emphysematous blebs

I suffered my second pnemothorax this last May and had corrective surgery.  The thorasic surgeon told me I had moderate emphysema.  However, the pulmanologist said that "it is important to distinguish between the pathalogic description of enlarged holes at the edge of your lung (called emphysematous blebs) that are common in tall thin people and the disease of emphysema".  He went on to say I had the blebs but not the disease, and that if I stayed away from irritants then it is unlikely that I will develop the clinical disease emphysema.

Is this guy being straight up with me?  Whats the difference between the clinical disease of emphysema and emphysematous blebs.  Thank you

[National Jewish Health]

The pulmonologist is being straight with you.  The "emphysematous blebs" are common in the absence of emphysema/chronic obstructive pulmonary disease (COPD).  They actually may resemble those that occur with emphysema.  The diagnosis of emphysema is most reliably made based on accurate pulmonary function tests (PFTs), not generally based on the gross appearance of the lungs except when severe.  High resolution CT (HRCT) scans can also give a semi-quantitative estimate of the degree of emphysema.

The main "irritants" to avoid are cigarette smoke, cigar smoke, marijuana smoke and irritant industrial pollutants.

You should do well.