Lifestyle changes
If you smoke cigarettes, it's absolutely critical to quit. Should you continue to smoke, your emphysema is certain to become worse, regardless of the medical care you receive. But if you stop smoking, it will vastly improve your life and allow you to maintain your independence. Committing to this lifestyle change is admittedly very difficult for many people, but it can be done.And you don't have to go through it alone; there are various proven options to help you to kick the habit, some of which include therapy, medications and support groups (see Tobacco dependence, page 318).
It can also be very helpful to enrol in a pulmonary rehabilitation program, usually through a hospital recommended by your doctor. These program include exercise training, patient and carer education, and pyschological support. To get the best health payoff, try to incorporate the following into your lifestyle:
Seek out 'good' air. Avoid smoke-filled rooms or places with high levels of particulars in the air. And stay indoors on cold days or when air quality is poor.
Get plenty of fluids. Drink water---at least eight glasses a day--to thin mucus secretions. And moisten indoor air with a cool-mist humidifier.
Protect against infections. Steer clear of people with colds or the flu; emphysema lowers your resistance to infectious diseases, which can pose a serious threat. wash your hands frequently to reduce the risk of contracting a respiratory infection. And get vaccinated against influenza annually and pneumonia every five years.
Follow an exercise routine set up with the help of your doctor. Mild to moderate exercise improves endurance and cardiovascualr health, reduces breathelessness and boosts your sense of wellbeing.
Find out about postural drainage, a method of draining mucus by hanging your head lower than your torso. Ask your doctor or physiotherapist to teach you this technique.
OXYGEN THERAPY
You are eligible for long-term continuous oxygen therapy if your emphysema is classified as moderate, and all other reversible causes have been identified and treated. Research has shown that giving oxygen for at least 15 hours a day if your emphysema is this severe will lengthen your life.
If your emphysema is less severe but you suffer from significant shortness of breath when you exercise, or if you live a long way from a hospital or you are undergoing air travel, you might be offered intermittent oxygen therapy.
Sometimes your emphysema can mean that your oxygen levels go down overnight. In this instance you might be eligible for overnight oxygen.
TO STRENGTHEN YOUR BREATHING MUSCLES try a hand-held device called an incentive spirometer, which contains a breathing gauge that measures how forcefully you exhale. Use it for 15 minutes twice a day.
CHECK FOR AGGRAVATING FACTORS. Sleep apnoea, gastro-oesophageal reflux, alcohol and sedative use can all aggravate respiratory symptoms of emphysema.
Medications
When you stop smoking, adding drug therapy will help you breathe easier. whether the cause of your disease is cigarettes or a genetic abnormality, your doctor will prescribe bronchodilator drugs, which relax breathing muscles and expand constricted airways. Most bronchodilators are inhaled through a portable device called a metered-dose inhaler that allows the drug to enter deep into your lungs. When using an inhaler, be sure to follow the proper technique, which your doctor will explain, to ensure that you receive the maximum benefit from the medication. If you are unable to operate an inhaler--perhaps because of arthritis--you can get a nebuliser, which does all of the work for you, but is not portable.
The most commonly used bronchodilators are beta2-agonists, including salbutamol (Ventolin), orciprenanline (Alupent) and salmeterol (Servent). The new long-acting anticholinergic agent tiotropium (Spiriva) reduces breathelessness and the rate of flare-ups and improve patients' state of health, especially compared with the short-acting anticholinergic ipratropium. Some doctors prefer the drug Combivent (a combination of ipratropium with salbutamol), which provides a double-barrelled assault that may be superior to taking either type of drug alone.
If your respiratory system becomes severely inflamed, you may receive corticosteroids. These drugs, taken through inhalers, include budesonide (Pulmicort) and fluticasone (Flixotide). Newer,
About COPD
---------------------------------------------------------------------------------------------------------------------------------
Emphysema and chronic bronchitis are the two main respiratory condition referred to as chronic obstructive pulmonary disease (COPD). Both typically owe their origin to smoking cigarettes; both block air flow to your lungs and interfere with the exchange of oxygen and carbondioxide in your bloodstream; and both cause laboured, and sometimes painful, breathing.
For each condition, the goal of treatment is to optimise your physical abilities and improve your airway function enough to allow you as normal and independent a life as possible. Medications for both conditions are generally the same, and both are incurable but often controllable--if you stop smoking.
---------------------------------------------------------------------------------------------------------------------------------
nonsteroid alternatives that show promise include zafirlukast (Accolate) and singulair (Montelukast).
Emphysema increases your vulnerability to upper respiratory infections, which can pose serious risks because they can lead to bacterial infections. If you show signs of an infection, your doctor will prescribe an anitbitotic, such as amoxycillin (Amoxil, Moxacin), cefaclor (Ceclor) or doxycycline (Doryx, Vibramycin). Although antibiotics are useless against vital infections, such as colds and the flu, doctors frequently prescribe them to patients with emphysema because their risk potential is so high.
For the small percentage of patients with emphysema caused by AAT deficiency, drug treatment involves weekly or bimonthly injections of a purified form of human AAT.
Procedures
If your lung function becomes very low, supplemental oxygen can bring tremendous relief and reduce the risk of medical complications. Therapy may be continuous or noncontinuous, and oxygen units may be portable or stationary.
For patients with advancing emphysema, assistance with breathing can be necessary. The preferred option for this is noninvasive positive pressure ventilation.
In severe emphysema, surgery may be an option. Lung-volume reduction surgery removes the most diseased parts of the lung, allowing the remaining tissue and muscles to work better. Many people who undergo lung reduction are able to return to their daily activities without supplemental oxygen. Most encouraging is that, according to a 2000 report, nearly 75 percent of patients who undergo this procedure are alive after five years.
If your emphysema is very advanced, or you have inherited the disease, you could be a candidate for lung transplantation. After transplantation and for the rest of your life, you must take immunosuppressive drugs to prevent rejection of the new organ.
If you smoke cigarettes, it's absolutely critical to quit. Should you continue to smoke, your emphysema is certain to become worse, regardless of the medical care you receive. But if you stop smoking, it will vastly improve your life and allow you to maintain your independence. Committing to this lifestyle change is admittedly very difficult for many people, but it can be done.And you don't have to go through it alone; there are various proven options to help you to kick the habit, some of which include therapy, medications and support groups (see Tobacco dependence, page 318).
It can also be very helpful to enrol in a pulmonary rehabilitation program, usually through a hospital recommended by your doctor. These program include exercise training, patient and carer education, and pyschological support. To get the best health payoff, try to incorporate the following into your lifestyle:
Seek out 'good' air. Avoid smoke-filled rooms or places with high levels of particulars in the air. And stay indoors on cold days or when air quality is poor.
Get plenty of fluids. Drink water---at least eight glasses a day--to thin mucus secretions. And moisten indoor air with a cool-mist humidifier.
Protect against infections. Steer clear of people with colds or the flu; emphysema lowers your resistance to infectious diseases, which can pose a serious threat. wash your hands frequently to reduce the risk of contracting a respiratory infection. And get vaccinated against influenza annually and pneumonia every five years.
Follow an exercise routine set up with the help of your doctor. Mild to moderate exercise improves endurance and cardiovascualr health, reduces breathelessness and boosts your sense of wellbeing.
Find out about postural drainage, a method of draining mucus by hanging your head lower than your torso. Ask your doctor or physiotherapist to teach you this technique.
OXYGEN THERAPY
You are eligible for long-term continuous oxygen therapy if your emphysema is classified as moderate, and all other reversible causes have been identified and treated. Research has shown that giving oxygen for at least 15 hours a day if your emphysema is this severe will lengthen your life.
If your emphysema is less severe but you suffer from significant shortness of breath when you exercise, or if you live a long way from a hospital or you are undergoing air travel, you might be offered intermittent oxygen therapy.
Sometimes your emphysema can mean that your oxygen levels go down overnight. In this instance you might be eligible for overnight oxygen.
TO STRENGTHEN YOUR BREATHING MUSCLES try a hand-held device called an incentive spirometer, which contains a breathing gauge that measures how forcefully you exhale. Use it for 15 minutes twice a day.
CHECK FOR AGGRAVATING FACTORS. Sleep apnoea, gastro-oesophageal reflux, alcohol and sedative use can all aggravate respiratory symptoms of emphysema.
Medications
When you stop smoking, adding drug therapy will help you breathe easier. whether the cause of your disease is cigarettes or a genetic abnormality, your doctor will prescribe bronchodilator drugs, which relax breathing muscles and expand constricted airways. Most bronchodilators are inhaled through a portable device called a metered-dose inhaler that allows the drug to enter deep into your lungs. When using an inhaler, be sure to follow the proper technique, which your doctor will explain, to ensure that you receive the maximum benefit from the medication. If you are unable to operate an inhaler--perhaps because of arthritis--you can get a nebuliser, which does all of the work for you, but is not portable.
The most commonly used bronchodilators are beta2-agonists, including salbutamol (Ventolin), orciprenanline (Alupent) and salmeterol (Servent). The new long-acting anticholinergic agent tiotropium (Spiriva) reduces breathelessness and the rate of flare-ups and improve patients' state of health, especially compared with the short-acting anticholinergic ipratropium. Some doctors prefer the drug Combivent (a combination of ipratropium with salbutamol), which provides a double-barrelled assault that may be superior to taking either type of drug alone.
If your respiratory system becomes severely inflamed, you may receive corticosteroids. These drugs, taken through inhalers, include budesonide (Pulmicort) and fluticasone (Flixotide). Newer,
About COPD
---------------------------------------------------------------------------------------------------------------------------------
Emphysema and chronic bronchitis are the two main respiratory condition referred to as chronic obstructive pulmonary disease (COPD). Both typically owe their origin to smoking cigarettes; both block air flow to your lungs and interfere with the exchange of oxygen and carbondioxide in your bloodstream; and both cause laboured, and sometimes painful, breathing.
For each condition, the goal of treatment is to optimise your physical abilities and improve your airway function enough to allow you as normal and independent a life as possible. Medications for both conditions are generally the same, and both are incurable but often controllable--if you stop smoking.
---------------------------------------------------------------------------------------------------------------------------------
nonsteroid alternatives that show promise include zafirlukast (Accolate) and singulair (Montelukast).
Emphysema increases your vulnerability to upper respiratory infections, which can pose serious risks because they can lead to bacterial infections. If you show signs of an infection, your doctor will prescribe an anitbitotic, such as amoxycillin (Amoxil, Moxacin), cefaclor (Ceclor) or doxycycline (Doryx, Vibramycin). Although antibiotics are useless against vital infections, such as colds and the flu, doctors frequently prescribe them to patients with emphysema because their risk potential is so high.
For the small percentage of patients with emphysema caused by AAT deficiency, drug treatment involves weekly or bimonthly injections of a purified form of human AAT.
Procedures
If your lung function becomes very low, supplemental oxygen can bring tremendous relief and reduce the risk of medical complications. Therapy may be continuous or noncontinuous, and oxygen units may be portable or stationary.
For patients with advancing emphysema, assistance with breathing can be necessary. The preferred option for this is noninvasive positive pressure ventilation.
In severe emphysema, surgery may be an option. Lung-volume reduction surgery removes the most diseased parts of the lung, allowing the remaining tissue and muscles to work better. Many people who undergo lung reduction are able to return to their daily activities without supplemental oxygen. Most encouraging is that, according to a 2000 report, nearly 75 percent of patients who undergo this procedure are alive after five years.
If your emphysema is very advanced, or you have inherited the disease, you could be a candidate for lung transplantation. After transplantation and for the rest of your life, you must take immunosuppressive drugs to prevent rejection of the new organ.
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