ASK THE DOCTOR: Smoke Signals: Emphysema is preventable
By DR JIM MITTERANDOQ - I stopped smoking in 1981 and was diagnosed with emphysema in 2001 and have been on oxygen for almost three years. Why did I get it after quitting smoking 20 years later? I worked in the coal and oil business and wonder whether this may have contributed. I currently use inhalers which are not that helpful. Do you have any advice?
A - Emphysema is a chronic, debilitating disease that has no cure and is not reversible. Quitting smoking can help prevent further damage but will not undo years of abuse. With age, you naturally lose some lung function. More symptoms show when diseased lungs cannot supply enough oxygen to the heart and muscles. If you had not quit smoking, your emphysema would be worse. In fact, much of the past damage diminished any extra lung reserve. Long-term exposure to other agents, such as coal dust may have contributed to your condition.
Many people with emphysema have oxygen concentrations in their blood around the upper 80-percent range or low-90 percent range, compared to healthy people are around 100 percent. When blood oxygen levels drop below the upper 80s, oxygen supplementation is required. One patient described emphysema as feeling as ‘‘though you are drowning. You cannot get enough air.'' Emphysema diminishes activity and quality of life.
Treatments have limited benefits. Prescription inhalers help with symptoms but do not modify the disease. Sometimes, steroid inhalers are also used, particularly if someone also has wheezing or asthma. Inhalers are very expensive and do not help everybody.
People with severe emphysema may also require treatment with oral steroids. Long-term use of steroids has side effects including, diabetes, immune system suppression and osteoporosis.
People with emphysema are more susceptible to the effects of a cold or flu illness that can sometimes lead to hospitalization or death. Flu and pneumonia vaccines are recommended to prevent these complications. Generally, surgery to remove the diseased part of the lung is dangerous and not recommended.
The disease occurs from progressive destruction of the lungs after years of exposure to tobacco smoke or other irritants. To avoid this preventable disease, smokers need to quit and children should not start.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2005 The Patriot Ledger
Transmitted Tuesday, February 01, 2005