Acute respiratory symptoms

[sid010]

Some time ago my father, who has smoked heavily for close to 60 years was diagnosed with COPD. He quit smoking five months ago when he underwent major surgery for an abdominal aneurysm. He  now is continually coughing up large amounts of mucous. It is often green or brown in colour. He is also having trouble breathing and gasps for breath as though he just finished a long run. Doctors have repeatedly x-rayed his chest and pronounced it to be clear and open. He has no fever but was given two rounds of antibiotics. The symptoms persist despite the antibiotics. I read a study awhile ago that said people such as my father who have smoked heavily for such a long time should be discouraged from quitting because of the severe respiratory symptoms that will follow. I have two questions. What could be causing these symptoms? Will resumption of smoking decrease his symptoms?

Thanks in advance.

Sid Freeman

[National Jewish]

In the healthy lung there are small hair-like projections called cilia that clean the lungs by moving mucus up and out.  Smoking paralyzes this cleaning system.  When your father quit smoking his lungs began to recover from the inflammation caused by close to 60 years of smoking abuse.  This inflammation is causing your father’s symptoms.  Constantly coughing up mucus is a good sign.  It shows that this cleaning system is working again.  When your father was smoking this mucus would just stay in his lungs.  When you quit smoking before there has been permanent damage to your lungs then you get better as the cleaning system cleans your lungs.  This may take up to a year after smoking stops.

Some people are susceptible to the harmful effects of cigarette smoke.  Your father is one of these people since COPD has effected his lungs.  His smoking had caused permanent damage to his lungs by the time he quit smoking.  Unfortunately this lung damage cannot be reversed.  However by quitting smoking the progression of the COPD will slow down.  Over time less of his lung will be effected by COPD than if he had continued to smoke.  As you read in the study, your father will have respiratory symptoms even though he has quit smoking.  This is because the damage to his lungs by COPD started before he quit smoking.  Resumption of smoking may temporarily decrease your father’s symptoms.  However in the long run smoking will worsen his COPD and increase his symptoms.  Your father has made an excellent decision to stop smoking!

The term COPD is an abbreviation for chronic obstructive pulmonary disease.  COPD is a general term used to describe the chronic lung disease linked with cigarette smoking and worsened by contact with industrial dusts and other toxins.  This is also called emphysema.  It is a disease that worsens over time.  There is a relatively irreversible decrease in airflow and permanent destruction of the airsacs in the lung.

We all have much more lung capacity than we need.  In the healthy lung the airsacs of the lung look like a bunch of grapes.  COPD causes destruction of the walls between the airsacs.  Over time these individual airsacs become one large airsac called a bullae.  When this happens there is less surface area for oxygen to get from the lungs into the blood and for carbon dioxide to get from the blood into the lungs to be exhaled.  It can take up to 50% to 80% of the lung to be damaged before symptoms start.  The most common complaint with COPD is shortness of breath.  Some people will also cough up large amounts of mucus just like your father is doing.  Green or brown mucus is often a sign of a lung infection.

[AndyRRT]

Sid,

First lets start with the easiest posrtion of your question. If your dad starts smoking again, it WILL NOT make his symptoms better. Not sure where you read that "study", its nothing but 100% bunk.

The symtpoms your dad is experiencing is what COPD is all about. BEcausze of the cigarette smoke, lung tissue has been destroyed. since there is less lung tissue to absorb oxygen, what ever he is able to take in, is used up quickly leaving him gasping for more. I like to describe to my COPD patients that their lungs are like a automobile gas tank. A person who has healthy lungs can fill up their gas tank to FULL. Someone with COPD can only fill up their gas tank to the 1/2 way mark. Their tank empties much quicker and holds less gas.

His sputum production is also characteristic of COPD. Brown, green, yellow sputum. Some is infection and some is just dirty sputum. Cigarette smoke destroys the cillia in the lungs. Cillia are microscopic hairs that wiggle along the lining of the bronchial tubes. These hairs wave back and forth moving sputum closer to the top of the lungs. When the sputum reaches a spot, we cough it out. This is called the mucocilliary escalator. COPD'ers do not have this. Sputum just sits in the linings of the bronchi. When smoke and every day pollution is inhaled, the depbris simply gets stuck in the sputum. When they finally get to cough it out, it doesnt look very pretty.

Andy, RRT, CPFT

[Bruce1]

I have a similiar problem myself. However on a smaller scale. I smoked alot for about 6 years, and quit roughly 3-4 months ago. During my last 3-6 months of smoking prior to quitting, i was coughing up brown/blackish mucus. It was a daily occurance, quite often, almost every time i smoked and would cough. After i quit smoking, the amount of dark mucus declined substantially and almost dissapeared for the past 3 months or so. However recently, the dark phlegm has returned. Not much, but maybe a bad/nasty bout of it every 2-4 days. I don't cough often at all, and when i do cough, i usually do cough up that dark mucus.(cough about 2 times per week) Sometimes the amount of dark phlegm is small, and about once a week it is substantial. Like i said, this just began again recently- and i havent started to smoke again.
    Years ago i was diagnosed with bronchitis, and was told that it might be chronic bronchitis.
I am wondering if this dark mucus i am coughing up is normal considering i just quit 3-4 months ago, and how long the dark mucus cough up will persist?
    I have seen a doctor about it, and have gotten no real answer other then that it is probably a normal function and my lungs are repairing themselves. I have also had a chest x-ray and everything was "normal".

    Just wondering about this dark mucus, and weather i should be worried and see another specialist in the near future(I saw my GP last week) BTW- I also have minor chest pain every so often, but was told that was due to my excessive coughing before i quit smoking. Altho it seems that the chest pain dissapeared and then reappeared about 2-3 weeks after the brown mucus started up again. Also, is this illness infectous? Can i pass bronchitis or COPD onto others? (I am currently not sick, but am wondering for future referance)