Severe Emphysema Symptoms and Remedies in its Fourth Stage
In the advanced stage of emphysema, treatment focuses on slowing disease progression, improving quality of life, and managing symptoms. This stage, often referred to as end-stage disease, requires a multidisciplinary approach.
Slowing Disease Progression
The most critical step in managing stage 4 emphysema is smoking cessation. Quitting smoking can significantly slow further lung damage and improve outcomes [1][4].
Symptom Management and Prevention of Complications
Medications play a crucial role in symptom management. Bronchodilators are used to open airways and ease breathing, while corticosteroids help reduce lung inflammation [1]. Antibiotics are prescribed during infections to prevent exacerbations [1]. In some cases, doctors may also prescribe vaccines to protect against pneumonia and flu.
Oxygen therapy (Long-term oxygen therapy, LTOT) is prescribed for patients with low oxygen levels at rest. Continuous oxygen for at least 15 hours daily improves survival and quality of life in severe hypoxemia, though it does not reverse damage [3].
Pulmonary rehabilitation involves breathing exercises and physical activity training to relieve symptoms, reduce hospitalizations, and improve functional status [1][3]. Nutritional support and stress management are also essential to maintain strength and reduce symptom burden [2].
Advanced Treatment Options
For some patients, surgical treatments may be considered. Lung volume reduction surgery removes damaged lung areas to improve function in selected patients with hyperinflation but without large bullae. Bullectomy is performed for large bullae causing compression in some patients [3]. Lung transplantation is a potential option for eligible patients, typically under age 65, when other treatments fail. It can improve survival and quality of life but comes with significant risks [1][3][5].
Ventilatory support may be used for select patients with chronic respiratory failure or associated sleep apnea [3].
Diagnosis and Assessment
Doctors use a combination of laboratory tests, such as complete pulmonary function tests (PFTs) and arterial blood gas tests, to diagnose advanced emphysema. A CT scan is most effective at identifying general signs of emphysema. COPD questionnaires, including the COPD Assessment TEST (CAT) and the COPD Control Questionnaire, are used to further understand the severity of emphysema. A 6-minute walking test is a measure of a person's aerobic exercise capacity and can help determine if a person with emphysema requires long-term oxygen therapy (LTOT).
An echocardiogram can help doctors identify secondary pulmonary hypertension due to COPD. The staging system for COPD, according to the Global initiative for chronic obstructive lung disease (GOLD) severity assessment, uses the FEV1 score along with additional tests to determine disease severity. Cardiopulmonary exercise testing is another test for assessing how well the lungs and heart are functioning.
Living with Stage 4 Emphysema
Stage 4 emphysema can cause a range of physical symptoms, such as low blood oxygen, shortness of breath, fatigue, cyanosis, swelling of the feet and ankles, lung infections, changes in consciousness, difficulty walking, difficulty eating, and difficulty swallowing. Mental symptoms may include anxiety, depression, confusion, and memory loss.
Despite the challenges, people with stage 4 emphysema can live for a decade or more following the diagnosis, especially if they quit smoking and manage their symptoms well [6]. Early intervention and comprehensive management are critical to maximising symptom relief and quality of life while slowing progression as much as possible [1][3][4][5].
Therapies and treatments like CPAP or BiPAP ventilation may be used for patients experiencing chronic respiratory failure or sleep apnea not responding to other treatments [3].
Achieving workplace-wellness is essential, with proper fitness-and-exercise and skin-care routines reducing the strain on the respiratory system and boosting overall health [7].
Keeping a balanced diet rich in nutrients is crucial, as a nutrient-dense diet can provide vital energy without putting extra strain on the lungs [2].
Incorporating mindfulness practices, yoga, and other stress-reduction techniques, respectively, may help improve mental health and emotional wellbeing – reducing the anxiety and depression often associated with emphysema [2].
Medicare provides coverage for treatments related to emphysema and allows for access to specialists, medication, and therapies [8].
Recent studies have shown that CBD oil may help alleviate inflammation, pain, and anxiety in patients with chronic diseases or respiratory conditions such as emphysema [9].
Long-term, continuous airway clearance techniques may reduce the risk of mucus accumulation and secondary infections, improving lung function and maintaining health status [10].
