Emphysema

WHAT YOU SHOULD KNOW:

Emphysema (em-fi-SEE-mah) is a long-term disease of the lungs. Emphysema is one of a group of lung diseases called COPD, or chronic obstructive pulmonary disease. Emphysema causes damage to the alveoli (al-VEE-oh-lie) that cannot be reversed (cured). The alveoli are the tiny air sacs of the lungs where oxygen is put into the bloodstream. With emphysema, your lungs become less able to take in oxygen (good air) and get rid of carbon dioxide (deye-OKS-eyed). Carbon dioxide is an invisible gas that your body gives off as a waste product. People with emphysema often have chronic bronchitis (brong-KEYE-tis), another form of COPD, also. Treatments include medicines to help you breathe easier, lung exercises, and avoiding colds and the flu. You may need oxygen as your emphysema gets worse.

INSTRUCTIONS:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• You may need medicines to help you breathe easier, or to prevent other lung problems. These medicines may include one or more of the following:
  
  
  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
    
    
  • Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
    
    
  • Inhalers and nebulizers: Your caregiver may give you one or more inhalers to help you breathe easier and cough up mucus. An inhaler gives your medicine in a mist form so that you can breathe it into your lungs. This type of medicine may also be given using a nebulizer, or "breathing treatment machine". Using inhalers and nebulizers the right way takes practice. Ask your caregiver for more information about using inhalers and nebulizers correctly.
    
    
  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
    
    
  • Over-the-counter medicine: Over-the-counter (OTC) medicines are the kind you buy without an order (prescription) from a caregiver. OTC medicines (such as headache medicines) can help you feel better when they are used correctly. However, they can cause serious problems when they are not used correctly. Some OTC medicines that are safe for most people may not be safe for people with emphysema. Some OTC medicines may react badly with your other medicines, or worsen your emphysema symptoms. Using too much, or using these medicines for longer than the label says can also cause problems. Follow directions on the label carefully. Ask your caregiver for more information about which OTC medicines may be right for you.
    
    
  • Steroids: Steroid medicine may help to open your air passages so you can breathe easier. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Advice on breathing easier with emphysema:

• Quit smoking: The only way to greatly slow the downhill course of emphysema is to quit smoking. It is never too late to quit smoking. Quitting smoking will help you feel better, slow the rate of worsening symptoms, and help you live longer. Quitting smoking is helpful, even for people with advanced (very bad) emphysema. Never allow anyone to smoke around you.
  
  
• Avoid things that can irritate your lungs: Avoid lung irritants, such as air pollution, dusts, and fumes (gases). Follow safety instructions if you must work with chemicals and dusts. Stay inside on days that the air quality in your area is bad. Avoid fireplaces and other sources of smoke. Avoid high altitudes and places with high humidity (air moisture). Stay inside during very hot or cold weather. If you must go outside in cold weather, cover your mouth and nose with a clean scarf.
  
  
• Breathing exercises: Breathing exercises can help you breathe easier. Pursed-lip breathing can be especially helpful before you start an activity. Diaphragmatic (deye-ah-frag-MAT-ik) breathing can help strengthen some of the muscles you use to breathe. Coughing and taking deep breaths every hour while awake may help prevent lung infections. Ask your caregiver for more information about any of these breathing exercises.
  
  
• Special positions while sleeping: You may have trouble breathing when lying down. Sleeping in a position with your upper body raised may help you breathe easier. You can use foam wedges or elevate the head of your bed. There are many devices that you can buy to help raise your upper body while in bed. Use a device that will tilt your whole body, or bend your body at the waist. The device should not bend your body at the upper back or neck.

How can I live a healthy lifestyle?

• Eat a healthy diet. Good nutrition can help your body fight illness. Eat a variety of healthy foods every day. Your diet should include fruits, vegetables, breads, and protein (such as chicken, fish, and beans). If you are underweight, eat frequent high-calorie meals and snacks. Ask your caregiver for more information about a diet that is right for you.
  
  
• Drink enough liquids. Be sure to drink enough liquids every day. Most people should drink at least eight (8 ounce) cups of water a day. This helps to keep your air passages moist and better able to get rid of germs and other irritants.
  
  
• Do not drink alcohol. Alcohol dulls your urge to cough and sneeze. When you have emphysema, you need to be able to cough and sneeze to clear your air passages. Alcohol also causes your body to lose fluid. This can make the mucus in your lungs thicker and harder to cough up.
  
  
• Balance exercise and rest. You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed. Ask your caregiver about an exercise program that is right for you. Try to have a regular program of exercise, such as walking for 20 minutes a day. Use your inhalers as directed by your caregiver before you exercise. Start your exercise by "warming-up" your muscles with gentle, slow movement and gentle stretching. Stop exercising if you become too short of breath.

How can I decrease my chances of getting lung infections?

Lung infections can be especially dangerous for people with emphysema. You can decrease your chance of getting lung infections by not smoking. Other things you can do to avoid illness include:

• Vaccines: To prevent influenza (flu), all adults should get the influenza vaccine. They should get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older to prevent pneumococcal disease, such as pneumonia. People aged 19 to 64 years at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.
  
  
• Avoid the spread of germs:
  
  
  • Wash your hands often with soap and water. Carry germ-killing gel with you. You can use the gel to clean your hands when there is no soap and water available.
    
    
  • Do not touch your eyes, nose, or mouth unless you have washed your hands first.
    
    
  • Always cover your mouth when you cough. Cough into a tissue or your shirtsleeve so you do not spread germs from your hands.
    
    
  • Try to avoid people who have a cold or the flu. If you are sick, stay away from others as much as possible.

For more information:

• American Lung Association
  1301 Pennsylvania Ave. NW
  Washington , DC 20004
  Phone: 1- 202 - 785-3355
  Phone: 1- 800 - 548-8252
  Web Address: www.lung.org
  

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 404 - 6393311
  Phone: 1- 800 - 3113435
  Web Address: http://www.cdc.gov
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You need to use your inhalers or take breathing treatments more often than usual.
  
  
• The amount or color of your sputum changes or becomes too hard to cough up. Also call if you start to cough up blood.
  
  
• You have new or worsening swelling in your legs, ankles, or abdomen (belly).
  
  
• You have trouble talking or doing your usual exercise or activities because of trouble breathing. Also call if you start having to use more pillows when sleeping, or start having to sleep in a chair to breathe at night.
  
  
• You have a new or worsening gray or blue tint of the nail beds or the skin of your fingers or mouth.
  
  
• You have any questions or concerns about your condition or medicine.

SEEK CARE IMMEDIATELY IF:

• You cannot get your breath or you begin to wear out from the effort of breathing.
  
  
• You become confused, dizzy, or feel like you may faint (pass out).
  
  
• You have new chest pain or tightness.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Emphysema (Aftercare Instructions)