Emphysema: You Really Don’t Want to Have It
Smoking and emphysema have long been known to be closely related. If you’re a heavy smoker, you probably already know that there’s a very good possibility that emphysema is in the cards. But emphysema doesn’t really sound that bad, right? Certainly not as bad as lung cancer.

That’s where you’re wrong. Emphysema is a progressive disease, which means it worsens, grows, or spreads during its course, until organ failure or death occurs. It’s considered a sub-type or precursor to chronic obstructive pulmonary disease or COPD, which is the third leading cause of death in the US.

Emphysema primarily affects your capillary blood vessels, systematically destroying them. This greatly limits the capacity of air and blood to mix, reducing the exchange of oxygen and carbon dioxide in your body. As a result, you find it harder and harder to breath.

Symptoms of emphysema include shortness of breath, pain or tightness in the chest, wheezing, and coughing. These symptoms usually arise during exercise or other activities that require considerable physical exertion. As emphysema progresses, a smoker can experience these symptoms when he or she is not exerting any physical effort at all. Some smokers say that they experience these symptoms even when lying down.

What happens in the early stages of emphysema
Like many progressive diseases, emphysema starts out small. In the disease’s early stages, you’ll just feel like it’s harder to breathe. This is because the walls of your lungs’ alveoli collapse each time you breathe out. The alveoli are air sacs or cavities that give your lungs an appearance similar to honeycomb. When emphysema affects the alveoli in your lungs, it also causes lung tissue to lose its elasticity, so it doesn’t stretch as well as it used to upon each breath you exhale. This is why it gets difficult for you to breathe.

As a result, your lungs start to form bullae, which are air sacs that don’t actually do anything except take up space in your lungs. These useless air sacs are particularly dangerous when they take over your lungs and rupture. Ruptured bullae can cause a pneumothorax, which in turns causes the collapse of the lungs.

The stages of emphysema
Since emphysema is a progressive disease, it’s important to determine the extent of its damage to the lungs so the proper treatment can be used. The Global Initiative for Chronic Obstructive Lung Disease or GOLD determines the progression of emphysema and the extent of lung damage through FEV1 measurements. FEV, or Forced Expiratory Volume, measures the volume of air you exhale after holding it in your lungs for a certain period. Lower FEV levels indicate that the lungs aren’t capable of holding as much air, which is a sign of major lung damage.

Stage 1: mild emphysema, with FEV1 levels at 80% or higher
Stage 2: moderate emphysema, with FEV1 levels between 50% and 80%
Stage 3: severe emphysema, with FEV1 levels between 30% and 50%
Stage 4: very severe emphysema, with FEV1 levels of less than 30% or FEV1 levels of less than 50%, with accompanying chronic respiratory failure

The progression of emphysema
As a progressive disease, emphysema only gets worse with time. It works on the tissues of your lungs until they’re destroyed, which, understandably, makes it harder and harder for you to breathe.
What’s worse is that the more lung tissues emphysema destroys, the lower the oxygen concentration in your blood becomes, which spreads the damage all over your body. Your body’s natural reaction to its low oxygen concentration is to make you breathe faster, but that doesn’t help much. Your skin may take on a bluish or purplish tinge, which means that you’re cyanotic. Cyanosis occurs due to low oxygen saturation in the blood.

As emphysema progresses, your cardiovascular system starts to get affected. The arteries in your lungs are now narrower or thinner, so your heart works harder to pump blood through them. When your heart works too hard for too long, your risk of heart failure increases. So emphysema doesn’t affect just your lungs, the disease also takes your heart down with it.
Treatments for emphysema
A cure for emphysema is still unavailable, but there are many medications and treatments that can make you more comfortable and improve your quality of life as the disease progresses.

Short-acting bronchodilators such as albuterol can be inhaled to open up or expand your lungs, making it easier for you to breathe. These are used to relieve the discomfort brought by acute respiratory attacks caused by emphysema. Long-acting bronchodilators such as Serevent and Spiriva are said to have longer-lasting effects and are typically used as maintenance medications. People who suffer from emphysema usually have a treatment regimen consisting of a combination of short-acting and long-acting medications.

Corticosteroid medications can also be used to reduce inflammation in the respiratory system, particularly in the airways. As emphysema worsens, patients will need supplemental oxygen; at first, the supplemental oxygen is used only at night or after physical activities. Eventually, the patient will need the additional oxygen throughout the day as well.

Quitting smoking to alleviate the effects of emphysema
Emphysema is not curable, but that doesn’t mean you should just give up once you have it. Emphysema does not directly cause death; what causes death in patients suffering from emphysema is the organ failure resulting from lack of oxygen.

You can prevent emphysema from getting worse, and one of the best ways to do that is to quit smoking. Stopping smoking will greatly improve your quality of life, as will taking medications that can ease the effects of the disease.