The powerful emphysema treatment nobody knows

My father was a 3-pack-a-day smoker. Started in the military. During the Chinese Civil War, he was conscripted to an island outpost, fighting the communists. Daily the two sides exchanged fire. Nightly, frogmen – nicknamed “water ghosts” – ambushed and killed patrols, cutting their ears off for tally. “Brothers killing brothers,” Father said. “You smoke or go insane.”

My mother tells a different story. The active war ended. In 1964, the U.S. Surgeon General first warned: "Smoking causes cancer." His words reverberated, reaching remote corners of the world, except, apparently, my dad’s ears. “Everybody quit but him.” She was not sympathetic.

At 62, he had a heart attack. After a five-vessel bypass, a grim-faced surgeon informed Mother that while the heart surgery was a success, he feared the worst. Dad’s lungs?

For the first time, we learned that he had advanced emphysema.

Emphysema is one of the chronic obstructive lung diseases (COPD) – progressive and irreversible. In X-rays, emphysematous lungs swell like overinflated balloons.

An entry on the COPD Foundation blog reads: “Have you ever seen a fish out of water, how it flops around & gulps air & it tries to breath [sic] any way it can … That's me on most days!”

Thirty million Americans (12 percent) have COPD, but millions, like my father, have it but don’t know. Insidiously, they tire easily, dread stairs, skip outdoor activities. Another shocker: Smoking causes 75 percent of COPD, so a quarter of COPD sufferers have never smoked.

Women have it worse. After the 1950s smoking boom, women’s COPD rate tripled from 1980 to 2000. Today more women have COPD than men. In Ohio, the rate is 8.5 percent for women, 6.6 percent for men.

The gold standard for diagnosing COPD is a simple huff-and-puff office test (spirometry).

Doctors can’t cure COPD but can make life easier.

Their toolkit: inhalers (ease breathing by relaxing airway muscles), vaccines (Pneumovax and flu shots), in advanced cases, supplemental oxygen and maybe lung-reduction surgery. And smoking cessation.

Using drugs to contain smoking damage is like pulling dandelions without digging the roots. You look busy, but it’s not weeding.  

Psst, here’s another shouldn’t-be-a-secret secret – pulmonary rehab.

Study after study shows pulmonary rehabilitation significantly improves walking distance and sense of well-being. It includes nutritional counseling, psychosocial support, supervised exercise 2-3 times weekly for 1-3 months. Yet, only 4 percent of those qualified are enrolled. For patients hospitalized for COPD, it halves the readmission and death rates. Works better than drugs. Please, consider it.

My father quit smoking, lived another 20 years, died at 82 slumped over a chair. The last years were hard. He dragged an oxygen tank, rested after showers. Once he and Mother went to a school reunion; the excitement left him breathless. He couldn’t get out of the car. They turned around and went home.

As a child, I’d mimic his smoker’s cough, hawking and spitting over a sink until I was dizzy. I went into medicine to be him. And from him I learned to love a simple life, waking up each morning – grateful for having a set of ears.