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Emphysema



Emphysema

A typical set of lungs contains about 300 million tiny, elastic air sacs that, with every breath, add oxygen to the blood and remove carbon dioxide. Emphysema occurs when the elasticity in these sacs changes and they enlarge and rupture--making it impossible to fully exhale.

Father Time can take some of the blame, since most people experience a change in lung elasticity as they age (though usually not enough to cause serious problems). And maybe you can cast some blame on genes, too, as a small percentage of folks inherit a protein deficiency that causes emphysema. But if you want to point the finger at culprit number one, it's demon weed: Most emphysema strikes long-term smokers and is a direct result of smoking. Emphysema is serious business. It can make breathing difficult and simple chores nearly impossible. It also increases the risk of heart disease by interfering with the passage of blood through the lungs. For many people, even eating becomes difficult. But even though it's usually irreversible, here's what you can do to deemphasize emphysema and breathe easier.

Munch a bunch. Since people with emphysema cannot fully exhale, the lungs enlarge with trapped air. The enlarged lungs push down into the abdomen, leaving less room for the stomach to expand--making eating uncomfortable.

"Many people with emphysema find it's much better to eat many smaller meals instead of three large ones," says Barry Make, M.D., director of pulmonary rehabilitation at the National Jewish Center for Immunology and Respiratory Medicine in Denver. "When you eat a large meal, it puts more pressure on the stomach and pushes up the diaphragm, which makes it more difficult to breathe. Besides eating a lot of little meals, it's also important to take small bites, to eat slowly and to chew your food well, which will make it easier on your breathing."

"A lot of people with emphysema lose weight or have trouble keeping weight on because eating can become so difficult," adds Mark J. Rosen, M.D., chief of the Division of Pulmonary and Critical Care Medicine at Beth Israel Medical Center in New York City. "You want to avoid weight loss, so be sure to eat enough."

When to See the Doctor

Emphysema is a serious condition that requires medical supervision. And other respiratory conditions, such as a cold or flu, can make it a lot worse. So besides paying special attention to preventing these ailments, call your doctor for immediate advice at the first indication that you've caught a "bug"--such as fever, chills or severe coughing.

Profit from produce. Some of the most advantageous eats you can have are fresh fruits and vegetables high in vitamin C and beta-carotene. "Some evidence suggests that vitamin C and beta-carotene may help protect against a decline in lung function," says Joel Schwartz, Ph.D., an epidemiologist and senior scientist at the Environmental Protection Agency in Washington, D.C. "It may be a very minimal effect in those with emphysema, but eating foods rich in these nutrients certainly won't hurt and may help."

Good sources of vitamin C include citrus fruits, strawberries and other fruits, as well as peppers and broccoli. Beta-carotene is abundant in sweet potatoes, squash, carrots and other fruits and vegetables with a yellowish orange color.

Stop smoking now! "When you stop smoking, you slow the deterioration of your lungs, and that's probably the best thing you can do once you've been diagnosed with emphysema," says Dr. Rosen. "Besides that, you will boost your feeling of well-being. And you'll be able to exercise longer, which will improve your comfort in breathing."

Failing to quit, on the other hand, speeds the deterioration of your lungs. It's also wise to avoid any exposure to secondhand smoke as well as any substances that may trigger allergies.

Get your heart pumping. "Aerobic exercise is very important for people with emphysema because it strengthens the heart and can help improve your breathing," says Dr. Rosen. "Walking is probably the best thing you can do, and you should try to do it every day."

Although you'll probably tire quickly, try to slowly build your endurance so that you can walk for about 20 minutes at least three days a week. Riding a stationary bicycle, swimming and participating in low-impact aerobics classes are also good, adds Dr. Make.

Breathe Easier with These Techniques

Besides following a regular exercise program, you can strengthen your breathing muscles--and make yourself more comfortable--if you practice special breathing techniques.

One of the most effective is also the simplest: Just blow out. Here's how: To practice, exhale twice as long as you inhale, suggests Henry Gong, M.D., professor of medicine at the University of California, Los Angeles (UCLA), and associate chief of the Pulmonary Division of the UCLA Medical Center. For 30 minutes a day, concentrate on blowing out slowly through pursed lips to help keep the airways open.

Learning to breathe from your diaphragm is also helpful, since it's the most efficient way to breathe. To make sure you're breathing from your diaphragm-and not your chest-try this exercise.

Lie down with a book on your stomach, then watch what happens to the book when you breathe. If it moves up and down, you're breathing from your diaphragm; if not, you're chest breathing. Practice belly breathing (that is, using your diaphragm rather than your chest and shoulders) until you're doing it naturally every day.

Build your body, too. What good are bulging biceps when you have trouble breathing? "The muscles in your shoulders, arms and upper chest comprise one of the two muscle groups that participate in breathing," says Dr. Make. (The other is the diaphragm.) Whether it's doing some simple exercises while holding wrist or hand weights or starting a full-fledged weight-training program, anything you can do to build your upper body strength will help your breathing. But make sure you breathe correctly while pumping iron: Exhale through pursed lips as you lift, and inhale as you relax.

Dress in the baggy look. Wearing clothing that fits loosely around your chest and abdomen allows plenty of room for them to expand freely, keeping breathing more comfortable. You might want to try suspenders instead of a belt, a camisole instead of a bra and going without a girdle.