Emphysema

[Winojim]

Hi there, I just found out through my sister that my father has just been diagnosed with emphysema at 65. Nowhere on the net have I been able to find information on life expectancy. I realize that it varies from case to case coupled with proper treatment and exercise but... Is there an average out there? He is bull headed and before I discuss this with him I would like to be armed with as much info as possible so that I can at least get him to treat this seriously and to finally quit smoking! Any info would be greatly appreciated.

Thanks,

Jim

[lisalane]

Just a quickie Andy, Thanks for taking the time to provide an excellent explanation of E.

My father is just 60 (god that sounds so old but is not as i am knocking on 40 now with heavy chest syndrome).

I know I have the big E coming as I coff when I laff etc and feel like someone is tanding on my chest but i never realised that my dad (who is continously breathing in and out) is doing so because his elasticity has gone.

Now i can try this for an hour and maybe THAT will get me off the fags.. which I know is phsycological anyway!

Cheers Andy.. you are making a big difference here x

[weelamb]

Hi everyone, I'm new so forgive me if I have done this wrong, I'm from Scotland in the UK so be nice to me.
In relation to the above question, I too have the same question about life expectancy. I have just returned from hospital again to see my chronically ill precious uncle. He was there 6 weeks ago due to a severe chest infection, and also 8 weeks before that. He had been diagnosed with emphysema 5 or 6 years ago, he also has asthma. He is in a dreadful state he looks emaciated, withdrawn, pale skinned and as breathless as a person could be. He can't manage to walk more than 5 steps before he stops to rest. He has been on anti-biotics for weeks at a time for recurring chest infections. He has been like this for approx 18 months and he is 61 years old. He was a heavy smoker for years and is now down to approx 4 a day which he cannot give up but is always trying. The doctors will not give him oxygen at home as he is still smoking. Can anyone tell me how long he has left as he cannot take much more of feeling and looking like he does. He is a typical scotsman so is very proud. Hope you can help. Thanks

[National Jewish]

As you have stated life expectancy with emphysema varies from case to case.  There is no average.  However there are 3 things that shorten life expectancy.  A forced expiratory volume in the first second (FEV1) of exhaling that is less than 1 liter per minute.  This is the amount of air that a person can forcefully blow out in the first second of exhaling, which is measured as part of a simple breathing test called spirometry.  Severe bouts with emphysema that occur frequently can shorten life expectancy.  Smoking causes emphysema to progress 3 times faster.  This means the FEV1 drops 3 times faster in smokers than in non-smokers.  So the most important thing that your father can do to help himself is to quit smoking.  It is not possible to say that this will stop the emphysema from effecting more of his lung, but it will slow down the rate of progression.

You may want to look at our Quit Smoking Topic Center at http://www.nationaljewish.org/topic/smoking_cessation.html for ways to help your father to quit smoking.  Also check with your father

[starion]

Your simple explanation summed up the basic points of emphysema very nicely!  Good job!
Aloha,
Starion

[AndyRRT]

Emphysema is in a catagory of diseases otherwise known as Chronic Obstructive Pulmonary Disease (COPD) Emephysema is more of a pin pointed type of COPD your dad has.

Its very hard to blurt out a life expectancy with someone who has Emphysema. Some people get it at a relatively young age, and some get it later in life. What I may suggest is determining the stage of the emphysema.

I'll try and explain to you what Emphysema is in understandable terms, rather than copy/pasting definitions and instructions like the majority of the posts here. So please bear with me.

Emphysema is a complicated and destructive disease of the lung of the lung. Several things happen. as I will list and explain below.

1. Lung lose compliance.
What this means is, the natural ELASTIC properties of the lung are lost. In normal lungs, the tissue have the tendancy to carry on elastic properties. When the lungs inflate, they will passively deflate by "snapping back" like a rubber bad. This is because of a chemical called "Elastin. Ephesmatic patients are deficiant in Elastin. In this scenario, when the lungs inflate during respiration, they do not passively deflate on their own. They kind of fizzle down. In turn, this is extra work for the patient to breath. (With normal lung, it only takes exertion to inhale. Exhalation is passive and takes NO energy) Emphesmatic patients exert themselve during inhalation AND exhalation. They need to work during exhalsation by forcfully pushing the air out. This is strenuous as you can imagine.

2. Tissue break down.
Gas diffusion occurs at the smallest level of the lungs called the Alveoli. They are microscopic sacs only one cell thick. They are clustered tightly together kind of like grapes you see at the market. Cigarette smoke destroys these sacs. The cell walls break down and the sacs can sometimes conjoin into each other making bigger and bigger sacs. Sometimes these sacs get very big and even seal off any airflow during breathing. This is called a bulli. Its a sac full of air that isn't "ventilating. Because if this, the lungs have just lost valuable realistate for oxygenation and ventilation. Thus, the patient has to work harder and breath faster with the remaining lung tissue that is working. A better concept to grasp would be comparing SURFACE AREA. If you were flatten out a normal pair of lungs, with normal alveoli with a rolling pin down to 1 cell thick, it would be measure to the size of a football field. If you tool emphysmatic lungs and fletted them out, it would be the size of a tennis court. Get it?

3. Bronchosmasm.
COPD patients have reactive airways. This means the muscles lining the bronchial tubes crunch down tight much like that of an asthmatic. But this is VERY chrinic. As in, on a daily basis, day and night. BEcause of this, inflamation of the airways play a big role on the narrowed airways. Those inhalters you may see asthmatics take sometimes dont work. Hence, the use of steroids to decrease the inflamatory responce of such exacerbations.

4. Hypoxia.
This basically means lack of oxygen. Because of all the above disorders, there is less oxygen in the body. Thus, less energy to expend. Think of you body a big gas tank. Today, your gas tank is full with your normal breathing. When you run up and down the stair, you drain some of your gas, but it is easily refilled by breathing faster. In a COPD patient, their gastank is always filled 1/2 way. And if they run up and down the stairs, it will QUICKLY be empty and take a MUCH-MUCH longer time to refill their gas tank.

This is just some of the basic-basic stuff with COPD patients who have Emphysema. It can get very complicated. And yes, each case is different. And life expectancy varies depending on each case. Most importantly, your dad needs to STOP SMOKING and begin a light excercise regimine. I'm sure his physician will fill him on such programs. Goodluck, and I hope this little bit of info helped!


Andy, RRT, CPFT

[AndyRRT]

My appologies for not proof reading my post. There are many spelling errors. Hope you can make out the rambling!

-Andy

[starion]

Hi!  Sorry to hear about your dad's diagnosis.  As you stated, so much about emphysema does depend on the individual patient.  If a patient has mild emphysema, quits smoking, and avoids all lung irritants, the person GREATLY slows the progression of emphysema and may well live a full and active life, dying of other causes.
One thing IS certain about emphysema; continuing to smoke is the BEST way to speed progression & shorten your breath and life.  Quitting smoking is THE BEST thing anyone with ANY lung condition can do for their health.
You can great info about emphysema by going to www.NationalJewish.org, particularly their MedFacts and Understanding series.  You can also get great free info sent to you from your local branch of the American Lung Association.
Best of luck!
Aloha,
Starion