Emphysema

Emphysema

If you seriously injured your back, you’d most likely go to rehabilitation therapy to get it into shape. You might not be able to do the things you did with your back before, but you’d learn how to use it effectively and work with your limitations.

Well, the same goes for your lungs. If they’ve been damaged by a disease like emphysema, you have to learn how to use your lungs so you get the most from them. It’s called pulmonary rehabilitation, and it’s a way for people with emphysema to lead as active lives as they possibly can.

“It’s the major thing we have to offer. It does not improve the way the lungs function, but it offers the prospect of improving your general condition. It teaches you how to function better with what you have,” says Mark J. Rosen, M.D., chief of the division of pulmonary and critical-care medicine at the Beth Israel Medical Center in New York City.

Over time, emphysema destroys a system of saclike structures in your lungs, called alveoli, that moves oxygen into your bloodstream and takes carbon dioxide out. These sacs are thin, fragile, and easily damaged.

When the alveoli are destroyed, holes form in the lungs. The lungs transfer less oxygen to your bloodstream, causing shortness of breath during exercise and then eventually at rest. The lungs also lose elasticity, making it harder for them to expand and contract, which in turn causes you to have a hard time exhaling.

Although there is a genetic form of emphysema, “it is mostly a smokers’ disease,” says Barry Make, M.D., director of pulmonary rehabilitation at the National Jewish Center for Immunology and Respiratory Medicine in Denver.

Currently, there is no cure, but you can learn to manage the problem. The following tips offer some rehabilitation exercises as well as lifestyle changes that will make your life easier with emphysema. “Even with severe emphysema, there are certain things that can be done,” Dr. Rosen says.

Try This Now

Put your lips together and blow. An exercise called pursed-lips breathing is taught to people with emphysema to help their lungs work better, Dr. Make says. Inhale fully through your nose. Purse your lips lightly as though you are going to blow out a candle and exhale slowly and fully. Practice the exercise daily and use it when you feel short of breath during exertion. You can also use it when you feel anxious.

Other Wise Ways

Quit smoking. Don’t assume that because you already have emphysema it is too late to stop smoking. “No matter what stage you are, if you stop smoking, you will stop further damage and prevent decline from emphysema,” Dr. Make says.

Maintain a smoke-free environment. Keep away from other people who smoke and places where you’re likely to encounter secondhand smoke, says Henry Gong Jr., M.D., professor of medicine in the division of pulmonary and critical-care medicine and environmental health service at the University of Southern California School of Medicine in Downey. Smoke or pollutants can make it harder for you to breathe, he says.

Breathe the right way. Proper, more efficient breathing means filling your lungs with air from the bottom up. To do this, you need to learn how to breathe from your diaphragm, the group of muscles between your chest and your stomach, Dr. Make says. It is often easier to learn how to do this when you are lying down. Place your hand on your belly. While relaxing your stomach, inhale slowly through your nose. Keep your abdomen relaxed so that your diaphragm drops down and your stomach expands. The hand on your stomach should move up if you are breathing with your diaphragm. Slowly breathe out of pursed lips.

Take a walk. Whether it be down the street or down your hallway, take a stroll every day, Dr. Make says. While exercise won’t get rid of emphysema, it builds endurance, meaning you will be able to do more without getting tired and winded as quickly. Dr. Make recommends walking because it is the easiest and cheapest activity, although you could also use a treadmill. Walk as far as you can each day, trying to go farther over time.

If the pollution is bad, it doesn’t mean you can’t exercise, Dr. Make says. You just have to find an indoor place to walk. Go to a mall with air conditioning and walk around there.

Search for quality air. Air pollution can make life harder on people with emphysema. Watch for or listen to local air-quality reports on the television or radio news, Dr. Make says. If the pollution is high, take it easy that day, he advises. Also, trust your own judgment. Many people with emphysema can feel when the pollution is up even without air-quality reports. If you have some trouble breathing, lighten your load for the day.

Find shortcuts. It’s the little things that can save you energy and effort when you have emphysema. Buy slip-on shoes instead of sneakers and shoes that need to be tied, says Michael S. Stulbarg, M.D., professor of clinical medicine and director of the clinical pulmonary center at the University of California, San Francisco. Take showers instead of baths. Put things that you use regularly in easy-to-reach places. These steps, though small, can help conserve your energy to do things you really want or need to do.

Go belt-free. Tight clothes, especially around the stomach and waist, restrict your breathing, so dress in loose, comfortable clothing. While you are overhauling your wardrobe, get rid of girdles or tight belts, Dr. Make says. They also pinch your waist and make it difficult to breathe.

Make the temperature just right. “Temperatures too hot or too cold put more stress on your lungs,” Dr. Make says. So when the heat is on, retreat to a nice air-conditioned house or shopping mall. When Jack Frost is about, try to stay inside a warm house if you can. If you must venture out, bundle up and wrap a scarf around your nose and mouth to help warm the air before you inhale.