emphysema..:)

okay, as the true purpose of this blog existence was to share about my searching in medical field..

today we got emphysema...:)

introduction to emphysema..

Emphysema is a long-term, progressive disease of the lungs that primarily causes shortness of breath due to over-inflation of the alveoli (air sacs in the lung). In people with emphysema, the lung tissue involved in exchange of gases (oxygen and carbon dioxide) is impaired or destroyed. Emphysema is included in a group of diseases called chronic obstructive pulmonary disease or COPD (pulmonary refers to the lungs). Emphysema is called an obstructive lung disease because airflow on exhalation is slowed or stopped because over-inflated alveoli do not exchange gases when a person breaths due to little or no movement of gases out of the alveoli.

what cause it?? huh, pls, tell ur friend and ur family to avoid doing this..

Cigarette smoking is by far the most dangerous behavior that causes people to develop emphysema, and it is also the most preventable cause. Other risk factors include a deficiency of an enzyme called alpha-1-antitrypsin, air pollution, airway reactivity, heredity, male sex, and age.

when to seek medical care?

If you have new or worsening shortness of breath, seek medical attention from your doctor. Shortness of breath can occur with other diseases, particularly heart disease and other lung diseases, so it is important not to overlook or minimize this symptom. A gradual decrease in the ability to exercise or perform daily activities, a persistent cough, and wheezing also suggest a visit to the doctors.

exam and tests you must undergo??

• A chest X-ray helps the doctor to identify changes in your lung that may indicate emphysema. The X-ray also may show the presence of an infection or a mass in the lung (such as a tumor) that could explain your symptoms. Shortness of breath has many causes. The chest X-ray is considered by most doctors to be the quickest and easiest test to begin to separate the different possible causes and formulate a diagnosis.

• Lung function tests can give the doctor specific information about how the lungs work mechanically. These tests involve having you breathe into a tube that is connected to a computer or some other monitoring device, which can record the necessary information. The tests measure how much air your lungs can hold, how quickly your lungs can expel air during expiration, and how much reserve capacity your lungs have for increased demand, such as during exercise.

• If you have a family history of alpha-1-antitrypsin deficiency, the doctor may wish to send a blood test to evaluate for this genetic disease.

• Blood tests may also be used to check your white blood cell count, which can sometimes indicate an acute infection. This information can be used with the chest X-ray to evaluate for pneumonia, bronchitis, or other respiratory infections that can make emphysema worse.

• Another blood test that may be helpful, especially in the hospital setting, is called the arterial blood gas. This test helps doctors determine how much oxygen and carbon dioxide are in your blood.

medication that the doctors will give to you?

• Bronchodilating medications: These medications, which cause the air passages to open more fully and allow better air exchange, are usually the first medications that a doctor will prescribe for emphysema. In very mild cases, bronchodilators may be used only as needed, for episodes of shortness of breath.
  
  
  • The most common bronchodilator for mild cases of emphysema is albuterol (Proventil or Ventolin). It acts quickly, and 1 dose usually provides relief for 4-6 hours. Albuterol is most commonly available as a metered-dose inhaler or MDI, and this is the form that is used most often for patients with mild emphysema, with intermittent shortness of breath. When used for this purpose, some people refer to their albuterol inhaler as a "rescue" medication. It acts to rescue them from a more serious attack of shortness of breath.
  • If you have some degree of shortness of breath at rest, a doctor may prescribe the albuterol to be given at regularly scheduled intervals, either through the MDI, or by nebulization. Nebulization involves breathing in liquid medication that has been vaporized by a continuous flow of air (in much the same way a whole-room vaporizer causes liquid droplets to enter the air by the flow of air through water). Nebulized albuterol may be prescribed once scheduled doses via inhaler are no longer adequate to alleviate shortness of breath.
  • Ipratropium bromide (Atrovent) is another bronchodilating medication that is used for relatively mild emphysema. Similar to albuterol, it is available in both an inhaler and as a liquid for nebulization. Unlike albuterol, however, ipratropium bromide is usually given in scheduled intervals. Therefore, it is not usually prescribed for "rescue" purposes. Atrovent lasts longer than albuterol, however, and often provides greater relief. Tiotropium (Spiriva) is a long acting form of ipratropium. This once a day medicine has shown to result in a fewer hospitalizations and possible increased survival in some patients with COPD.
  • Methylxanthines (Theophylline) and other bronchodilating medications are available that have varying properties that may make them useful in certain cases. Theophylline (Theo-Dur, Uniphyl) is a medication given orally (tablets). It can have a sustained effect on keeping air passageways open. Theophylline levels must be monitored by blood tests. This medicine is used less frequently today due to its narrow therapeutic window. Too much theophylline can produce an overdose; too little, and there will not be enough relief of shortness of breath. In addition, other drugs can interact with theophylline, altering the blood level without warning. For this reason, doctors now prescribe theophylline after very carefully considering its potential for other drug interactions. If you take theophylline, take the medication as prescribed and check with your doctor before starting any new medication. Some new studies are suggesting that very low dose theophylline may have anti-inflammatory properties as well. Theophylline used to be widely prescribed; currently it is prescribed infrequently and usually only in special circumstances because of its narrow range of effectiveness, necessity of blood level monitoring and its interactions with other drugs.
• Steroid medications: They decrease inflammation in the body. They are used for this effect in the lung and elsewhere and have been shown to be of some benefit in emphysema. However, not all people will respond to steroid therapy. Steroids may either be given orally or inhaled through an MDI or another form of inhaler.
• Antibiotics: These medications are often prescribed for people with emphysema who have increased shortness of breath. Even when the chest x-ray does not show pneumonia or evidence of infection, people treated withantibiotics tend to have shorter episodes of shortness of breath. It is suspected that infection may play a role in an acute bout of emphysema, even before the infection worsens into a pneumonia or acute bronchitis.
  
  
  • Data now suggests that when patients with COPD have a sudden worsening of their symptoms of cough and shortness of breath (also termed an exacerbation), brief and immediate use of steroids and antibiotics can reduce hospitalizations.
• Oxygen: If you have shortness of breath and go to a hospital's emergency department, you often are given oxygen. It may even be necessary to give oxygen by placing a tube in your windpipe and allowing a machine to assist your breathing (also termed tracheal intubation). In some cases, it may be necessary for you to receive oxygen at home as well. There are home-based oxygen tanks available and portable units that enable you to be mobile and engage in normal day-to-day activities.

you may also undergo surgery;) dont worry, it safe! 

Surgical options are available to some people with advanced emphysema.

• Lung Volume Reduction surgery (LVRS): Although it may not make sense that reducing the size of the lung could help the shortness of breath from emphysema, it is important to remember that emphysema causes an abnormal expansion of the chest wall, which decreases the efficiency of breathing. This surgery is only effective if both upper lobes of the lungs are involved. Removal of this involved lung allows for better expansion of the lower portion of lungs. In a select group of emphysema patients this can improve quality of life for a period of years. Newer studies are underway using one way valves placed in the airways to simulate this volume reduction. The effectiveness of this less invasive procedure is undergoing study at this time.
• Lung transplant: For people with the most advanced disease, transplantation of either one or both lungs can produce a near-cure. Transplantation brings with it another set of risks and benefits. People who undergo transplantation, however, will have to take medication to prevent the rejection of the transplant by the body. Also, not everyone qualifies for transplantation, and those who do are limited by the short supply of available organs.

remember!! to follow ups..to make sure it's not happen again..:)

If you have emphysema, follow-up care is crucial to managing this disease. You need to become a partner with your doctor in the management of your health.

As Benjamin Franklin wrote, "An ounce of prevention is worth a pound of cure." Realistically, the "cures" or treatments available to doctors and people dealing with emphysema are far more difficult and far less effective than preventing the progression of the disease in the first place.

some prevention you can do to avoid the disease..

The prevention of emphysema is closely linked to the prevention of smoking. The primary risk factor for this disease that you can control is the smoking of cigarettes. Those who are daily smokers put themselves and their health at increasing risk with every pack of cigarettes and with every year they continue to smoke. For individuals that have emphysema caused by other causes such as air pollution, avoiding the pollution is the best first step toward prevention.

Flare-ups of emphysema can be reduced or prevented by taking medications as prescribed and seeking medical care for any signs or symptoms of respiratory infection or shortness of breath. Also, if you have emphysema, you should keep current on vaccines that can prevent respiratory infection. It is important to obtain the pneumococcal vaccine every 5 years and the influenza virus vaccine every year, before flu season.

:) hope you get some benefits from this! see ya!

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