doing the physical exam can hear the difficulty of the air exchange. Tests are needed to confirm the physician's suspicions. The tests include:
  • Laboratory tests of blood, urine and sometimes sputum; arterial blood may also be taken to explore the status of the oxygen exchange
  • Lung function studies
  • X-rays

Treatment

The lungs are resilient but cannot be directly treated so the focus of the treatment plan is to relieve the symptoms. Medications include:
  • Antibiotics
  • Bronchodilators
  • Steroid therapy
Increased fluid intake is recommended to keep secretions thin. Breathing exercises with fitness training and rehabilitation also help. Oxygen may ultimately be needed.

Who is at risk?

Exposure to frequent irritation and subsequent lung damage puts people at risk for developing emphysema. This includes persons who:
  • Are exposed actively or passively ("second hand smoke") to chronic air pollution or smoke on the job
  • Are men
  • Are over 65 years of age
  • Have a history of childhood lung problems
  • Have chronic bronchial and/or lung infections
  • Smoke
  • Use alcohol

What you can do

Emphysema is a chronic illness. There is much you can do to impact on the progression of this condition. Eliminate factors that you can that are known to directly contribute to this disease. This includes:
  • Avoiding exposure to contaminants and crowds
  • Balancing nutrition
  • Exercising regularly
  • Maintaining monitoring by a health care professional
  • Managing stressful situations
  • Pacing activities
  • Reducing exposure to people with upper respiratory illnesses
  • Stopping smoking
  • Taking prescribed medications
  • Taking the flu and pneumonia vaccines
The more you work to reduce or eliminate exposure of your respiratory tract to bronchial irritants, the more likely you are to limit the impact that emphysema can have on your life.

This article was last updated on: 06/22/2010
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