Aging Begins at 30

Short Of Breath All The Time - Prevent It Now

When you have accumulated 40 pack years of smoking you are a candidate for emphysema (the Greek name for "inflated lungs"). What's a pack year? One pack of cigarettes a day for a year. So you can accumulate this threshold in 40 years or 10 years, according to how many cigarettes you smoke daily. Cigarettes cause 85% of emphysema because chemicals in the smoke weaken and break the cords of elastic that surround our air sacs (alveoli) and the smallest of our lung tubes. Big air sacs with poor recoil and lesser absorption surface to take in oxygen and excrete carbon dioxide are produced. There is a 30 year period of hidden progression. If you have to light up in the morning to clear your lungs of sputum, brother (or sister), you're in bad trouble! The puzzle is that not everyone gets emphysema but don't bet on protection by some unknown genetic factor. You'll lose and will go short of breath ever so slowly to your just reward. The loss of recoil causes your lungs to expand, push on your rib cage, and flatten your diaphragm, the muscle between your chest and abdomen which automatically "breathes" for you.

Can people be motivated to stop smoking? Lung elasticity declines slightly with aging but smoking accelerates this greatly. You can motivate people to stop smoking by showing them the cross section of normal delicately lacy lung compared to smoker's lung (from a person of the same age) with holes of lost tissue. My wife showed these slices to fifth graders and six teachers quit smoking the next day. Although past results have shown limited success in motivating the public to stop smoking, there are reasons to believe that there will be more success in the future. Patients shown to have abnormal lung function have been found to quit smoking more often than those with normal tests. Tobacco irritants also poison the vibrating hairs called cilia that line the respiratory tract and beat mucus and debris upwards toward the mouth. Cigarette smoking also causes 60% of chronic bronchitis. So emphysema is rarely an isolated finding.

Lungs with less elastic recoil drain normal mucus slowly and, like slow streams filled with algae, allow the normal bacteria of the lung to grow. Because it is "normal" flora, cultures are of little use but almost any antibiotic will reduce the numbers of bacteria which otherwise cause further loss of lung function. These patients should get influenza vaccine every year and pneumococcal vaccine every 6 years. The junk from these infections causes obstruction to drainage so emphysema is also called chronic obstructive pulmonary disease (COPD). The most important symptoms of COPD are cough, production of sputum, wheezing, and labored breathing.

Deaths from emphysema are increasing from 16 to 22 per 100,000 since 1975. Mortality for women is rapidly increasing. Seventeen percent of male smokers have emphysema and it involves 1.7 million people. The cost to the nation for treatment is over $1 billion, reduced productivity costs $4 billion more, and further costs due to reduced productivity from deaths total another $1 billion. Two-thirds of death in COPD patients are directly due to the disease.

Diagnosis is made by how hard you can puff out your breath in one second, called the forced expiratory volume or FEV1. Accelerated decline of I FEV1 can often be picked up at age 30.

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See related Patient Topics Breathing Problems, COPD (Chronic Obstructive Pulmonary Disease), Lungs and Breathing or Symptoms and Manifestations.

See related Provider Topics Breathing Problems, COPD (Chronic Obstructive Pulmonary Disease), Lungs and Breathing or Symptoms and Manifestations.

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