Introduction: Emphysema is a condition of the lungs that involves the over-inflation of the air sacs, otherwise known as the alveoli. Normal functioning of the alveoli helps breathing in normal respiration. Unlike other lung diseases this one can be inherited. This is a disease that can affect people of all ages and genders. In 1994, the number of males with emphysema outnumbered the females by fifty four percent. However, in the two years that followed the difference between males and females decreased by ten percent. Classification: Emphysema is a lung disease that is classified as a COPD. (Chronic obstructive pulmonary disease) Natural History (Symptoms): A person may notice various signs that will lead them to believe they may have emphysema. The most common symptom that people begin to feel is shortness of breath. Usually, this begins while exercising or taking part in some sort of physical activity. Eventually, they will even begin to feel like they are not getting enough oxygen even when they are just sitting and relaxing. Some other symptoms that could be related are chronic coughing which could worsen in the morning upon waking up, wheezing, and chronic mucus production, which may result in a constant need to clear the throat. Some may notice that they feel fatigued very easily as well. There can also be many health complications that may occur which include recurrent respiratory tract infections and respiratory failure. This is caused by the lung's loss of ability to function properly. There are many physical changes that may occur as well, leading some to believe they may have emphysema. The most common physical change may be in their chest, which takes on a barrel-like appearance. This will happen so that the lungs can make up for the actual dysfunction by expanding. Others may notice a bluish discoloration of the lips and nail beds caused by lack of oxygen in the blood. Swelling and increased fluid in the lungs may also be a sign to look for. A steady tracking of the symptoms and health history of the person should be taken into consideration as well. Prevalence and/or Incidence: Emphysema is a fairly common disease, with two out of one thousand people reporting cases. Currently, there are 1.8 million Americans in the United States that have emphysema. Emphysema is ranked 15th among chronic conditions or diseases which limit people's daily activity. A study by the American Lung Association shows that 44 percent of people with emphysema have reported that their daily activities have been greatly limited due to the disease. Ethnical Distribution: Emphysema can be contracted by people of all walks of life and does not favor any particular ethnic groups. The contraction of emphysema mainly depends on life style. Geographical Distribution: Emphysema is a disease that in not only caused by the way you live, but can be contracted through the area in which a person lives. For example, people who live in urban areas are at higher risk. This is due to the fact that these areas are more highly populated with factories and cluttered with automobiles. These factories produce a great deal of smoke which can be very harmful to the lungs of the people who inhale it. The automobile exhaust has the same affect on the lungs if inhaled for long periods of time. Time of Study: In 1994 the study on males and females and their percentage difference was performed and then in 1996 the study was updated. Risk Factors or Causes: Scientific research shows that the normal lung system has a strong balance between two classes of chemicals, which strongly oppose each other. Also included in the lungs are many elastic fibers, which are necessary for the lung to expand and contract. The chemical balance in a normal lung can be altered which will result in destruction of these elastic fibers. Exhaling becomes difficult because the elastic fibers are damaged which in turn harms the lung. According to the American Lung Association, this is what happens when someone is suffering from emphysema. The reasons why this chemical balance might occur are numerous. The majority of emphysema cases are related to smoking, specifically eighty two percent. Emphysema occurs as a gradual process that is due not only to cigarette smoke, but great exposure to other types of polluted air as well. Often times, irritating fumes and dust can be responsible for the disease. Most people are exposed to these toxic fumes through their work environment or if they spend a lot of time partaking in outside activities. Inherited defects also make a small contribution to the great number of emphysema cases. These defects can be caused an inherited lack of a protective protein called alpha 1-antitrysin. If this occurs, it can lead to a rare form of emphysema called alpha 1-antitrypsin deficiency-related emphysema. Prevention Factors and Behaviors: "My last birthday was sad for me. I made a wish and tried to blow out the candles but I could not do it. Emphysema has taken away my ability to hope that a dream might come true." Sharon Adkins says this in a letter about how cigarettes have affected her life. Sharon is just one out of the 16-30 million Americans afflicted with emphysema. There is hope for people like Sharon. It is a treatable disease, but unfortunately not curable. The single most important factor for maintaining healthy lungs is to stop smoking. Pulmonary function tests (PFT's) are various tests used to determine several characteristics and capabilities of your lungs. Your tests results are compared to values considered healthy for your age, height, weight, gender, and race. These tests will determine the amount of air your lungs can hold, how quickly you move the air in and out, and how well your lungs can transfer oxygen from the air into your blood. Control: Emphysema cannot be controlled when it comes to genetics and inheriting alpha- 1 antitrypsin. However, a person can control their own actions and the place where they live. For example, a person who smokes needs to stop immediately and if they live in an urban area they can move to a more rural area where the risk factors are not so great. Treatment: Bronchodilators are also used in treating patients with emphysema. This class of medication is most commonly used in an inhaled form. This can be either as a small canister that sprays a fine mist when pushed (known as an metered dose inhaler or MDI), or in a liquid form made into a mist to breathe by a machine at home. There are short and long-acting forms of both the inhaled and pill forms. Theophylline is a type of medication that can have multiple effects on your body's ability to breathe better. It can cause your airways to relax and open further, thereby making it easier to breathe. It can also improve the diaphragm's ability to contract. Also, theophylline can increase the clearance of mucus from your airways and help you clear excessive phlegm. However, there are side effects such as feeling nervous or tremors which is why your doctor may need to check the level. Metered dose inhalers or hand held inhalers are a convenient, effective, and safe way to deliver medications to the lungs. Because they are delivered locally and directly to the lungs, smaller doses of medication can be used. The beneficial effects of the medication can occur while the side effects are minimized. If the inhalers are not used correctly, the medication will not get to the right place. For carefully selected patients a special type of lung surgery may offer improvement in lung function. This surgery removes damaged areas of the lung so that any remaining normal lung can function better. While early data suggest there is benefit in a select group of patients, it is still a major surgical procedure and should not be taken lightly. Prospective patients need to undergo very careful testing prior to consideration for this type of surgery. While lung transplantation is currently being performed for some patients this is a highly complex and dangerous procedure. There are strict criteria for lung transplant recipients and there is a long waiting list. For reasons such as this and that of possible complications this is an option only in a small select group of patients. Surgery and lung transplants are the worse alternatives. Some basic tips to decrease the risk are avoiding exposure to tobacco smoke and other pollutants. Also, exercise and proper nutrition helps decrease one's risk for emphysema. Avoiding fatty foods or with high cholesterol is highly recommended. All these are important factors to help decrease your risk, but the single most important factor to reduce emphysema, lung cancer, bronchitis, COPD and other diseases is to stop smoking. Smoking limits your ability to perform in activities such as running, swimming, playing basketball, or even walking around the mall. Just think twice before you light that next cigarette. Is it worth it right now? Critique: Emphysema is a topic which is very easily accessible. We enjoyed researching this topic because it allowed use to educate ourselves on emphysema and made us more aware of the kind of lifestyle we would need to live in order to live a longer and happier life.
Bibliography
References: Adams, F. (1998). The Breathing Disorders Sourcebook.Lincolnwood, IL, Lowell House. Berland, T. (1972). Living With Your Chronic Bronchitis and Emphysema. NY, Saint Martin's Press. Haas, F. (1990). The Chronic Bronchitis and Emphysema Handbook. NY, John Wiley and Sons. Shayevitz, M. (1985). Living Well With Emphysema and Bronchitis. NY, DoubleDay & Company. American Lung Association (2001). Emphysema facts. http://www.lungusa.org/diseases/lungemphysema.html. -Yahoo Health (2001). Emphysema. http://health.yahoo.com/health/Diseases_and_Conditions/Disease_Feed_/Data/Emphysema/
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