What is Emphysema?

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What is Emphysema?



Emphysema is a long-lasting and continuously advancing ailment affecting the lungs particularly the lower respiratory tract. The physical structure and the functionality of the lungs are damaged as the very tissues supporting it are destructed leading to breathlessness or wheezing. The exhalation becomes difficult as the tissues surrounding the alveoli is damaged and are not capable of holding their shape. This panting condition gets poorer as time progresses and can be fatal as well. This condition falls under the category of diseases called chronic obstructive pulmonary disease (COPD).






Hollow bag like structures, alveoli are responsible for the absorption of oxygen into the blood. In normal healthy lungs, upon inhalation the air is passed through upper respiratory tract and then within the alveoli and the bronchioles. It has been found that if the lungs of a person have been subjected to irritants and smoke for long, then the pliability of the alveoli and bronchioles is reduced considerably. This potentially hampers normal breathing and inhalation of oxygen due to the destruction of the alveoli walls.






The prime cause of emphysema is smoking. Prolonged exposure to irritants as found in polluted air, chemical exhausts and dust are other reasons as well. Long term passive smoking and heredity are also two of the reasons of development of this condition. Though the chances of acquiring it due to heredity are rare, but it can if a baby is born without a particular protein supposed to protect the lungs. The protein is alpha 1-antitrypsin and its absence is called AAT deficiency related emphysema. If a person already has AAT deficiency and is an active smoker, then his/her condition can be aggravated. The ailment majorly affects middle aged or senior people. Nonetheless it can affect young as well. Complications can lead to additional symptoms apart from breathlessness.






Emphysema Stages and Life Expectancy


The prognosis of emphysema is done by a unique staging process inclusive of pulmonary function testing (PFTs). Here the patient is made to blow air through a tube in order to measure the airflow. Due to emphysema, air is trapped inside his lungs and it will be difficult for him to blow air out of lungs forcefully. Based on the staging test, it can be classified into four stages of mild (stage 1), moderate (stage 2), severe (stage 3) and very severe (stage 4). These stages are referred as GOLD (global initiative for chronic obstructive lung disease) criteria.






For determining the life expectancy with emphysema, spirometry is done. This is actually the measure of the percentage of air which is exhaled in a second. This is termed as forced expiratory volume over one second or FEV1. Almost 80% of mild or stage I emphysema patients have a mild emphysema life expectancy of more than 4 years. If an adult is perfectly healthy, then the reading of the spirometer is betwixt 80 to 100 percent. A person who has emphysema and who’s reading on the spirometer is below 35 percent; then the prognosis of the disease depicts the last period of emphysema and the Stage IV emphysema life expectancy or in other words the end stage emphysema life expectancy is about four years. Only 50% of people with severe emphysema survive beyond four years. However, if the stage 4 emphysema is left undiagnosed then the life expectancy is reduced to 2 to 3 years. In the final stage suffers from extreme difficulty in breathing, absence of activity tolerance along with consistent coughing with discharge of phlegm.






Stage II is called the moderate emphysema in which the FEV1 is below 80 percent but at least more than or equivalent to 50 percent of the normal. About 60-70% of people with the stage II have a moderate emphysema life expectancy of more than four years.






The meaning of the word “bulla” is anomalous growth of the skin which is filled with fluid. In bullous emphysema, the size of the alveoli is increased due to irregular spaces filed with air. The air sacs get enlarged thereby restricting the amount of oxygen into the bloodstream. These enlarged and stretched alveoli gets ruptured in due course and immediate surgery is required. The bullous emphysema life expectancy increases up to after a surgery.

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I tend to disagree with the life expectancy.  I think there are so many variables that can prolong life.  A good diet and exercise program, good circulation, good breathing techniques, weight, age.  There are just so many factors.  2 years ago... the above would have scared me to death.  I spent the first 6 months waiting for something dreadful to happen to me.  I finally figured out that I had better get on with life instead of waiting to die.

Just from last year (looking back in this blog) I can see many changes with me.  For one... I am more serious about my weight loss and exercise, but in some areas I can tell I am declining.  My lung pain is probably at least 30% worse than this time last year.  I am quicker to have anxiety attacks when my breathing worsens.  I am having issues with my heart, or I should say my pulse rate.  My eye sight is nearly twice as bad as this time last year.  I think that is due to the inhaled steroids I use daily.  I need more sleep in a 24 hour period to feel like I can thrive during the day.  I am sleeping most days 10 to 12 hours.  I have never done that in my life. 
I am having more issues with air quality and harsh odors inside the house too.  Even bacon cooking can make me run to a different room. 

I intend on fighting this every step of the way.  I won't give up and I won't just lay down and wait to die.  There is too much life to live, and too many people I want to spend more time with.