Chronic cough and morning sputum – at the latest with this sign every smoker should be alarmed. After all, a smoker’s lung can hide behind it. But what is this disease all about?
What is smoker’s lung?
Lung cancer-affected alveoli (alveoli) labeled in section. Click to enlarge. Doctors call it chronic abstructive pulmonary disease (COPD), better known as smoker’s lung. There are now five million sufferers in Germany, and the number is rising. In smoker’s lung, the small cilia of the bronchial tubes are destroyed. Mucus can no longer be removed properly. As a result, bacteria settle and the bronchial tubes are permanently inflamed. The exchange of gases between blood and air no longer functions. A smoker’s lung becomes noticeable through a morning cough. Many call it a smoker’s cough. This cough is accompanied by a usually yellow-brownish discolored mucus. In the beginning, only physical activities cause trouble. Later, breathing problems occur even with the slightest step. These attacks of shortness of breath take place episodically. If the three symptoms of cough, discolored sputum and shortness of breath come together, there is a high probability of smoker’s lung. Experts refer to these as AHA symptoms.
Causes
One thing is certain: smoker’s lung does not develop overnight. For a long time, smoking alone was considered the cause of smoker’s lung. After all, nine out of ten patients suffering from smoker’s lung are also active smokers. The dangerous thing is that even the first cigarette can cause inflammation of the sensitive bronchial tubes. If this inflammation becomes chronic, the dreaded smoker’s lung develops. Scientists have now recognized that increasing environmental pollution can also cause smoker’s lung. This includes breathing air polluted by dust particles and sulfur dioxide, as well as fumes from biofuels. All of this puts a lot of stress on the respiratory tract and can trigger chronic obstructive bronchitis. Not for nothing are respiratory diseases the number four cause of death worldwide.
Symptoms, complaints and signs
Smoker’s lung is associated with several symptoms, all of which affect the function of the lungs. A characteristic symptom is the so-called smoker’s cough, which occurs mainly in the morning. There is sputum from the lungs. The sputum may appear in different shapes depending on the cause of the smoker’s cough. Most often the sputum is grayish or brownish. After the morning sputum, the affected person usually does not have to cough up sputum for many hours. If sputum is completely absent, smoker’s lung has usually already caused damage to the alveoli. Smoker’s lung leads to chronic coughing and increased shortness of breath. The shortness of breath occurs at the beginning, especially during exertion, and can occur later for no reason. Colds or bronchitis also occur more frequently. People with smoker’s lung also suffer more often from pneumonia. The symptomatology consisting of shortness of breath, coughing and sputum is referred to as an AHA symptom. In the case of prolonged COPD, sleep apnea also occurs occasionally. This promotes the development of heart failure. The prolonged lack of oxygen can also lead to cyanosis: The lips become bluish and skin and nail changes occur. Drumbeat fingers develop. Eventually, in the most severe stage of smoker’s lung, there is a deterioration of the alveoli, leading to emphysema.
Diagnosis and progression
Schematic diagram of a healthy lung and a smoker’s lung. Click to enlarge. A smoker’s lung is diagnosed by a pulmonologist. He or she also has the necessary technology to clearly diagnose smoker’s lung using breathing and blood tests. After the initial seemingly harmless cough, smoker’s lung progressively narrows the bronchial tubes. The attacks of breathlessness occur in fits and episodes. With each attack, the condition worsens further. If smoker’s lung is not treated, it leads to the death of the patient. The disease is not limited to the lungs. In later stages, it also affects the heart, blood vessels, muscles and bones. When death occurs, it feels like suffocation.
Complications
The most common complication of smoker’s lung is bacterial infection and pneumonia, as a result of which the patient must be ventilated or dies from oxygen deprivation. Associated with the worsened oxygenation are complications such as muscle weakening, stress reactions and, as a result, high blood pressure, fatty deposits and moodiness. Chronic lung disease also damages the heart in the long term – the heart’s pumping capacity decreases and right heart failure develops. In such a severe course, the affected person often becomes immobile. The lack of exercise eventually leads to obesity, digestive problems and the intensification of the original symptoms. Accompanying the smoker’s lung, bronchitis, breathing cessations and, in the worst case, sleep apnea and suffocation of the patient then occur. With timely therapy, adverse events are unlikely. However, the administered cortisone preparations can cause various side effects. For example, water retention, further cardiovascular problems or infections often occur. In addition, the risk of developing osteoporosis is increased. Nicotine replacement therapy can be associated with weight gain. In addition, during the acute withdrawal phase, those affected suffer from enormous stress, moods and other withdrawal symptoms, which almost always represent a major psychological burden.
When should you see a doctor?
If breathing is impaired, a visit to the doctor should be made. If there is shortness of breath, lack of oxygen in the organism or cardiac arrhythmia, a doctor must be consulted. People who are active smokers or who regularly spend time in environments where people smoke should pay particular attention to signs and irregularities of respiratory activity. If any impairment occurs, seek medical attention immediately. If there is a cough, sputum, or bluish discolored lips, a follow-up visit to a physician should be made. Sleep disturbances, a decrease in physical performance and low resilience are signs of a health irregularity. If the complaints last for a longer period of time or increase in extent as well as intensity, a doctor is needed. Drumbeat fingers are a characteristic sign of the presence of smoker’s lung. In case of this symptom, a doctor should be consulted immediately. If deformations of the nails or other irregularities of the limbs appear, an advanced stage is already present. Rapid fatigue, an increased need for rest or a decrease in athletic performance are to be understood as warning signals of the organism. If colds occur more frequently, there is internal weakness or a loss of quality of life, the observations should be discussed with a physician.
Treatment and therapy
If COPD patients learn of their disease, they should stop smoking immediately. Thus, there is a possibility that the progression of smoker’s lung can at least be delayed. In rare cases, deterioration can even be stopped. Nevertheless, treatment extends to the end of the patient’s life. The reason: smoker’s lung cannot be cured. Regular medication becomes mandatory. In the beginning, the pulmonologist will prescribe short-acting inhalers. Later, steroids are added. The cortisone is usually inhaled and is supposed to help reduce the inflammation of the bronchial tubes. Thus, stays in the pulmonary clinic become necessary again and again. It is important to include regular exercise in one’s daily routine in addition to medication. Many patients with smoker’s lung shy away from sporting exertion because they are afraid of a new bout of breathlessness. However, this avoidance leads to exactly the opposite. At some point, the body is too weak for every step. Therefore: start training slowly and carefully, if necessary consult with a doctor.
Prevention
Prevention of smoker’s lung cannot be simpler: smokers should stop smoking. Immediately and without hesitation. Because each inhaled tobacco smoke damages the mucous membranes in the lungs more and more. Of course, it would be even better not to start smoking in the first place. Since passive smoking is also dangerous, smokers should consciously keep their distance from other people. In general, a healthy lifestyle with plenty of drinking should be preferred. Regular exercise is also essential.
Aftercare
Patients diagnosed with smoker’s lung should undergo regular follow-up examinations. Special lung function tests and X-rays should be performed on a rotational basis to evaluate the lungs by the patient’s primary care physician or a pulmonology specialist. Follow-up examinations follow a set schedule of physician visits. Follow-up examinations are designed to detect progression of smoker’s lung in a timely manner so that further therapies can be started early. In principle, the treating physicians and specialists strive to achieve this goal and to implement it as optimally as possible through appropriate measures. The prerequisite and basis, however, is the patient’s general refraining from smoking. This important measure is not only for the primary prevention of smoker’s lung, but is also supportive and helpful in the case of other existing diseases. It is never too late to stop smoking. If smoking is strictly and sustainably stopped, the patient will significantly regain lung function. An essential therapeutic aftercare measure is sport activities, especially sports, which are very useful especially for patients with lung diseases. In this regard, lung sports, breathing exercises and rehabilitation measures can significantly improve the function of the patient’s lungs. An important part of follow-up care is also adherence to a balanced diet rich in vitamins, which, in conjunction with sports activities, will lead to significant improvement in the patient’s lung function and quality of life.
Here’s what you can do yourself
Smoker’s lung is also called COPD. Recent studies have shown that those affected are usually more optimistic about their condition than would be appropriate and thus show too little initiative in treating it themselves. Quitting smoking is indispensable for this disease. However, since it can also be triggered by particulate matter and other air pollutants, these sources of danger must also be avoided. This may mean that the patient should look for another job or move to a rural area. It is possible that giving up smoking will cause the patient to become overweight and stressed. In this case, dietary measures as well as relaxation techniques of all kinds are recommended. An extremely effective and at the same time very easy to learn technique is progressive muscle relaxation according to Jacobson. Yoga meditations with simultaneous breathing exercises are also highly recommended. A dreaded complication of smoker’s lung is pneumonia. It usually results from a previous bacterial infection. To avoid it, the patient should avoid sources of infection while strengthening his immune system. This means that he should strive for and maintain a healthy lifestyle. It includes several components: little to no alcohol consumption, as much exercise and fresh air as possible, plus a diet low in fat and sugar. The patient should also ensure adequate rest and sleep.
