honey...you really need to get a life! you've posted this basic same question a couple of times in a matter of what...5 mintues?

i try to answer all the questions i can...but yo're posting faster than i can answer.

you need to take a deep breathe...adn google emphysema! that's your best bet...if you cant' or wont ask your doc.

good luck. im' sure you'll be busy for the evening.

thats not very nice is it mamamarg i suppose your old hat to this and know everything about it dont you well it would be nice if you had a little more patience with people who have only just been diagnosed

skye

you're absolutely right. i'm sorry.

to be honest...i dont knwo crap about this disease. i google stuff all the time about it. it is a handy way to find things out.

good luck, and i'm sorry for being so rude.

skye, you can live a long time with COPD if you follow some guidelines along your journey with it. I sense that you are in the initial shock stage--emotional from finding yourself diagnosed with it and running on some fears without educational resources to alleviate your new-found emotional responses.

Take some time to use the internet and read what different organizations and doctors say about it overall--and also read some of the posts here regarding COPD specifically. In time, you will get over the emotional stage and put it all in a more realistic perspective for yourself. Welcome to our board.

:>))

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153

Emphysema*

*Diagnosis

Emphysema often exists in conjunction with chronic bronchitis in the COPD population; nonetheless, emphysema and chronic bronchitis are two distinct diseases. Although a diagnosis of emphysema can, technically speaking, be made only upon postmortem examination, enough evidence can be accumulated from medical history, physical assessment, and diagnostic procedures to make the correct clinical diagnosis.

A patient with emphysema typically seeks medical intervention when shortness of breath occurs while performing ordinary daily activities, such as ascending a flight of stairs. Coughing is usually absent; if it exists, the cough tends to be minor and devoid of sputum.

Characteristic findings can be seen upon physical examination. The patient generally displays tachypnea, lengthened expiratory time, use of accessory muscles of ventilation during inspiration and exhalation, pursed-lip breathing, increased heart rate, and increased anteroposterior chest wall diameter (barrel chest).

The patients posture also may be revealing. Emphysema patients frequently attempt to increase the vertical dimension of the thorax to achieve a mechanical advantage for the muscles of ventilation. For example, when sitting, they place both elbows on the arms of the chair and lean forward. Palpation tends to demonstrate decreased vocal and tactile fremitus because the hyperaerated condition of the lungs creates a suboptimal environment for the transmission of sound waves. Similarly, hyperresonant notes are perceived via percussion, and auscultation reveals diminished or distant breath sounds.

A chest radiograph generally cannot establish the diagnosis of mild emphysema. No remarkable findings appear when mild emphysema exists, however, when emphysema is fully established, classic radiographic findings on an anteroposterior view are typically observed. These findings include bilaterally hyperlucent lungs, flattened hemidiaphragms with widened costophrenic angles, and horizontal ribs. The peripheral vascular markings frequently abate quickly. On the other hand, the markings become prominent when the patient has pulmonary hypertension and cor pulmonale. A lateral view shows an increased retrosternal airspace.

Typically, the heart appears long and narrow because it is influenced by the downward pull created by the flattened hemidiaphragms. In the presence of cor pulmonale, the right ventricle appears enlarged because of right-ventricular hypertrophy.

Spirometry documents the presence of chronic airflow obstruction. Forced vital capacity (FVC) measurement provides data for assessment of expiratory airflow. Measurements of FVC, forced expiratory volume in 1 second (FEV1/FVC), show the presence and degree of airflow obstruction.

The FEV1 itself is a useful index of physiological impairment because it correlates closely with the extent of a persons functional disability and prognosis. An FEV1 of less than 1 L indicates a dismal prognosis.

Carbon monoxide diffusing capacity (dlco) testing is performed in conjunction with spirometry to assist in differentiating emphysema from asthma and chronic bronchitis. In emphysema, the dlco is usually decreased because of the loss of surface area of the alveolar-capillary membrane. The combination of a decreased FVC, a decreased FEV1, a decreased dlco, and increased lung volumes and capacities is generally diagnostic of emphysema.

Arterial blood gas data tend to vary according to the stage of emphysema. In the mild and moderate stages, the PaO2 and the PaCO2 measurements may remain normal or, while the PaO2 stays normal, the PaCO2 can be decreased (respiratory alkalosis). In the moderately severe and severe forms of emphysema, the patient is likely to be hypoxemic and hypercarbic (respiratory acidosis).

High resolution CT may be useful in the diagnosis of subclinical or mild emphysema. High resolution CT scanners furnish images of low attenuation lesions associated with emphysema.

*Treatment

The major goal in treating emphysema is improving the patients quality of life. Smoking cessation is a primary focus. Avoidance of exposure to other noxious gases (including secondhand smoke and air contaminants in general) is stressed to lessen the deterioration of lung function.

Many medications are available for emphysema patients. The pharmacological mainstays are bronchodilators and anti-inflammatory agents. The bronchodilators primarily used are b2-agonists and anticholinergics. Two b2 agonists frequently prescribed are albuterol and salmeterol. Ipratropium bromide is an anticholinergic bronchodilator that sometimes affords emphysema patients improved expiratory airflow. A combination of albuterol and ipratropium bromide is also available in a metered dose inhaler. Not all emphysema patients derive clinical benefit from bronchodilators; however, some clinicians believe that emphysema patients, especially those who have an FEV1 of less than 2 L, should be given a 1 week trial of a bronchodilator.

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), prolonged treatment with inhaled glucocorticosteroids does not alter long-term deterioration in FEV1 in patients with Emphysema. Some clinicians prescribe a 2 week trial of an oral glucocorticosteroid to identify patients who respond favorably to these anti-inflammatory agents. These patients are then prescribed an inhaled glucocorticosteroid to minimize the adverse reactions to this drug seen with long-term oral administration. GOLD advocates a trial of 6 weeks to 3 months to identify patients who may experience symptomatic relief and, possibly, benefit from prolonged treatment.

Theophylline has been used; however, its effectiveness in treating emphysema has been questioned because theophylline inhibits multiple phosphodiesterase enzymes.

Oxygen therapy constitutes the cornerstone of treatment in emphysema. Prolonged use of oxygen for 15 hours per day increases the life expectancies of patients experiencing chronic respiratory failure. For patients who have a PaO2 of 55 mm Hg or less (or a pulse oximetry result of 88% or less), supplemental oxygen is indicated. The administration of oxygen to these patients generally improves gas exchange, decreases the work of the heart, reduces pulmonary vascular resistance, and improves the ability to perform activities of daily living. Oxygen is usually administered via standard nasal cannula or some type of oxygen conserving device.

Lung volume reduction surgery (LVRS) is another method for treating emphysema. In the advanced stages of emphysema, the lungs overfill the thoracic cavity because of the loss of lung elasticity. This condition contributes to airway compression, difficulty in breathing, and the use of accessory ventilatory muscles. LVRS involves reducing the size of the lung by excising a lung section. The smaller lung is better accommodated inside the thorax, and this enables the ventilatory muscles to work more efficiently; however, no randomized controlled studies support the therapeutic benefit of LVRS, compared with nonsurgical intervention.

Single lung transplantation is performed more commonly among Emphysema patients than in any other patient population. Its success rate among Emphysema patients, compared with patients having other diseases, is favorable; however, emphysema patients experience the worst survival rate among patients with chronic airflow limitation. Data have shown that patients with the lowest dlco results experience the poorest outcomes.

Thank you all for your kind replies on this and yes floydian your right i am still in the initial shock stage and i,m very emotional with it i have 3 very young children and it scares me to death mamamarg i,m also sorry for having a go at you aswell i just dont know wether i,m coming or going with this i,m crying all the time and everything its awful and digitinc thank you for all your information i will have to keep going over it though for it all to sink in and thanks deb for your link i,m sorry if i seem to be all over the place

skye xxx

Skye, Floyd gave some good personal advice! COPD is a general term for a "group" of obstructive pulmonary diseases! Emphysema is a specific lung disease. I would find a doctor that you feel comfortable with and find out exactly what it is that you have. You can just have Chronic Bronchitis and have COPD. And even though the internet has alot of good information, it's best to get any and all medical advice from a doctor.

hi digitinc no i know its emphysema i,ve been told
skye xx

hi skye, how are u feeling, ur dr should explain everything to u, dont be so upset, i just found out to it comes in stages, iam stage 4 copd,w stage 4 end stage emphysema, as long as u stop smoking excersie and keep it all togther ull be ok. did u do an fev1 test, i just did mine last week, it tells ur lung function,which mine is 33%, i also panicked with that but wen i came here i found there are ppl with less then mine, and i dont plan on dyin eaither, im to young and i also have 4 kids id like to have grandchildren to spoil :)) so read up on it and reli take very good care of urself, this crap is not cureable but it is treatable, so thats a plus for us :))) hope u feel better.

Hi smokyjo thanks for that my fev1 i think was 54% which to most on here is good i suppose they told me i,m moderate which when i read up on it last night the site said that was stage 3 but i will try to take care of myself and i do have a fantastic hubby who is always there for me so that really does help

skye xxx

ok i am soo confused. skye, will you please humor me and tell me what kind of history you have where you could posssibly out of the blue just one day be diagnosed and dumbfounded with Emphazema??? I say this because I am 43. I started smoking when I was 12. Started as a pack a day smoker day one and past 10 years been a 4 pack a day smoker. When I was 19 I was diagnosed with COPD (no emphazema, still to this day no emphazema) So I just dont understand how someone like me who abused myself for so long and has been sick for so long is not even nearly as sick as you?
BTW: God has a funny snese of humor, I had a problem with alcohol, I prayed to be releaved of it and He made me violently alergic to it! I cant even think about it without getting queezy! And now I prayed about the cigs and for the past week I have not been able to catch my breath and the coughing fits horrible, well 5 hours ago I was on a 2 hour choking and coughing gag!! It was horrible!! I did breathing treatment after breathing treatment NOTHING worked! It was torture!! Gasping breathes in between the hacking coughs! Luckily I had some prednisone left over from last week and now I am still hurting bad in my chest and lungs but the coughing fits are getting further apart and lasting much quicker. I am happy to say I have not had nor do I have a single desire for a cigarette nor do I ever want one ever again!! That was so horrible, I NEVER want to go through that again!! Now for the real wierd but cool part, last week I was in the ER and they did a chest xray and they can not believe how good it looks considering my history and they say definately good future outlook if I stay off the cigs from now on.
Good luck to you. Am very interested to know how on earth you ended up with Emphazema?? Please tell.....

I have been nicotene free for 4 hours, 58 minutes and 14 seconds. 8 cigarettes not smoked, saving $1.86. Life saved: 40 minutes.

Hi tytybaby so my history were do i start well i started smoking when i was 11and i,ve been smoking 3 packs a day for the past 22 years sometimes 4 packs i,ve suffered with my chest for about 15 years if not more but my breathing etc has been bad for about 10 years and progressively got worse over time and had many xrays over the years and always been told its just an infection i,ve only been back in the uk for 2 years i was in spain for 7 years were i got ill a few times with bacterial pnuemonia etc anyway the past few years my breathing has been so bad were sometimes i can hardly breathe at all and i,m fighting for my breath literally anyway back in january i saw a sign in a hospital on C.O.P.D at this very time i could hardly breathe so i went to see my GP and i said about C.O.P.D and she agreed with me that she also thought thats what i had so she had me tested for it with the spirometry etc and yes she was right i did have it she did say that c.o.p.d was another term for emphysema and thats wat i had and instantly put me on medication i was told i was looking at 5 or 6 years but if i stop smoking i might get a bit longer so i was in total shock having such young children etc i,ve got to go back and see her again soon hope this helps on some of my history for you

skye xx

Skye, what other tests did they do besides a spirometry?

Hugs ((((Skye)))) Never feel wrong for asking a question, and I don't much care how many times one has to ask before they begin to absorb the information...Its all new to you and its a lot to take in and process....Information seems to be power so my advice to you is to search all you can both here and on the internet...write your questions down so you remember then when you see the doctor...

I know when I see my specialist, I understand prefectly as he is explaining but once I leave....whew its quite another story...

I know its terribly scary, but there is no reason, once you adjust etc. that you cannot go on to live a full happy life....A new normal will be born and its going to be okay....One day, one step, one breath at a time and its just okay....Hugs hugs my new friend...Keep hanging in there and keep asking questions....
Love and Blessings, Serenity