Worsening of emphysema

[Debser]

My question relates to my being diagnosed with emphysema last year, not a smoker for 7 years, I am only 43, but I lived near the WTC around and after 9/11. If emphysema is caused by environmentall factors, does it get worse or just sort of stay the same if the environmental cause is removed. Also, more recently I was diagnosed with chronic sinusitis and GERD. Do the new conditions make emphysema worse? I know they can cause exacerbations but I am interested in knowing if it affects the progression of the disease. Also, can you recover from an exacerbation or does the lung loss of function become permanent at that point? I have small children and am worried about the future. So far its O.K. I take Advair and Spiriva, albuteral if I need it, and if I never get any worse its manageable. I work out now, 3 times a week. I know no one can predict the future but I want to have a handle on what to expect. Thank-you for your time

[National Jewish]

Tobacco smoke is the most common cause of emphysema.  Environmental exposures, in certain instances, can also contribute to this.  Once the exposure is eliminated, the ongoing destruction usually subsides, but there is no new regeneration of lung tissue or reversal of loss of airways.  Chronic sinusitis and GERD can play a role in exacerbations, but unless followed by a severe destructive infection in the lungs, do not usually add to the progression of the disease.  The same is the case with exacerbations.  The response to all of these questions, of course, is individual in nature.  That means, if you have significant disease, when you have further exposure or an exacerbation, you are more likely to have more damage.  As far as what to expect, you are doing the right things: eliminating exposure, taking medications and are under the care of someone who knows how to treat COPD.