Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Emphysema is a progressive disease that usually manifests itself in patients
after 50 years of age. Emphysema is a subtype of chronic obstructive pulmonary
disease (COPD in the US, COLD in the United Kingdom). Most patients, except in
those in whom disease is the result of a genetic deficiency (alpha-1 antitrypsin
deficiency), have variable manifestations of the different components of COPD
which include:
chronic bronchitis,
asthma,
emphysema, and
bronchiectasis.
Each of the subtypes has characteristic symptoms; those primarily associated
with emphysema are shortness of breath and wheezing. Initially the shortness of
breath (dyspnea) occurs with activity; as time continues and the disease
progresses, the episodes of dyspnea occur more frequently eventually occurring
at rest.
Emphysema facts
Emphysema is a destructive disease of the lung in which the alveoli (small sacs) that promote oxygen exchange between the air and the bloodstream are
destroyed.
Smoking is the primary cause of emphysema,
which makes it a preventable
illness.
Shortness of breath is the primary symptom of emphysema. It is a
progressive complaint, worsening over time. Early in the disease, shortness of
breath may occur with exercise and activity but symptoms gradually worsen and
may occur at rest.
Diagnosis of emphysema is based upon history, physical examination, and pulmonary
function studies.
Once present, emphysema is not curable, but its symptoms are controllable.
Medication regimens are available to preserve function for daily activities
and quality of life for an individual with emphysema.
Oxygen supplementation may be required for a person with emphysema.
Exercise training and education are essential components of emphysema
therapy and pulmonary rehabilitation.
Surgical options for individuals with emphysema have been developed and but are not expected to be
available for widespread use.
Emphysema does not affect quantity of life, but rather quality of life. There are no
studies that can predict life-expectancy in individuals with emphysema.
Introduction to emphysema
The lungs are a pair of organs in the chest that are primarily responsible
for the exchange of oxygen and carbon dioxide between the air we breathe and the
blood.
The lung is composed of clusters of small air sacs (alveoli) divided by thin,
elastic walls or membranes. Capillaries, the tiniest of blood vessels, run
within these walls between the alveoli and allow blood and air to come near each other. The distance between the air in the lungs and the blood in the
capillaries is very small, and allows molecules of oxygen and carbon dioxide to
transfer across the membranes.
Air reaches the alveoli via the bronchial tree. The trachea splits into the
right and left mainstem bronchi, which branch further into bronchioles and
finally ends in the alveolar air sacs.
When we breathe in, air enters the lung and the alveoli expand. Oxygen is
transferred onto hemoglobin molecules in the red blood cells to be transported
to the rest of the body for use. As oxygen attaches to the red blood cell,
carbon dioxide, the waste product of metabolism, detaches and crosses into the
alveoli to be exhaled. When we breathe out, the alveoli get squeezed by the
elasticity in their walls and air is pushed out of the lungs.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Bronchitis is a disease of the respiratory system in which the bronchial passages become inflamed. There are two types of bronchitis, acute and chronic. Symptoms of acute bronchitis include frequent cough with mucus, lack of energy, wheezing, and possible fever. Treatment may require medication such as bronchial inhalers and predinsone. Supportive treatment is focused on relieving the symptoms with fever reducers, cough suppressants, and rest. Treatment may be more aggressive in patients with pre-existing conditions such as empyema, COPD, or cigarette smoking.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Ehlers-Danlos syndromes are genetic disorders that include symptoms such as loose joints, tissue weakness, easy bruising, and skin that stretches easily. There are seven types of Ehlers-Danlos syndromes: Classical type, Hypermobility type, Vascular type, Kyphoscoliosis type, Arthrochalsia type, Dermatosparaxis type, and Tenascin-X Deficient type. Treatment for Ehlers-Danlos syndromes depends on which symptoms are present.
Smoker's lung photo essay is a collection of pictures and microscopic slides of lung disease caused by cigarette smoking. Smoker's lung refers to the diseases and structural abnormalities in the lung caused by cigarette smoking.
Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Chagas disease is an infection caused by the T. cruzi parasite. Symptoms of Chagas disease include rash, swollen lymph nodes, fever, fatigue, nausea, vomiting, and the Romaña sign. An ELISA test is used to diagnose Chagas disease. Treatment depends upon the phase of the disease and the patient's age.
Alpha-1 antitrypsin deficiency is an inherited disorder that may cause liver and lung disease in adults. Signs and symptoms include shortness of breath, wheezing, weight loss, respiratory infections, fatigue, vision abnormalities. Advanced lung disease from alpha-1 antitrypsin deficiency include emphysema. Liver damage from alpha-1 antitrypsin deficiency causes a swollen abdomen, swollen legs or feet, and jaundice.
Nicotine is delivered to the brain through smoking, chewing, or sniffing tobacco. Nicotine is an addictive agent. Common names for nicotine products include smokes, cigs, butts, chew, dip, spit, or snuff. Habitual nicotine use leads to many debilitating medical conditions.
The lungs are primarily responsible for the exchange of oxygen and carbon dioxide between the air we breathe and the blood. Eliminating carbon dioxide from the blood is important, because as it builds up in the blood, headaches, drowsiness, coma, and eventually death may occur. The air we breathe in (inhalation) is warmed, humidified, and cleaned by the nose and the lungs.
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
Secondhand smoke can cause illness and disease in nonsmokers. Some of these conditions include lung cancer, heart disease, respiratory illnesses such as asthma, SIDS, bronchitis, and pneumonia. Learn how you can protect yourself and your family from secondhand smoke exposure in the home environment and workplace.
Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs
to the body's tissues and returns carbon dioxide from the tissues to the lungs.
Hemoglobin is made up of four protein molecules (globulin
chains) that are connected together. The normal adult hemoglobin (Hbg) molecule
contains 2 alpha-globulin chains and 2 beta-globulin chains. In fetuses and
infants, there are only a few beta chains and the hemoglobin molecule is made up
of 2 alpha chains and 2 gamma chains. As the infant grows, the gamma chains are gradually replaced by beta chains.
Each globulin chain contains an important central
structure called the heme molecule. Embedded within the heme molecule is iron
that transports the oxygen and carbon dioxide in our blood. The iron contained in hemoglobin is also responsible for the red color of blood.
Hemoglobin also plays an important role in maintaining
the shape of the red...
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