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Pulmonary emphysema takes the lives of increasing numbers of people each year. Called chronic obstructive pulmonary disease, this condition develops insidiously in people exposed to heavy pollution of the airways. The commonest cause of emphysema today is tobacco smoking. Unfortunately, most individuals do not know that their disease has developed until it is too late to cure the condition. The basic process involved in the development of emphysema first involves the destruction of elastic tissue in the bronchial tubes. Respiration becomes increasingly difficult. Then in later stages many tiny air sacs, called alveoli, lose their walls and coalesce, forming large air sacs or emphysematous blebs.

The earliest symptom in developing emphysema is shortness of breath. This is commonly associated with exertion. This exhibits disease risk with decreased ability to carry packages, climb stairs, walk rapidly, or engage in the usual sports. Advanced sufferers of emphysema may develop cyanosis, a bluish tinge around the mouth with a dusky appearance of the nail beds. This sign indicates advanced impairment of oxygen intake with a chronic deficiency in the blood. There is abnormal shunting of blood across the lungs, with resultant deficient oxygenation.

When chronic bronchitis or pneumonia are superimposed on the underlying condition, respiratory failure can develop. Heroic efforts are being made today in intensive care units to salvage individuals who would otherwise die in such a respiratory crisis. Unfortunately, some hapless victims continue smoking after surviving an acute crisis. I have seen individuals who unfortunately were completely resistant to heroic educational efforts for improving their lifestyle and thus failed to avoid additional relapses.

There is good news, however, for many people with mild to moderate emphysema. Not all need to progress to the end stage, sitting beside an oxygen tank just to support life. Proper diaphragmatic breathing with learning to exhale forcefully through pursed lips constitutes a valuable way of retraining the respiratory muscles and improving the oxygen delivery to the blood and distant tissues. Exercise programs with gradually increasing walking distance has, in my experience, enabled many patients again to return home, climbing stairs, mowing the lawn, working in the garden, or engaging in moderately active sports. It is certainly worthwhile to attempt rehabilitation of a patient with emphysema, at any stage. These efforts, in combination with a strict avoidance of tobacco and air pollution, will add quality to the life of many.

Pulmonary Hygiene is also important. The individual with fragile or delicate lungs must avoid contact with people who have colds or other respiratory infections. For those producing large amounts of mucus, postural drainage treatment is a daily necessity. This can be done in the morning, usually after a few minutes of steam inhalation. Bend over or lie with the head down, allowing gravity to help drain mucus from the chest. The side of a bed is a good place to do this drainage procedure. Calculated to drain the affected segments of the lung, these postural maneuvers are very effective. Clapping of the chest, inhalation therapy, and other specialized procedures may be prescribed by a physician to aid in the home care of the emphysema victim.

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When it comes to the lungs, everyone needs a healthy pair, for without air no one can live more than a few minutes. Of all the elements in nature, oxygen has to be most constantly supplied to the human system. With rare exceptions, more than 4-5 minutes without oxygen will result in irreversible damage to the brain and other vital organs. For this reason, our bodies have been designed with a mechanism for constant exchange of air. Furthermore, the respiratory tract has been provided with marvelous safeguards to cleanse the membranes and prevent any entrance of infectious agents.

The rapid growth of urban populations, as well as the use of tobacco, has produced a large number of respiratory diseases. Still, most of the diseases of the respiratory system are of an infectious nature. In studies of mortality, the deaths due to pneumonia and tuberculosis have been replaced by an increasing number from lung cancer and emphysema. A few of the more common conditions will be dealt with below.

First, it is helpful to include a brief description of the proper mechanics of breathing. Correct posture is invaluable in allowing complete expansion of the lungs. It is proper to avoid tight-fitting garments, such as elastic bands about the chest and waist, all habitual stooping or a slumped sitting posture, all of which can prevent complete chest expansion. The most efficient respiration utilizes the diaphragm. This is a large flat muscle that separates the chest from the abdominal cavity. Contraction of the diaphragm creates a vacuum within the chest, allowing entrance of air concurrent with the moderate protrusion of the abdomen. Sitting erect and standing with the shoulders back and the head up, together with a straightened position of the spine are all essential to deep, full diaphragmatic breathing.

The vital capacity is a measure of the greatest volume of air one can take into the lungs in a deep breath. Pulmonary function tests can also measure the timed vital capacity, which shows the degree of elasticity of the lungs, which is impaired early in the development of emphysema. Other breathing capacity measurements can be made and serve as predictors of the development of diseases such as asthma, emphysema, or other chronic conditions. The examination of the chest and lungs, as well as brief comments on diagnostic x-rays are described in chapter one.

Lung development just before birth coincides with the production of a detergent-like substance called surfactant. This is deficient in a premature baby and is one of the reasons why hyaline membrane disease may develop. Another enzyme that is usually present in the bronchial tubes is called alpha-1antitrypsin. Congenitally deficient in some people, this can lead to the development of early emphysema, particularly in smokers or people exposed occupationally to inhaled particles, such as asbestos or coal dust. A simply performed blood test can determine the existence of this hereditary enzyme deficiency. We turn now to consider some of the common diseases of the respiratory tract.

In next few days we will be posting about some Breathing & Respirotory Diseases and how to avoid/ control them. We would like to have your comments

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Several other types of allergies manifest themselves in inflammatory states of various body organs. Allergies have been implicated as the cause of cystitis or inflammation of the bladder, and this typically resembles a urinary tract infection. The joints can be affected by allergies, with ensuing pain, swelling, and disability. Allergies in the bronchial tree, the sinuses, and the upper respiratory tract are likewise common.

Most commonly seen is hypersensitivity to substances contacting the skin. Nickel, as in watch bands, elastic in undergarments, various cosmetics, dyes, creams, lotions, medications, and plant substances all can produce the skin rash of allergic dermatitis or aggravate an existing eczema. All known offenders must be avoided to regain health. Allergy as a medical specialty is growing, with the increasing number of chemical, biological, and food sensitivities that send more people for testing and treatment each year. While cures are illusive, control is frequently possible, offering considerable hope, especially good news to allergy sufferers.

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Anaphylactic shock is a highly dangerous allergic manifestation that occurs when an individual has an immediate life threatening reaction to contact, ingestion, or injection of an allergen. This rarely occurs with food allergy, but is most commonly associated with drugs. Penicillin injections have periodically produced this severe type of anaphylactic shock.

Stings from hornets, honey bees, bumblebees, and yellow jackets in sensitized individuals can provoke anaphylactic reactions. Even inhalation of allergens, such as antibiotic powder, or caster bean flour, may cause anaphylaxis. Symptoms occur within seconds to minutes after the substance enters into the body, when precipitous drop in blood pressure occurs. Frequently there is difficulty breathing, profuse sweating, and sudden generalized vascular relaxation that causes faintness. In fatal cases stoppage of the heart or respiration follows.

Prompt emergency resuscitative measures are necessary to save the life of a victim in anaphylactic shock. Subcutaneous injection of adrenalin in the appropriate dosage (based on body size) is life saving in such a situation, while general first aid measures involving adequate airway, artificial respiration, and closed chest cardiac massage are instituted. Increasing anaphylactic cases of this nature has brought physicians to adopt a more conservative attitude in the administration of antibiotics by injection. Bee sting allergy kits are available for those sensitized individuals who live with this ever present threat of danger.

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There is probably no area more controversial and perplexing as suspected allergies connected with food. These range from sensitivity to food additives, such as coloring, preservatives, and other foreign chemicals, to plant sources, to actual hypersensitivity to protein and other constituents of fruits, grains, nuts, vegetables, or animal foods. Careful detective work and long-term adherence to dietary regimens are frequently necessary to first diagnose and then live with food allergies.

It is my belief that the stage is set for many food allergies by feeding patterns in infancy, such as the early introduction of solid foods, the widespread use of cow’s s milk in prepared formulas, and the relative lack of mother interest in prolonged breast feeding. Maternal use of drugs which sensitize the babies in utero or during the breast-feeding period can also prepare the way for allergic responses to develop.

The most common allergy that occurs in infancy is a sensitivity to cow’s milk. This is often manifested in diarrhea, unusual regurgitation, excessive gas or colic, or a “failure to thrive.” Usually a change to soymilk formula if breast feeding is not available will stabilize the situation, although rarely more restricted and specific formulas have to be devised.

A majority of the black and oriental races and lesser percentages of Caucasians are sensitive to cow’s s milk even in adult life. This, however, is due to the deficiency of lactase, an enzyme which helps to split milk sugar (lactose) and render it available for absorption. Diarrhea, excessive gas, and an acid stool are produced. Simply abstaining from milk is curative. You must always suspect the diagnosis in order to apply the proper remedy at once, thus removing the cause.

Other people are truly allergic to the proteins of cow’s milk and find unpleasant symptoms, such as frequent sinus or nasal congestion, related to the intake of milk. Please note, however, that skin scratch tests for food allergies are notoriously unreliable as indicators of an individual’s s sensitivity to the eating of these foods. It appears that the skin is just not a parallel indicator with the gastrointestinal tract. The only way to be certain in diagnosing food allergies is through trying an elimination diet.

Next to milk as a cause of allergy, chocolate and wheat lead the list. Usually the grains are less common allergens, but berries (such as strawberries), nuts, shellfish, eggs, and many other foods can produce similar symptoms. It is believed by some that symptoms resembling hypoglycemia, such as episodic weakness and certain mental aberrations (anxiety, panic attacks, depression, etc.) may be related to food allergies. It must be acknowledged, though, full proof is lacking to completely confirm this theory as yet. Nevertheless, eliminating the offending food, then gradually progressing from a limited diet to a more liberal intake of varied foods will help bring a return of health and strength, with fewer physical symptoms and more emotional stability.

Sulfites are added to foods to serve a variety of purposes. They preserve food by killing bacteria and yeasts. They retain color and apparent freshness by acting as antioxidant. They may also be used to sterilize containers and arrest fermentation in alcoholic drinks. The label may contain any of the following listings, all various types of sulfites: sulfur dioxide, sodium sulfite, sodium bisulfite, potassium bisulfite, sodium metabisulfite and potassium metabisulfite. Many people are allergic to sulfites, reacting with skin rash or asthmatic wheezing.

Carefully test for allergies with a medically approved method. RAST (Radio Allergo Sorbent Test) testing offers an easy way to evaluate the blood for immediate immune reactive (IgE) factors. The more definitive, though expensive, ELISA/ACT TM (Enzyme Linked Immune Sorbent Assay / Advanced Cell Test) measures both immediate and delayed responsiveness to over 300 foods and environmental chemicals. Additional detailed evaluations, however, may require a period of observation and careful dietary therapy in a sanitarium or preventive lifestyle institution to isolate specific factors or undertake dietary trials.

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