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Emphysema

What is emphysema?

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Emphysema affects the air sacs in your lungs. Normally, these sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out.

In emphysema, the walls between many of the air sacs in the lungs are damaged. This causes the air sacs to lose their shape and become floppy. The damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. This makes it harder for your lungs to move oxygen in and carbon dioxide out of your body.

What causes emphysema?

The cause of emphysema is usually long-term exposure to irritants that damage your lungs and the airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause emphysema, especially if you inhale them.

Exposure to other inhaled irritants can contribute to emphysema. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing emphysema.

Who is at risk for emphysema?

The risk factors for emphysema include:

  • Smoking. This the main risk factor. Up to 75% of people who have emphysema smoke or used to smoke.
  • Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
  • Age. Most people who have emphysema are at least 40 years old when their symptoms begin.
  • Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get emphysema are more likely to get it if they have a family history of COPD.
What are the symptoms of emphysema?

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

  • Frequent coughing or wheezing
  • A cough that produces a lot mucus
  • Shortness of breath, especially with physical activity
  • A whistling or squeaky sound when you breathe
  • Tightness in your chest

Some people with emphysema get frequent respiratory infections such as colds and the flu. In severe cases, emphysema can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

How is emphysema diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • A family history
  • Other tests tests, such as lung function tests, a chest x-ray or CT scan, and blood tests
What are the treatments for emphysema?

There is no cure for emphysema. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

  • Lifestyle changes, such as
    • Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
    • Avoiding secondhand smoke and places where you might breathe in other lung irritants
    • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
  • Medicines, such as
    • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
    • Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
    • Antibiotics if you get a bacterial or viral lung infection
  • Oxygen therapy, if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
  • Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
    • An exercise program
    • Disease management training
    • Nutritional counseling
    • Psychological counseling
  • Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
    • Remove damaged lung tissue
    • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
    • Do a lung transplant. This is might be an option if you have very severe emphysema.

If you have emphysema, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Can emphysema be prevented?

Since smoking causes most cases of emphysema, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Flu

What is the flu?

The flu, also called influenza, is a respiratory infection caused by viruses. Each year, millions of Americans get sick with the flu. Sometimes it causes mild illness. But it can also be serious or even deadly, especially for people over 65, newborn babies, and people with certain chronic illnesses.

What causes the flu?

The flu is caused by flu viruses that spread from person to person. When someone with the flu coughs, sneezes, or talks, they spray tiny droplets. These droplets can land in the mouths or noses of people who are nearby. Less often, a person may get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes.

What are the symptoms of the flu?

Symptoms of the flu come on suddenly and may include:

  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)

Some people may also have vomiting and diarrhea. This is more common in children.

Sometimes people have trouble figuring out whether they have a cold or the flu. There are differences between them:

Signs and SymptomsColdFluStart of symptomsSlowlySuddenlyFeverRarelyUsuallyAchesSometimes (slight)UsuallyFatigue, weaknessSometimesUsuallyHeadacheRarelyCommonStuffy nose, sneezing, or sore throatCommonSometimes

Sometimes people say that they have a "flu" when they really have something else. For example, "stomach flu" isn't the flu; it's gastroenteritis.

What other problems can the flu cause?

Some people who get the flu will develop complications. Some of these complications can be serious or even life-threatening. They include:

  • Bronchitis
  • Ear infection
  • Sinus infection
  • Pneumonia
  • Inflammation of the heart (myocarditis), brain (encephalitis), or muscle tissues (myositis, rhabdomyolysis)

The flu also can make chronic health problems worse. For example, people with asthma may have asthma attacks while they have flu.

Certain people are more likely to have complications from the flu, including:

  • Adults 65 and older
  • Pregnant women
  • Children younger than 5
  • People with certain chronic health conditions, such as asthma, diabetes, and heart disease
How is the flu diagnosed?

To diagnose the flu, health care providers will first do a medical history and ask about your symptoms. There are several tests for the flu. For the tests, your provider will swipe the inside of your nose or the back of your throat with a swab. Then the swab will be tested for the flu virus.

Some tests are quick and give results in 15-20 minutes. But these tests are not as accurate as other flu tests. These other tests can give you the results in one hour or several hours.

What are the treatments for the flu?

Most people with the flu recover on their own without medical care. People with mild cases of the flu should stay home and avoid contact with others, except to get medical care.

But if you have symptoms of flu and are in a high risk group or are very sick or worried about your illness, contact your health care provider. You might need antiviral medicines to treat your flu. Antiviral medicines can make the illness milder and shorten the time you are sick. They also can prevent serious flu complications. They usually work best when you start taking them within 2 days of getting sick.

Can the flu be prevented?

The best way to prevent the flu is to get a flu vaccine every year. But it's also important to have good health habits like covering your cough and washing your hands often. This can help stop the spread of germs and prevent the flu.

Centers for Disease Control and Prevention

Haemophilus Infections

Haemophilus is the name of a group of bacteria. There are several types of Haemophilus. They can cause different types of illnesses involving breathing, bones and joints, and the nervous system.

One common type, Hib (Haemophilus influenzae type b), causes serious disease. It usually strikes children under 5 years old. Your child can get Hib disease by being around other children or adults who may have the bacteria and not know it. The germs spread from person to person. If the germs stay in the child's nose and throat, the child probably will not get sick. But sometimes the germs spread into the lungs or the bloodstream, and then Hib can cause serious problems such as meningitis and pneumonia.

Treatment is with antibiotics. There is a vaccine to prevent Hib disease. All children younger than 5 years of age should be vaccinated with the Hib vaccine.

Centers for Disease Control and Prevention

Homelessness and Health

What are the causes of homelessness?

Each night, hundreds of thousands of people experience homelessness in the United States. Some of these people experience chronic homelessness, while others have temporarily lost their shelter. The reasons why they are homelessness are complex. They can include a combination of factors such as:

  • Poverty
  • Unemployment
  • Lack of affordable housing
  • Mental and substance use disorders
  • Trauma and violence
  • Intimate partner violence
  • Justice-system involvement
  • Sudden serious illness
  • Divorce
  • Death of a partner or parent
  • Disabilities
What is the link between homelessness and health?

Poor health can contribute to homelessness. And being homeless can contribute to poor health. Many of the problems that people experiencing homelessness face can make their health worse, including:

  • Limited access to health care
  • Problems getting enough food
  • Trouble staying safe
  • Violence
  • Stress
  • Unsanitary living conditions
  • Exposure to severe weather
What are some of the common health problems that people experiencing homelessness have?

Some of the common health problems that people experiencing homelessness may have include:

  • HIV
  • Lung diseases, including bronchitis, tuberculosis, and pneumonia
  • Malnutrition
  • Mental health problems
  • Substance use problems
  • Wounds and skin infections

Many people experiencing homelessness are dealing with trauma. They may have been abused or assaulted. This includes children, who are at risk for emotional and behavioral problems.

Contact your local homelessness assistance agency to get the help you need, such as access to shelters, health centers, and free meals.

Infection Control

Every year, lives are lost because of the spread of infections in hospitals. Health care workers can take steps to prevent the spread of infectious diseases. These steps are part of infection control.

Proper hand washing is the most effective way to prevent the spread of infections in hospitals. If you are a patient, don't be afraid to remind friends, family and health care providers to wash their hands before getting close to you.

Other steps health care workers can take include:

  • Covering coughs and sneezes
  • Staying up to date with vaccinations
  • Using gloves, masks and protective clothing
  • Making tissues and hand cleaners available
  • Following hospital guidelines when dealing with blood or contaminated items

If you are thinking about hospice, palliative care, or home health, please do not hesitate to contact us. We will be happy to answer any questions and even visit your home for a free consultation.


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