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MoonDragon's Health & WellnessEmphysema

"For Informational Use Only"For more detailed information contact your health care providerabout options that may be available for your specific situation.

BASIC INFORMATION

DESCRIPTION Emphysema is a degenerative disease that usually develops after many years of exposure of lung tissues from cigarette smoke or other toxins that pollute the air. These toxins destroy the small air sacs in the lungs, called alveoli, that stretch as the person takes an in-breath, transporting oxygen from the air to the blood and then shrink as they force out carbon dioxide with an out-breath. As a result, the lungs lose the ability to dilate and the elasticity of the lung tissue. Exhaling becomes difficult as the damaged lungs trap air and cannot effectively exchange it with fresh air. This trapped, stale air remains trapped in the lungs, preventing the needed exchange of oxygen and carbon dioxide found in fresh air. As the damage progresses, the effort needed to breathe increases and, ultimately, each breath becomes labored. Emphysema is a form of chronic obstructive pulmonary disease (COPD) that can interfere with normal breathing. Other diseases that come under COPD include asthma and chronic bronchitis. According to the American Lung Association (ALA), nearly 16 million Americans are estimated to suffer from some form of COPD, and COPD is the fourth-ranking cause of death just behind heart ailments, cancers, and stroke.

CAUSES

Most people who are diagnosed with emphysema are long-term cigarette smokers. Smoking causes chronic low-level inflammation of the lungs, which increases the chance of developing this progressive disease.

Exposure to air pollution and irritating fumes and dusts on the job are also thought to be contributing factors of emphysema.

In rare cases, emphysema is due to a deficiency of a blood protein called antitrypsin .

FREQUENT SIGNS & SYMPTOMS

The predominant symptom of emphysema is shortness of breath or feeling of not being able to get enough air.

Breathlessness followed by coughing during exertion, no matter how slight. As the disease progresses, this symptom may be present all the time, even while sitting quietly.

Coughing, wheezing, and chronic mucus production are other common symptoms.

Symptoms may not occur until middle age, when the individual's ability to exercise or do heavy work begins to decline, and a productive cough begins.

The symptoms may be subtle at first, but worsen with time. Diagnosis cannot be based on these symptoms alone. A careful history is taken with a focus on the number and duration of these symptoms, as well as smoking and occupational histories, is basic to diagnosing the disease. A thorough examination of the chest, observing breathing patterns, monitoring how hard the person is working to breathe along with noting the degree of over-inflation of the lungs and listening to the chest with a stethoscope to hear the airflow in and out of the lungs is necessary. Listening to heart sounds is done to determine its rate and rhythm and any signs of heart strain that may accompany advanced stages of emphysema is necessary. Routine lung function tests can determine several characteristics and capabilities of the lungs. The following tests identify various stages of emphysema:

Spirometry: Through a tube connected to a machine that records air flow and capacity, the person takes a deep breath and blows it out as quickly as possible. Measuring the amount of air that can be forced out in one second and the total amount of air that can be exhaled is the best way to determine the amount of airways obstruction. (On a personal note: This test will often send the person into a major coughing fit...I have had lung problems all my life and I really hate this test...it leaves me coughing and gasping for my next breath and grabbing for my inhaler medication!...MoonDragon Midwife) Pulse Oximetry: A special light, clipped onto the finger or earlobe, can indirectly measure the amount of oxygen in the blood. X-rays: X-rays are not often helpful in early-stage diagnosis of emphysema, but in moderate to severe cases, a reasonably accurate diagnosis can be made with the plain chest x-ray and computerized axial tomography (CAT) scanning. Some of the more common appearances on the chest x-ray include flattened diaphragms, loss of blood vessel markings, and the appearance of a reduced size of the heart. These and other test results are then compared to values considered healthy for various age groups, heights, weights, genders, and races.

TREATMENT

There are a number of medical mainstream treatments that can help people with emphysema, but the most important step is to stop smoking. Stopping smoking when the airflow obstruction is mild or moderate slows the development of disabling shortness of birth. However, "stopping smoking at any point in the disease process provides some benefit. People with emphysema should also try to avoid exposure to other airborne irritants. Bronchodilator Medications: This class of medication works by relaxing the muscles around the airways. They are typically indicated for relief of bronchospasm in people with reversible obstructive airways disease. More commonly used to treat asthma, they may be prescribed for emphysema if there is a tendency toward airway constriction or tightening. Some of the more common bronchodilator medicines include: albuterol, terbutaline, ipratopium bromide, and theophylline. Inhaled medicines, which go directly into the lungs and have less exposure to other parts of the body, are often tried first because they usually begin working in less than 5 minutes with a lower incidence of side effects. Blood tests are used to monitor medications such as theophylline. Although tests for measuring theophylline have been available for decades, there continues to be refinements in this type of testing which make them more accurate and accessible. Anti-inflammatories (corticosteroids) Since emphysema may be associated with inflammation, a corticosteriod may be used to soothe and ultimately heal the delicate lining layer of the air passageways, making them more resistant to obstruction. Inhaled steroids do not carry an FDA-approved indication for COPD but are used off-label by many health care providers. The type of steroid contained in these preparations is not the type that builds muscles. Long-term use of oral corticosteroids is commonly associated with a variety of dose-dependent side effects, such as osteoporosis (in both men and women), weight gain and fat redistribution, hypertension, loss of lean body mass, and high blood sugar. Commonly used corticosteroids include the oral preparation prednisone and several inhaled corticosteroids. Oxygen therapy: Supplemental oxygen can benefit the person whose lung function is severely impaired and cannot absorb enough oxygen from the air. Long-term oxygen therapy prolongs life in people who have low blood oxygen levels (hypoxemia). This therapy reduces the excess red blood cells, which helps improve mental functioning and heart failure concerns. It may also improve shortness of breath during exercise. Lung reduction surgery: Emphysema sufferers may find relief from their symptoms with this surgical procedure. It often eliminates the need for oxygen and significantly enhances breathing function. This technique, which is a minimally invasive procedure, requires two or three small incisions made in the chest and a tiny camera inserted through one of the incisions to view the lung. Through another incision, a special stapling device is inserted to cut portions of the lung so that the healthy lung tissue has more room to expand. Prospective candidates need to undergo careful testing prior to consideration of this surgery. Lung transplant surgery: A lung transplant is a highly invasive, complex procedure that carries substantial risk. Because of known complications of any organ transplant surgery (not to mention the great financial cost), this option is only viable in a very small, select group of individuals. Exercise programs can be carried out to improve a person's independence and quality of life, and decrease the frequency and length of hospital stays, even though lung function doesn't improve. Gains achieved by exercise is in conditioning, which are quickly lost if a person stops exercising. For the future, the key to managing emphysema is to identify the disease as early as possible. Methods continue to be developed to health care providers find the earliest signs so that preventive and therapeutic measures can be instituted. At this time, with current treatments, even those who are severely afflicted with emphysema and are homebound can be made more comfortable and can experience a higher quality of life. There is a rare inherited form of the disease called alpha 1-antitrypsin deficiency (A1AD) related emphysema. People with A1AD lack a protective protein called alpha 1-antitrypsin (AAT), or alpha 1-proteinase inhibitor. Without AAT, a natural enzyme called neutrophil elastase that initially fights bacteria and cleans up dead lung tissue can run rampant and eventually damage lung tissue. For people with A1AD, the missing or defective protein, alpha 1, can be replaced or augmented. In December 1987, FDA approved the first specific treatment for A1AD-related emphysema, called Prolastin, which raises the level of AAT in the blood and may protect the lung tissue from the destructive enzyme. The replacement therapy is derived from human plasma that has been screened and tested for viruses, and it is usually taken in weekly intravenous infusions.

Some of this information was obtained from The Food and Drug Administration. FDA Consumer Magazine: Every Breath You Take: Preventing and Treating Emphysema, March-April 1999. (Online) www.fda.gov/fdac/features/1999/299_emph.html

HOLISTIC CONSIDERATIONS

There is known cure for emphysema, but the measures outlined below should help ease discomfort and make breathing a bit easier.

The Air Supply personal air purifier from Wein Products is a miniature unit that is worn around the neck. It sets up an invisible pure air shield against microorganisms (such as viruses, bacteria, and mold) and microparticles (including dust, pollen, and pollutants). It also eliminates vapors, smells, and harmful volatile compounds in the air. The Living Air XL-15 unit from Alpine Industries is an ionizing unit that purifies the air in the home or workplace.

The University of Pennsylvania Hospital Department of Allergy reports that having an air conditioner and an electrostatic air cleaning machine in the bedroom of persons with respiratory disease is a major factor in the health of individuals with breathing problems.

HERBAL & HOLISTIC RECOMMENDATIONS HERBS

ClearLungs from Natural Alternatives is an herbal combination that helps provide relief from shortness of breath, tightness in the chest, and wheezing due to bronchial congestion. It is available in two formulas, with ephedra and without. Both have been found to be equally effective.

Ephedra (ma huang) is beneficial for respiratory disorders. Thyme is also very helpful. Caution: Do not use ephedra if you suffer from anxiety, glaucoma, heart disease, high blood pressure, or insomnia, or if you are taking a monoamine oxidase (MAO) inhibitor drug for depression.

Licorice extract increases energy levels and helps to improve organ function. Use an alcohol-free extract or Bio Rizin from American Biologics. Caution: If overused, licorice can elevate blood pressure. Do not use this herb on a daily basis for more than 7 days in a row. Avoid it completely if you have high blood pressure.

Other beneficial herbs for emphysema include alfalfa, fenugreek, fresh horseradish, mullein tea, and rosemary.

RECOMMENDATIONS

Avoid any and all contact with tobacco. Tobacco smoke is the single most dangerous thing anyone suffering from emphysema can encounter. If you have emphysema and smoke, you must quit. Avoid areas where people smoke and do not allow smoking in your home, your care, or anywhere near you.

Eat a diet consisting of 50% raw foods. The other 50% should consist of soups, skinless chicken or turkey, brown rice, millet, and whole grain cereals.

Upon arising, take 1 teaspoon of pure, cold-pressed olive oil mixed in apple juice. This will supply essential fatty acids while aiding in the elimination of toxic waste in the gallbladder and large intestine.

Consume onions and garlic daily.

Avoid fried and greasy foods, salt, and all foods that cause excess mucus to be formed in the gastrointestinal tract, lungs, sinuses, and nasal cavity. foods that lead to the formation of mucus include meats, eggs, all dairy products and cheese, processed foods, tobacco, junk foods, and while flour products. Read labels carefully; these are sometimes "hidden" ingredients in food products.

Avoid gas-forming foods such as legumes and cabbage. These foods cause abdominal distension that can interfere with breathing.

Avoid foods that require a great deal of chewing, such as meats and nuts. Chronic lung disease can make it difficult to breathe while chewing. If necessary, vegetables can be steamed to make them easier to eat.

Do not eat a typical American breakfast. Instead, sip hot, clear liquids (such as herbal teas) in the morning to help clear the mucus from the airways. Using a psyllium-based fiber product or Aerobic Bulk Cleanse (ABC) from Aerobic Life Industries (a colon cleanser available in health food stores) is helpful after consuming the liquids. Mix ABC with a glass of juice and drink it quickly. This will help rid the colon of excess mucus and reduce gas and distension.

Use warm castor oil packs on the chest and back to help reduce mucus and enhance breathing. To make a castor oil pack, place a cup or so of castor oil in a pan and warm but do not boil it. Dip a piece of cheesecloth or other white cotton material into the oil until the cloth is saturated. Apply the cloth to the affected area and cover it with a piece of plastic that is larger in size than the cotton cloth, then place a warm cloth or a hot water bottle on top. Keep the pack in place for 1/2 to 2 hours, as needed.

Because every extra chemical adds potential risk to the lungs, use only essential (and unscented) laundry products. Avoid perfume and anything containing fragrance. Avoid gas stoves as well; electric stoves are far better for people with respiratory disorders. Choose flooring made from hardwood, ceramic tile, or stone rather than carpeting, which holds dust, mold, and many chemicals that get into the air and that can irritate the lungs. Avoid using window curtain and draperies, which also can harbor dust. Decorate with pain (new "odorless" formulas are now available) rather than wallpaper; the glues used to make the paper adhere to the wall can have volatile chemicals that may bother some people. Avoid plastic chairs, plastic dishes, and other plastic items in furnishing your home. Do not use aerosol products.

Rest and avoid stress. Get plenty of fresh air.

Go on a cleansing fast periodically, using carrot, celery, spinach, kale, and all dark green fresh juices. See Fasting for more information.

Avoid air pollution. If your current working environment is dirty, dusty, or toxic to inhale, change jobs.

Leave the hose during major house cleaning and other major household projects, and remain away for at least 2 hours afterward. House cleaning stirs up dust and mold.

Avoid hot, humid climates. If you must live in such a climate, continuous central air conditioning is essential. An air-conditioned car is also essential. Do not allow anyone to smoke or wear perfume in your car.

Avoid letting furry or feathered animals into your home or car, as their hair and dander can irritate the lungs.

NUTRITIONAL SUPPLEMENTS

Nutrients

Supplement

Suggested Dosage

Comments

Essential

Chlorophyll (Kyo-Green from Wakunaga is a good source)

As directed on label 3 times daily.

Aids in clear breathing.

Dimethylglycine (DMG) ( Aangamik DMG from FoodScience Lab)

250 mg 3 times daily.

Increases endurance. Use a sublingual form.

Very Important

Coenzyme Q10

60 mg daily.

A powerful antioxidant enhances oxygen in the lungs.

Free-form amino acid complex

As directed on label.

Important for repair of lung tissue.

Garlic (Kyolic)

2 capsules 3 times daily, with meals.

An immunity enhancer and detoxifier for protection against pneumonia.

L-CysteineAndL-methionine

500 mg each twice daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B6 and 100 mg vitamin C for better absorption.

To aid in repairing damaged lung tissue and act as antioxidants protecting lung tissue.

Vitamin A emulsionOrCapsules

100,000 IU daily for 1 month, then 50,000 IU daily until relief is achieved, then reduce to 25,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily.

Needed for repair of lung tissues and for the immune system. Emulsion form is recommended for easier assimilation and greater safety at higher doses.

PlusNatural beta-caroteneOrCarotenoid Complex

10,000 IU daily.As directed on label.

Needed for repair of lung tissues and for the immune system.

Vitamin E emulsionOrCapsules

1,000 IU daily.Start with 400 IU daily and increase slowly to 1,600 IU daily. If you have heart problems, start with 200 IU daily and increase slowly to 800 IU daily.

An oxygen carrier and potent antioxidant. A deficiency can lead to destruction of cell membranes. Emulsion form is recommended for easier assimilation and greater safety at higher doses.

Vitamin C with Bioflavonoids

5,000-10,000 mg daily, in divided doses.

Strengthens immune response and aids healing of inflamed tissue.

Important

Licorice extract

As directed on label.

Increases energy levels and helps to improve organ function. Use alcohol-free extract or Bio-Rizin from American Biologics.

Mullein Lung Complex from Planetary Formulas

2 tablets twice daily, between meals or as recommended by health care provider.

Blend of herbs mullein, wild cherry bark, platycodon root, ephedra, licorice root, elecampane root, and others. Caution: Do not take ephedra if you have high blood pressure, heart or thyroid disease, diabetes, glaucoma, difficulty in urination due to prostate enlargement, or if you are taking an MAO inhibitor or another prescription drug. Reduce or discontinue use if nervousness, tremor, sleeplessness, loss of appetite or nausea occur. If you are breastfeeding or pregnant, consult with your midwife or health care provider prior to use.

Helpful

Aerobic 07 from Aerobic Life Industries

9 drops in water once daily.

Supplies oxygen and kills bacteria.

CalciumAndMagnesium

2,000 mg daily, at bedtime.1,000 mg daily, at bedtime.

Act as a nerve tonic, protect nerve endings, and promote sound sleep. Use chelate forms.

Kelp

1,000-1,500 mg daily.

Supplies needed minerals for improved breathing and healing.

Multienzyme complexWithPancreatinPlusProteolytic enzymes

As directed on label, take between meals.

To keep infection in check by cleansing the lungs.

OrInfla-Zyme Fort FromAmerican Biologics

As directed on label.

A balance of potent enzymes and cofactors as a powerful inflammatory inhibitor.

OrOxy-5000 Forte from American Biologics

As directed on label.

A potent nutritional antioxidant for health and stress that destroys free radicals.

NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...

You or a family member experience symptoms of COPD, including emphysema, asthma, or bronchitis.

You or a family member need to obtain allergy testing for allergen sensitivities.

You or a family member need help to quit smoking.

You or a family member experience any sudden, unexplained symptoms or your symptoms get worse despite treatment. Some sensitive individuals may experience allergic reactions to some herbal formulas. Discontinue use immediately and consult your health care provider.

HELPFUL RESOURCES

For more information on emphysema, contact the following organizations:

American Lung Association1840 York RoadSuite MTimonium, MD 21093-51561-800-LUNG-USA (1-800-586-4872)Website: www.lungusa.org The National Emphysema FoundationHealthOne Center1719 East 19th Ave.Denver, CO 80218Website: http://emphysemafoundation.org/

For information on how to quit smoking, contact:

Centers for Disease Control and PreventionOffice on Smoking and Health4770 Buford Highway, N.EMailstop K-50Chamblee, GA 30341(707) 488-5705Website: www.cdc.gov/nccdphp/osh/resource.htm Agency for Health Care Policy and ResearchOffice of Health Care InformationExecutive Office CenterSuite 5012101 East Jefferson St.Rockville, MD 208521-800-358-9295Website: www.ahcpr.gov/clinic/toolskit.htm See the November-December 1997 FDA Consumer magazine article "It's Quittin' Time"Website: www.fda.gov/fdac/features/1997/797_smoke.html

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