"little bit of emphysema?!"

[Summersunny]

My very healthy, active, youthful 45-year old husband went in for a general check. Upon examining his chest X-ray, his PCP stated in a non-chalant manner that he had a "bit of emphysema" due to the diaphram depression. Is a chest x-ray conclusive? Could he have just been taking too big of a breath during X-ray? My husband has not smoked in 13 years and was never a heavy smoker, yet his father died of emphysema at a 72. We have been distraught since this "diagnosis" and my husband, though not even short of breath, is convinced he at MOST has 18 years to live. He fears in a few short years he will be unable to work physically. He thinks he wants to pursue pulmonary testing but is afraid to hear more bad news. Are we over-reacting? What life expectancy should we anticipate?

[National Jewish Health]

I am sure there is a lot of anxiety with this finding.  It is not often that a diagnosis of emphysema is made based on a single chest x-ray without getting pulmonary function tests (PFTs) and a history.  If there is concern, getting PFTs is a simple and non-invasive next step to better understanding this radiologic finding.  It is important to get this information to better understand if there is a problem or not.  If there is a problem, then there are medical ways to deal with this problem and it is best to see a pulmonologist.  Not everyone who smokes gets emphysema.  Unfortunately, there are some with a genetic predisposition who get emphysema who may never have smoked.  The best next step is to get PFTs.

[Debser]

I would guess that if your husband has no symptoms he has no emphysema.
A pulmonary function test should confirm the diagnosos.

[poofey]

Your husband needs to live life to it's fullest and not worry about life expectancy.  If he has a little bit of emphysema then he definitely needs to stop smoking and being around second-hand smoke so his little bit doesn't get to alot.  My physician has me on spiriva for my moderate-severe emphysema.  Whenever I was diagnosed almost two years ago, I asked the life expectancy question and was told as long as I follow those guidelines I would definitely have 15-20 more years or longer to live.  I am currently in a pulmonary exercise program 3 days per week that helps build my uppper body, hear and lungs so that I can breathe without straining my lungs.  None of us know when we are going to die.  We could be killed tomorrow in a car accident, heart attack or whatever.  I know as my youngest daughter did die two years ago today in a car accident and she was only 22.  X-rays are not conclusive.  It could have been an infection or something that reflected on the x-rays.  I definitely would request further pulmonary function tests.  It is not how long we live that makes a difference.  It is what we do with our life while we are here on earth.  Have a great life and smile today because he woke up beside you today.  Today is important not tomorrow.

[hardware2]

I had a CT scan that showed some emphysema and followed that up with PFT's. Those showed mild to moderate obstruction - even though I never noticed any shortness of breath - I exercise 4-5 nights a week for 20-30 minutes on an elliptical or jog 2-1/2 miles outside in the summer. When jogging and really breathing hard, it IS obvious that my lungs aren't like they were 33 years ago when I was running cross-country in high-school (I'm 51 and was a heavy smoker until 4-1/2 years ago - haven't had a drag since the day I quit). Wait to hear what the doc/nurse says here when he or she replies. I'd guess they'll recommend PFT's as well as getting tested for the alpha 1 deficiency since your husband hasn't smoked since he was 32. I've read where some folks think its a combination of factors that permit/cause the development of emphysema. Since my grandpa smoked like a chimney and lived to be 85, I think I got it from a combination of smoking AND a case of LPR/EER reflux aspirating stuff into my lungs while I slept. I used to drink about six beers a night and eat a big meal just before going to bed. Plus, to really top things off - I always slept on my stomach. Not a good combination. In addition to quitting or staying quit on the ciggies, make sure your husband doesn't have something like reflux that could cause further injury to his lungs - that's a tip I don't see recommended enough by doctors - even super pros like those here.