Emphysema treatable, not curable

Dear Dr. Gott: I have emphysema. When I walk a short distance, I am out of breath. I have to stop, sit and wait until I get all my breath back before going on. At home, I am on 15 liters of oxygen, and, when I go out, I have to use a tank on wheels that goes only up to 10 liters. I take nine pills every day. I was told I had one blocked lung.

I started smoking when I was 14 but quit in 1982. As long as I take all my medicine, use the oxygen and don’t get out of breath, I’m OK. I am still able to work in the yard raking leaves. I always work slowly and use my oxygen.

My reason for writing is that a friend told me that emphysema is incurable. Is this true?

Dear Reader: Emphysema is a progressive lung disorder. It results from damage to the small air sacs and airways within the lungs that reduces airflow when breathing out. This means that “bad” air cannot be exhaled completely, which causes an inadequate amount of “good” air to be inhaled. The final result is shortness of breath, even during minimal exertion.
Symptoms in the early stages are generally so mild that they go unnoticed. Once they become more persistent and annoying, irreversible damage may have already been done.

Because the shortness of breath worsens as the disease progresses, most physical activity is difficult, if not impossible. In later, more severe stages, even breathing while lying down can be compromised. It is at this point that breathing requires most of the body’s energy, leaving little for other activities, such as walking or even eating.

The most common cause for emphysema is smoking. This means that by not smoking (and avoiding secondhand smoke), your chances of developing emphysema are incredibly low.

Another cause is alpha-1 antitrypsin protein deficiency, which is a hereditary condition. It occurs only when two defective genes (one from each parent) are passed on to a child. Millions of people are carriers, meaning they have only one of these genes. Often, they do not have problems, but some may develop mild to moderate symptoms or other lung or liver disorders.

Many people experience improvement when enrolled in a pulmonary rehabilitation program. It is also important to quit smoking, as smoking will only worsen symptoms.
Return to your pulmonologist. He or she will also be able to give you more information about other treatment options that may be beneficial to you.

• Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.