Emphysema Disease

Question:
Could someone please enlighten me with what exactly Emphysema is and what causes it along with some other questions please as a family member has been diagnosed with it and I want to learn as much as I can about it without upsetting the person involved by having to ask them the questions. The family member is a Male 44 years of age and WAS a heavy smoker. 1/ Is it Fatal eventually or cause him to slowly deteriorate health wise even though he has given up the smoking. I have heard of people not being able to walk without oxygen bottles etc. 2/ Can it be contained with exercise to hopefully enhance the lung parts that are still functioning OK to improve. 3/ Is it caused by smoking only.

Answer:
Emphysema is a disease primarily caused by smoking, which leads to the breakdown of the gas exchange surface of the lung, markedly reducing the surface area available for gas exchange...instead of two tennis courts you can be left with a squash court.... The lung has a fine sponge like structure, with millions of tiny air sacs of lung membrane where oxygen enters the blood, and carbon dioxide leaves it. With emphysema this structure is change to a coarse spongework, or becomes filled with big holes where there used to be lung. The cause is production of destructive enzymes in the bodys vain attempt to protect itself from constant irritation of cigarette smoke and infection. The enzymes produced by white blood cells, in an attemtp to contain infection and inflammation, actually break down the lung tissue, and over time, this leads to a loss of lung tissue. As your relative is only 44, it sounds to me like he may have a disorder called alpha 1 anti trypsin deficiency. These people lack a protective protein, that limits the damage caused by white blood cell enzymes, sort of 'mop up' the damge. If people lack A1AT the inflammatory response, and the damage, can become widespread. Typically these people develop emphysema, even without smoking, but if they smoke they develop it much earlier, and in a much more rapid pattern than other smokers. Emphysema usually happens to people who have smoked for 40 or 50 years as the result of many decades of damage. People with A!AT deficiency have the odds stacked against them, and can develop the problem in childhood, or in their 20s and 30s. They often have associated liver disease, in the worst cases, cirrhosis. Emphysema is most noticeable when a person tries to exercise, walk etc. There is just not enough lung tissue to provide gas exchange when the body demand is higher, as in exercise. >1/ Is it Fatal eventually or cause him to slowly deteriorate health >wise even though he has given up the smoking. I have heard of people >not being able to walk without oxygen bottles etc. Emphysema is permanent, once the lung tissue is destroyed it don't grow back, but it is slowable, the person must stop smoking. Far better to stop smoking and retain some reserve lung function. If he has early emphysema, and gets treatment for the present symptoms, and to prevent further lung damage, it can slow the deterioration of the lung, possibly http://detnews.com/1997/young/9711/30/11070008.htm If he has A!AT deficiency, the disease is much more progressive and harder to contain. When emphysema appears in a young person, the tests for A!AT are done, but its usually only found out in hindsight, which isn't much help to people who need to steer absolutely clear of cigarettes, because they will kill them. >2/ Can it be contained with exercise to hopefully enhance the lung >parts that are still functioning OK to improve. Since the lung tissue is actually destroyed and lost forever, no exercise will improve that loss. Breathing exercises can help to improve lung filling and ensure there is the best gas exchange possible, to a small extent. People who have emphysema tend to have very large over filled lung, and have to work very very hard to ventilate their lungs, as there is also a loss of elasticity in the lung. They need to work to breathe, rather than breathing being the simple unconscious process most people know. Over time their chest shape can change, and they can become very thin, due to the increased work of breathing. >3/ Is it caused by smoking only. 95% of the time. People with A!AT deficiency have the cards stacked against them even if they never smoke, but smoking will ensure they get early and destructive emphysema >Any other comments attaining to this condition would be much >appreciated. If he has alpha 1 antitrypsin deficiency, this is a gene defect, and is heritable. Are there others in the extended family who have had early severe emphysema or liver disease? It would certainly be a warning to others in the family to avoid cigarettes.