Emphysema Health Article

Treatment

Treatment methods for emphysema do not cure or reverse the damage to the lungs. However, they may slow the progression of the disease, relieve symptoms, and help control possibly fatal complications. The first step in treatment for smokers is to quit, so as to prevent any further deterioration of breathing ability. Smoking cessation programs may be effective. Consistent encouragement along with the help of health care professionals as well as family and friends can help increase the success rate of someone attempting to quit.

If the patient and the health care team develop and maintain a complete program of respiratory care, disability can be decreased, acute episodes of illness may be prevented, and the number of hospitalizations reduced. However, only quitting smoking has been shown to slow down the progression of the disease, and among all other

treatments, only oxygen therapy has shown an increase in the survival rate.

Home oxygen therapy may improve the survival times in those patients with advanced emphysema who also have low blood oxygen levels. It may improve the patient's tolerance of exercise, as well as improve their performance in certain aspects of brain function and muscle coordination. The functioning of the heart may also improve with an increased concentration of oxygen in the blood. Oxygen may also decrease insomnia and headaches. Some patients may only receive oxygen at night, but studies have illustrated that it is most effective when administered at least 18, but preferably 24 hours per day. Portable oxygen tanks prescribed to patients carry a limited supply and must be refilled on a regular basis by a home health provider. Medicare and most insurance companies cover a large proportion of the cost of home oxygen therapy. Patients should be instructed regarding special safety issues involving the transport and presence of oxygen in the home.

A variety of medications may be used in the treatment of emphysema. Usually the patient responds best to a combination of medicines, rather than one single drug.

Bronchodilators are sometimes used to help alleviate the patient's symptoms by relaxing and opening the airways. They can be inhaled, taken by mouth, or injected. Another category of medication often used is corticosteroids or steroids. These help to decrease the

inflammation of the airway walls. They are occasionally used if bronchodilators are ineffective in preventing airway obstruction. Some patients' lung function improves with corticosteroids, and inhaled steroids may be beneficial to patients with few side effects. A variety of antibiotics are frequently given at the first sign of a respiratory infection, such as increased amounts of sputum, or if there has been a change in the color of the sputum. Expectorants can help to loosen respiratory secretions, enabling the patient to more easily expel them from the airways.

Many of the medications prescribed involve the use of a metered dose inhaler (MDI) that may require special instruction to be used correctly. MDIs are a convenient and safe method of delivering medication to the lungs. However, if they are used incorrectly the medication will not get to the right place. Proper technique is essential for the medication to be effective.

For some patients, surgical treatment may be the best option. Lung volume reduction surgery is a surgical procedure in which the most diseased parts of the lung are removed to enable the remaining lung and breathing muscles to work more efficiently. Preliminary studies suggest improved survival rates and better functioning with the surgery. Another surgical procedure used for emphysema patients is lung transplantation. Transplantation may involve one or both lungs. However, it is a risky and expensive procedure, and donor organs may not be available.

For those patients with advanced emphysema, keeping the air passages reasonably clear of secretions can prove difficult. Some common methods for mobilizing and removing secretions include:

• Postural drainage. This helps to remove secretions from the airways. The patient lies in a position that allows gravity to aid in draining different parts of the lung. This is often done after the patient inhales an aerosol medication. The basic position involves the patient lying on the bed with his chest and head over the side and the forearms resting on the floor.
• Chest percussion. This technique involves lightly clapping the back and chest, and may help to loosen thick secretions.
• Coughing and deep breathing. These techniques may aid the patient in bringing up secretions.
• Aerosol treatments. These treatments may involve solutions of saline, often mixed with a bronchodilator, which are then inhaled as an aerosol. The aerosols thin and loosen secretions. A treatment normally takes 10 to 15 minutes, and is given three or four times a day.

Patients with COPD can learn to perform a variety of self-help measures that may help improve their symptoms and their ability to participate in everyday activities. These measures include:

• Avoiding any exposure to dusts and fumes.
• Avoiding air pollution, including the cigarette smoke of others.
• Avoiding other people who have infections like the cold or flu. Get a pneumonia vaccination and a yearly flu shot.
• Drinking plenty of fluids. This helps to loosen respiratory secretions so they can be brought up more easily through coughing.
• Avoiding extreme temperatures of heat or cold. Also avoiding high altitudes. (Special precautions can be taken that may enable the emphysema patient to fly on a plane.)
• Maintaining adequate nutritional intake. Normally a high protein diet taken in many small feedings is recommended.