Smoking Isn’T Only Cause Of Emphysema

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DEAR DR. DONOHUE: I work with a woman who claims she has emphysema. She smokes regularly and finds herself out of breath when coming up the stairs. She is 60. She says when she was 9, a local gas station near her home moved and, in the process, pulled up the gas tanks that provide gas to the pumps. The fumes from the move caused her emphysema. She doesn’t know anyone else with the problem, and there are no class-action lawsuits I can find that cite gas fumes from moving gas tanks as causing emphysema.

Will you clarify and talk about emphysema? — E.E.

ANSWER: Emphysema is destruction of the millions of air sacs that fill the lungs. It’s through these sacs that oxygen reaches the blood.

One of the chief signs of emphysema is shortness of breath when active, as in climbing stairs. Emphysema is one-half of chronic obstructive pulmonary disease, COPD. The other half is chronic bronchitis, an inflammation and narrowing of the breathing tubes, filled with pus. The inflamed tubes obstruct airflow into the lungs. The chief sign of chronic bronchitis is a never-ending cough.

Smoking is the greatest cause of COPD, emphysema and chronic bronchitis, but not the only cause. In past days, workers in mines inhaling the dust were subject to emphysema, as were people who worked in cotton mills. Those who made a living in grain-processing plants also were subject to COPD. Now stringent regulations protect these workers.

An inherited condition, called alpha-1 antitrypsin deficiency, also leads to emphysema. Alpha-1 antitrypsin tells cells that scrub the interior of air sacs to stop scrubbing when the air sacs are clean. Without its signal, scrubbing goes on, and the air sacs are destroyed.

I have never heard of emphysema arising in a situation like your fellow worker describes. She must be happy explaining her condition the way she does. Let her be happy. It’s her way of coping with the illness. She also must be smart enough to know that smoking is harming her greatly, regardless of her emphysema cause.

The booklet on COPD explains this common malady in clear terms. Readers can order a copy by writing: Dr. Donohue — No. 601W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: What is the purpose of making all Coumadin users make a separate trip to a nurse for having their blood checked? It’s an additional charge that I cannot afford. Is there any other drug I could use? I am 93. — R.J.

ANSWER: I imagine the procedure was instituted so the nurse can change your dose of Coumadin right away if the blood tests indicate that your blood is too thin or too thick. Coumadin is an anticoagulant that stops clots from forming; it really does thin blood. The medicine is prescribed when a person has a condition where clots form and might cause a stroke. Atrial fibrillation is such a condition.

You can ask your doctor if you’re a candidate for the new anticoagulant Pradaxa. With it, you don’t need to have the same blood checks.

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