Treatment
Emphysema can't be cured, but prompt treatment may prevent further damage to your respiratory system and lead to an improvement in your lung function. Besides steps you can take on your own, your doctor may recommend these treatments for emphysema and its complications:
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Antibiotics. A course of broad-spectrum antibiotics, such as ampicillin, tetracycline, erythromycin and cephalosporin, may help combat the periodic respiratory infections that can accompany emphysema. This must be done carefully so as not to overuse these drugs and cause excessive resistance to bacteria.
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Inoculations against influenza and pneumonia. If you have emphysema or other forms of COPD, you'll need an influenza (flu) shot annually and a pneumonia shot every 5 to 7 years.
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Bronchodilators. These are medications that help open up constricted airways. Taking bronchodilators may provide relief if you have emphysema accompanied by symptoms of asthma. Some bronchodilators may be more effective than others, but they must be used correctly to be effective at all.
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Supplemental oxygen. If you have severe emphysema, using oxygen at home may provide some relief. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs. Talk with your doctor about which is best for you. Ask your doctor for oxygen distributors in your area. Your dealer can set up your equipment, instruct you on care and maintenance and provide follow-up visits.
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Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may relieve symptoms of emphysema associated with asthma and bronchitis. Although inhaled steroids have fewer side effects than oral steroids, prolonged use may increase the risk of conditions such as high blood pressure, cataracts and diabetes.
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Protein therapy. If you have emphysema because you inherited a deficiency of alpha-1-antitrypsin — a protein that protects your lungs from destructive enzymes — weekly infusions of the protein may slow damage to your lung tissue.
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Surgery. In a procedure called lung volume reduction surgery (LVRS), or "lung shaving," your surgeon removes small wedges of damaged tissue from both of your lungs — usually 20 percent to 30 percent of each lung. A CT scan before the operation helps your doctor assess the location and extent of the damage. Removing some damaged air sacs reduces the size of your lungs. As a result, your diaphragm returns to a more normal position and contracts and relaxes more effectively and efficiently, and air exchange improves. Another procedure uses lasers to remove damaged lung tissue, but this technique hasn't been as effective as volume reduction surgery. Both surgeries still are considered experimental. You need to quit smoking before being considered for LVRS; not everyone with emphysema is a candidate for the surgery.
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Transplant. Lung transplantation is an option if you have severe emphysema and other options have failed. Usually just one lung is transplanted because the survival rate has proved to be higher for people with single-lung transplants than for people with double-lung transplants.
Pulmonary rehabilitation program
Part of treatment involves a pulmonary rehabilitation program, which combines education, exercise training and behavioral intervention to help restore you to the highest possible level of independent living.
You'll receive help with smoking cessation and your nutritional needs, and you may learn special breathing techniques and ways to conserve energy.
You'll also be given an exercise program that's appropriate for you. This may include aerobic exercises such as walking and riding an exercise bike as well as special exercises for your arms and legs.
Prevention
Most cases of emphysema are due to smoking. If you smoke — cigarettes, cigars or a pipe — your chance of developing emphysema is 10 times greater than it is for nonsmokers. The best way to prevent emphysema is to not smoke or to stop smoking. In addition, try to limit your exposure to secondhand smoke.
Although smoking is the most common cause of emphysema, occupational exposure to chemical fumes and dust also is a risk factor. Try wearing a dust mask for protection if you work in such an environment.
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