LUNG DISEASES
COPD
Chronic
obstructive pulmonary disease (COPD) is a
blockage of air flow out of the lungs. COPD
encompasses emphysema, alpha antritrypsin
deficiency-related (AAT) emphysema, and chronic
bronchitis. Nearly 16 million Americans suffer
from COPD, which is the fourth leading cause
of death, claiming the lives of nearly 87,000
Americans annually.
Approxiamtely
80 to 90 percent of COPD cases are caused
by smoking; a smoker is 10 times more likely
than a nonsmoker to die of COPD. Other known
causes are frequent lung infections and exposure
to air pollutants.
Depending on the severity of the disease,
treatments may include bronchodilators which
open up air passages in the lungs; antibiotics;
and exercise to strengthen muscles. People
with COPD may eventually require supplemental
oxygen and may have to rely on mechanical
respiratory assistance.
Pulmonary rehabilitation is a preventative
health-care program provided by a team of
health professionals to help people cope physically,
psychologically, and socially with COPD. Through
individualizes programs focusing on self-care
therapies, education, and support groups.
Pulmonary rehabilitation can improve the quality
of life for COPD patients, and helps minimize
and control the problems that COPD may cause.
Emphysemas causes irreversible lung damage.
The walls between the air sacs within the
lungs lose their ability to stretch and recoil.
They become weakened and break. Elasticity
of the lung tissue is lost, causing air to
be trapped in the air sacs and impairing the
exchange of oxygen and carbon dioxide.
An estimated 1.9 million American have emphysema.
Of the emphysema sufferers, 55 percent are
male and 45 percent are female. While more
men suffer from the disease than women, the
condition is increasing among women. Between
1982 and 1993 the emphysema prevalence rate
in women increased 24 percent.
Symptoms are characterized by cough, shortness
of breath and an increased effort to breath.
Diagnosis is by pulmonary function tests,
along with the patients history, examination
and other tests, along with the patients history,
examination and other tests.
The quality of life for a person suffering
from emphysema diminishes as the disease progresses.
At the onset, there is minimal shortness of
breath. Eventually, there is severe shortness
of breath often leading to the total dependency
on the administration of oxygen around the
clock.
Lung transplantation among people who suffer
from emphysema is being performed in increasing
numbers, from 2 in 1985 to 688 in 1994. New
surgical procedures are currently being evaluated
and advocated for emphysema.
Alpha antitrypsin deficiency-related (AAT)
emphysema, also called "early onset emphysema,"
is caused by the inherited deficiency of a
protein called alpha 1-antitrypsin (AAT) or
alpha-protease inhibitor. AAT, produce by
the liver, is a "lung protector."
In the absence of AAT, emphysema is inevitable.
An estimated 50,000 to 100,000 American have
AAT deficiency emphysema, primarily of northern
European descent.
The onset of AAT deficiency emphysema is characterized
by shortness of breath, decreased exercise
capacity. Blood screening is used if the trait
is known to be in the family and will determine
if a person is a carrier or AAT-deficient.
If children are diagnoses as AAT-deficient
through blood screening, they may undergo
a liver transplant to prevent the onset of
AAT deficiency emphysema in their adult life.
Smoking significantly increases the risk and
severity of emphysema in AAT-deficient individuals
and may decrease their life span by as much
as 10 years.
Treatment for AAT deficiency emphysema include
AAT replacement therapy (a life-long process),
liver transplantation, or lung transplantation.
Current research is focusing on gene therapy;
clinical trials of this type of therapy may
take place within the decade.
Chronic bronchitis is an inflammation of the
lining of the bronchial tubes. An estimated
13.8 million people suffer from chronic bronchitis,
the sixth leading chronic condition in America.
Whereas emphysema is more concentrated in
the elderly, chronic bronchitis affects people
of all ages. Symptoms include chronic cough,
increased mucus, frequent clearing of the
throat and shortness of breath. It may precede
or accompany pulmonary emphysema.
To reduce and control symptoms, sufferers
must live a health lifestyle by eating well,
exercising, avoiding cigarette smoke and other
air pollutants. Treatments aimed at reducing
irritation in the bronchial tubes include
antibiotics and bronchodilators.
From the American Lung Association, 1999
ASTHMA
Asthma
is a lung disease. It can be life threatening.
Asthma is chronic. In other words, you live
with it every day. Asthma causes breathing
problems. These breathing problems are called
attacks or episodes of asthma.
Doctors
are not exactly certain how you get asthma.
But they do know that once you have it, your
lungs react to things that can start an asthma
attack. For instance, when you have asthma,
you might get an asthma attack when you have
a cold (or some other kind 
of
respiratory infection). Or, you might get
an attack when you breathe something that
bothers your lungs (such as cigarette smoke,
dust or feathers). When this happens, three
changes take place in your lungs:
1. Cells in your air tubes make more mucus
than normal. This mucus is very thick and
sticky. It tends to clog up the tubes.
2. The air tubes tend to swell, just as skin
swells when you get a scrape.
3. The muscles in your air tubes tighten.
These
changes cause the air tubes to narrow. This
makes it hard to breathe. Asthma attacks may
start suddenly. Or they may take a long time,
even days, to develop. Attacks can be severe,
moderate or mild.
WHEN
YOU HAVE ASTHMA
It's
important to:
1. Take your asthma seriously.
2. Take your asthma medicines for asthma.
When
asthma symptoms don't improve, get help. Usually
symptoms get started or "triggered"
by something that bothers your lungs. These
things are called asthma triggers.
There
are many kinds of triggers. They can range
from viruses (such as colds) to allergies,
to gases and particles in the air. Given this
range, you may find it hard to figure out
what starts your asthma attacks. You may even
think your attacks "just happen."
But this is generally not true. Something
usually triggers an attack. Once you find
out your triggers, you can do something to
prevent your asthma attacks. This gives you
control. The result is that when and if you
have attacks, there's a good chance that they
will be less severe and you won't have as
many. For example, do you get an asthma attack
after you've exercised? If you do, you should
tell your doctor. You can get help. You can
still exercise when you have asthma, but you
may need to take rest breaks while you exercise.
If you know that exercise triggers your asthma,
the doctor may tell you to take your asthma
medicine before you exercise. This way, you
can still have fun exercising without having
an asthma attack.
There
are other asthma triggers that you can get
rid of or avoid. Good examples of these triggers
are cold air, dust, feathers or molds. Cigarette
smoking is another trigger that must be avoided.
If you smoke, you need to quit. Smoking cigarettes
will make your asthma worse, and if you breathe
the smoke from someone else's cigarette, you
may get an asthma attack. This is true for
children, too. In fact, children are especially
at risk when they breathe secondhand smoke.
Studies show that children of smokers are
more likely to suffer asthma attacks. Their
asthma gets worse, too. But you can do something
about this. You can protect yourself (and
if you're a parent with a child who has asthma,
you can protect your child, too) when you
know the risks of smoking cigarettes or breathing
secondhand smoke. The wisest and healthiest
things you can do are to live, work and play
in places that are smoke free.
Remember:
-Asthma symptoms and attacks usually get started
by triggers.
-Talk to a doctor about these triggers.
-Find ways to avoid them. Find ways to get
rid of them.
BRONCHITIS
There
are two types of bronchitis (brong-kigh-tiss)
-- acute and chronic. Acute bronchitis usually
only lasts a few days. It's often caused by
a viral infection and may begin after you
develop a cold or sore throat. The first symptom
is an uncomfortable cough. This inflarnes
the lining of the air passages, causing you
to cough up mucous that's thick and yellow
or gray in color. You may also feel achy and
run a fever. To make yourself more comfortable,
avoid cold air, tobacco smoke, and air pollution.
Warm steam will help clear the nasal and lung
passages, making breathing easier. Your doctor
may recommend cough medicines, antibiotics,
and plenty of bed rest. Chronic bronchitis
usually persists for long periods of time
and occurs most often in heavy smokers or
as the result of recurring episodes of acute
bronchitis. If you have bronchitis and smoke,
you should stop. Smoking puts you at risk
of emphysema (em-fuh-see-muh), a life-threatening
disease that deteriorates the lungs. An antibiotic
or inhaler is often prescribed. But cough
medicines shouldn't be used with chronic bronchitis
because coughing is the only way the lungs
can get rid of the mucous.
EMPHYSEMA
Emphysema
is a chronic lung disease that slowly deteriorates
the lungs by affecting the walls of the air
sacs, or aveoli, so that they cannot push
air out as normal air sacs do. This interferes
with breathing, making it hard to move air
into and out of the lungs. Smoking is the
most common cause of emphysema. Symptoms of
shortness of breath with exertion such as
climbing stairs can progess to the point that
you are disabled. If you have emphysema and
smoke, you should quit smoking. Your doctor
can recommend a program to help you. Exercises
that strengthen your diaphragm and abdominal
muscles will make breathing easier. Oxygen
therapy is often recommended for emphysemic
patients and the Pulmonary Clinic can evaluate
patients for alternative methods of oxygen
delivery. A trans-tracheal catheter is a thin
tube that is placed in the lower front neck
with little discomfort. Many patients find
the transtracheal oxygen delivery causes less
irritation, less shortness of breath and can
improve their appearance.
PNEUMONIA
In
pneumonia, your lungs are inflamed or infected.
The air spaces fill with pus and other liquids.
Oxygen can't reach your blood. Lack of oxygen
makes you breathless because your body cells
and organs can't work properly, and if you
don't get medical help you may die.
Each
year, over thousands die from pneumonia.
The
greatest risk of pneumococcal pneumonia is
usually among people who:
Have chronic illnesses such as lung disease,
heart disease, kidney disorders, sickle cell
anemia or diabetes.
Are recovering from a severe illness
Are in a nursing home or other chronic care
facility
Are age 50 or older
Have HIV
There are three main causes of pneumonia:
BACTERIAL
PNEUMONIA - can attack anyone from babies
to the very old. Alcoholics, people who are
run down, people who have just had surgery,
and people with chronic lung diseases or virus
infections are at a higher risk for developing
bacterial pneumonia.
VIRUS
PNEUMONIA - One third to one half of all pneumonia
are believed to be caused by viruses. Most
viruses attack the upper respiratory tract
and some cause pneumonia, especially in children.
Most of these pneumonias are not too severe
if treated properly. Primary influenza virus
pneumonia is severe and may be fatal. The
virus invades the lungs and grows, but there
are almost no signs of the lungs becoming
filled with fluid. Most of its victims have
heart problems, a lung disease or are pregnant.
MYCOPLASMA
PNEUMONIA - are the smallest free-living causes
of disease in humans. They are not classified
as either bacteria or viruses, but have features
of both. They generally cause a mild and widespread
pneumonia. It affects all age groups, but
happens most often in older children and young
adults. People with mycoplasma pneumonia can
be quite sick and often take a long time to
get back to normal
SARCOIDOSIS
Very
little is known about sarcoidosis. No one
knows how many people have it, why it develops,
or how to cure it. We do know that it commonly
strikes African American women ages twenty
to forty, and like lupus, is a chronic disease
in which the immune system attacks healthy
tissues and organs. It is not contagious.
Also
like lupus, sarcoidosis is difficult to diagnose
because of its wide range of symptoms and
severity. In addition, many doctors don't
know what it is. Most people with sarcoidosis
recover completely in about two years, with
or without treatment, while about 10 percent
suffer from chronic sarcoidosis.
Though there is no known cure for sarcoidosis,
keeping your body generally healthy can help
you recover faster and feel better. Eat good
food, excercize regularly, avoid cigarettes
and alcohol and keep stress to a minimum.
Common
symptoms of sarcoidosis include:
- Sinus
problems and/or a dry cough
- Unexplained
tiredness or weakness
- Bruising
of the skin
- Headache
- Mild
pain at the center of the chest
- Shortness
of breath
- Enlarged
lymph nodes
- Painful,
swollen, or numb joints
- Purple
rash on the face
- Unexplained
weight loss
BLACK
LUNG
A
respiratory disease caused by inhaling coal
dust for prolonged periods. Also known as
coal workers pneumoconiosis. Coal workers
pneumoconiosis occurs in two forms: simple
and complicated (progressive massive fibrosis).
Inhalation of coal dust causes this disease.
The simple form is usually not disabling,
but the complicated form often is. Smoking
does not increase the prevalence of this disease,
but may have an additive detrimental effect
on lung function. The risk of developing the
disease is related to the duration and extent
of exposure to the coal dust. Most affected
workers are over the age of 50. The incidence
is 6 out of 100,000 people.
Enforcement of maximum permitted dust levels
in occupational settings and the use of protective
masks are preventive measures used to minimize
occupational exposure to coal dust. There
is no specific treatment for this disorder
other than treatment of complications. Avoidance
of further exposure to coal dust is recommended.
ASBESTOS
RELATED DISEASE
Malignant
Mesothelioma, a rare form of cancer, is a
disease in which cancer (malignant) cells
are found in the sac lining the chest (the
pleura) or abdomen (the peritoneum). Most
people with malignant mesothelioma have worked
on jobs where they breathed asbestos."
A
doctor should be seen if a person has shortness
of breath, pain in the chest, or pain or swelling
in the abdomen. If there are symptoms, the
doctor may order an x-ray of the chest or
abdomen. The doctor may look inside the chest
cavity with a special instrument called a
thoracoscope. A cut will be made through the
chest wall and the thoracoscope will be put
into the chest between two ribs. This test,
called thoracoscopy, is usually done in the
hospital. Before the test, the patient will
be given a local anesthetic (a drug that causes
a loss of feeling for a short period of time).
Some pressure may be felt, but usually there
is no pain.
The
doctor may also look inside the abdomen (peritoneoscopy)
with a special tool called a peritoneoscope.
The peritoneoscope is put into an opening
made in the abdomen. This test is also usually
done in the hospital. Before the test is done,
a local anesthetic will be given.
If
tissue that is not normal is found, the doctor
will need to cut out a small piece and have
it looked at under a microscope to see if
there are any cancer cells. This is called
a biopsy. Biopsies are usually done during
the thoracoscopy or peritoneoscopy.
The
treatment program depends on the size of the
cancer, where the cancer is, how far the cancer
has spread, how the cancer cells look under
the microscope, how the cancer responds to
treatment, and the patient's age and desires.
