Asthma vs. Emphysema
- Friday, September 18, 2009, 8:56
- Asthma
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- Arlene:
- I have severe asthma, and I have emphysema. I was told when I quit smoking seven years ago that your lungs heal. Well, I don’t feel a difference in my lungs. What is asthma and what is emphysema?
- Dr. Ayars:
- Well, first of all, we usually define asthma as reversible airways obstruction. And that functionally tells what’s going on, but probably to describe it better, what goes on physiologically in the lung is that you get both bronchus spasm with narrowing of the bronchial tubes because of muscle constriction around the airways, as well as inflammation of the actual lining of the airways. The net result is compromise in the diameter of the tube that conducts airways and hence it’s harder to move air in and out. So typically if you have asthma, you make a wheezing sound like a wind instrument because you’re trying to force air through a smaller tube. Now the difference between that and COPD or emphysema is that they’re irreversible. You can’t get that back unfortunately. What you can do is hopefully stop the rapid progression of deterioration of your lung function by stopping smoking so, you clearly made the right decision to stop smoking, but it doesn’t surprise me that you’re continuing to have problems and your breathing is not great. Now you probably have a small element of asthma, and probably your predominant disease is emphysema, which we can’t do a whole bunch about unfortunately.
The other unfortunate thing is that all of us peak out with our lung function around age 30 or so, plus or minus a few years, and for all of us, our lung volumes and the amount of air we can get out decreases over time. The thing about most of us is that we have enough lung reserve so that doesn’t affect us much, and as we get older, we’re less active. If you have emphysema and you can’t reverse that, you can’t get it back and you will continue to deteriorate even though you have quit smoking. So you did the smartest thing, but unfortunately, you’re still going to have some problems.
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