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British Lung Foundation
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Progression of Emphysema.

Why does Emphysema progress even if you stop smoking? I know the lung volume declines with age just like every other part of the body but why does Emphysema progress if you don't do anything to agitate it?

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Am not 100% but am sure it's inflammation build up and swelling .. Even if you never smoked cooking would do it or even asbestos silica anything really even those who we think av good lung are bushed

It's impossible to live clean life


A was reading when we are born the think mucus in our lungs don't help as it rips them apart .... apparently the use steroid inhaler or something to stop mucus doing that



I also have Emphysema primary cause smoking, but any toxic fumes or smoke will make the condition worse, second hand smoke, exhaust fumes, household products, which as much as we try cannot always be avoided.

I spent three days in hospital with exacerbation caused by "auto air freshner" at daughters home.

I spent five hours in A and E from household products.

All of which chips away at my condition.

As well as stopping smoking a well balanced diet and exercise will strengthen resistance, our ever slightly.

I find it best to to dewell on it to much a continue as best I can but at a slower pace.



That is a good question and I have wondered myself. Some positive minded medical people do say that it doesn't always progress. Best scenario is that the rate of decline is as for age. Which leads into well why does it progress in some and not others. Perhaps because most people have quite a lot of lung function loss before they realise they have a problem. But if you are for want of a better term, fortunate enough to be diagnosed in the mild stages and wise enough to stop smoking I guess that would be more (but not always) the best situation to hopefully stop or dramatically slow the disease process. Another thought is well if smoking causes emphysema then why do only 15 / 20 % of smokers get the disease. Sometimes there is a family history other times there is not. Is it just bad luck. Are they just guessing placing the blame on smoking when not all smokers get the disease? (don't take that comment the wrong way I HATE cigarettes) I have searched for answers to better understand this disease process and if I have understood correctly smoking introduces pathogens. These pathogens trigger/cause disease and continue to cause destruction even though the original cause has been eliminated. Imagine how much quicker the destruction would be if we continued to smoke. Does that mean if they can isolate which pathogens cause the problem they can then cure emphysema? Its all very confusing! Until they do we give ourselves the best shot by quitting, exercising, eating well and avoiding people with colds and flu's. Hope your doing well 1968? Suz x


Hi sue...your comments make sense, however, I have always wondered about a connection to the auto immune system. I believe some day the medical world will find this. The inflammation link makes sense. And your immune system can attack organs when it is over active. What do you think? Regards.

Please read some of my previous posts - The General opinion and research of the younger generation Pulmonologist indicates that it only progress according to ageing. Everyone loses 15 ml to 25 ml per annum anyway and we are just ahead of them. The problem is most of us lives in cities with dirty air and other contributing factors that we can't avoid and where people without Emphysema are not influenced, we get more damage. However you will find many sufferers on this site that's been at the same stage for 25 years and more after they removed the danger factors and in many cases through exercise and living healthy even got better.

I'm choosing to get better - only a pity - 3 years from retirement and must still do the busiest highway in Africa between Johannesburg and Pretoria every day


Age! Everyone including the healthy loose lung function it's merely part of the ageing process. Our body's as humans start to break down after 40! ,this is medical fact, with the onslaught of medical science since the 1960's people live longer and due to drugs we are being mainly kept going and alive into ages never before seen by previous generations so the youth culture has a lot to answer for, population explosion , planet strain, food resources over strained , list endless....I suffer AATD genetically inherited liver,lung disease I left the inner CIty on being diagnosed at just 45 and moved to the countryside, in 2009 I was given 2 yrs left to live fev at 22 per cent! I was dying and foolishly still on the fags! I quit, started to walk got my first doggie (own 3now) ! Walked daily on the beaches where I choose to move to , eat well and my lung function sits stable now at 42 per cent, no bad habits lots of effort and great air got my ticket to life again, drastic changes effectively saved me and massively improved my life quality , I would recommend any lung patient to move away from the City life as far as they can great air is our key too! It's more than just quitting the cigs its a change of life and being determind and positive goes a long way too....keep winning ☺️


A good post Flo. Where did you move from and to where? :)

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Good for you for being able to quit smoking and then getting better. I quit smoking 20 years ago and just this year diagnosed with emphysema at 43% fev1. If I knew sooner, I wouldn't have gone to some of the pubs where people smoke, but I never presented with dyspnea or anything for the GPs to notice. That's water under the bridge. We live in a semi-rural area now where the air is good. Wife and I eat a balanced home-cooked diet (I'm the cook) , seldom eat takeout, etc. so hoping I will stay stable for a while also. Good luck!

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I assumed a lot of it was age related. But I think if you have got lungs which are already damaged then any exacerbtions will cause further damage whether it's by infection, polluted air, areosols etc. We are more susceptible than folk with healthy lungs and ours don't repair themselves so well. It's the same with any organ in a weakened state isn't it? x


I agree with you ,sadly the damage we did by smoking is irreversible ,,,and with every chest infection etc further damage is sometimes done, and it find with each infection it takes me longer to recover ,,,,air freshners etc spray polish , bleach ,,are all no no's for me ,so for cleaning bathrooms and kitchens etc I use sugar soap mix,no smell or fumes it does a great job,,,,and I do have to spray a little polish on my duster ,,,,but not on the surfaces ,,,this means I only inhale it once ,,lol ,,,, but years ago I would be hoovering and polishing every day ,,,,,not now though ,,,,


Some of the damage is reversible when you take the cause out of the equation. Lungs do repair to an extent under the right circumstances and improving your immune system and strengthening your lung muscle is key to accomplishing that goal. I have been diagnosed with both Bronchitis and Emphysema and 50% lung function. I retired early & then quit smoking which really helped me a lot cause I was getting sick from exposure from breathing the common air in the work environment (13 flrs with 100's of employees and a common air duct system) with lots of paper dust and parents coming to work sick and transference, driving in heavy traffic, and of course smoking, etc. I haven't been sick since and my breathing has improved from around 93 to 96-98% saturation of oxygen to body ( I bought a finger pulse oximeter like the one the dr. uses). Lifestyle changes are extremely important. Just like the lady who mention the guy who wrote a book about how he cured his mother (cured is subjective but improved yes) by eliminating foods that contribute to inflammation like sugar and milk type products that can contribute to Mucus, eating lots of good fresh foods with antioxidants that improve the gut flora which effects our immune system. Pay attention to good air quality outside which includes heat and moisture levels too that effect breathing (I get notifications by email). I find when it's high humidity out, it effects my breathing some. Allergies is another consideration that can be problematic if you have this condition; it's like getting a cold so stay on top of that too and immunizations. As soon as you have cold/flu symptoms go into high attach mode right away and take high does of vitamin C, gargle with warm salt water, pop some Zinc and Echinacea lozenges (great stuff to ward of an infection quickly), use some Vicks on the chest and a vaporizer to keep lungs moist, drink plenty of water too to keep the secretions thin and loosen congestion. I try "not" to use any cold remedies that says it drys you up and stops coughs which are important to rid the chest of mucus because if it drys things up, you set yourself up for a bronchial infection or worse. If mucus starts to get thick I don't wait any longer and drag out OTC big guns, Musenx, great stuff but not cheap still worth it (generics just don't seem as good). If you have an uncontrollable cough that's different or have low oxygen levels, go to ER right away - don't wait and let it do more damage. Also I am a believer in Chicken Soup and you can make some up in advance (without pasta or rice) and freeze it so you have it when you get sick and then throw some noodles in it. Also wash your hands often and avoid large crowds in inclosed areas helps too. I go to the store when I know it's not going to have a lot of people and it's more peaceful to shop too. I also buy local raw honey from a bee farm which helps with allergies and has other health benefits too (much better than other sugars). You can also start juicing with greens and fruit with the addition of chia seeds and Flax seeds and some plain greek yogurt for a meal substitute. You can find books with all kinds of smoothie recipes for health benefits. Making sure you get a broad range of vitamins including vitamin A, B's & D, Calcium, Omega 3, potassium which I take supplements for too. I buy Raw Calcium capsules with K-3 from Sprouts which I feel has the best ingredients to actually work. I also take medication "Advair" dry inhaler at low dosage (hurray) that works great for me and get my flu and pneumonia shots and of course exercise to work those lungs and make them stronger like any other muscle. I also wear a good breathing mask when working with chemicals or dust which require different rated type masks. So you can see there are lots of things you can do some mentioned here that can only help you feel better and improve your quality of life as well preventative to those things that can cause you further problems. A positive attitude along with taking charge of your future is also very important mentally which again can have physical consequences. The mind is a powerful thing if you harness it's energy in a positive way. My Pulmonologist also said to help with exercising, take a couple inhales from my rescue inhaler through a added VHC he gave me (Holding chamber) which gives a better treatment to prepare "before" exercising so you will be better able to exercise and longer. Don't let anyone else use words like "progression" to paralyze you into submission and depression.... you do have a lot of control over this! If you still smoke, I highly recommend whyquit.com which was a great source of information in understanding the process and benefits of quitting which motivated me and allowed me to mentally overcome the addiction.....yes I said mentally because the physical really is not the hard part. This was my daily support system where I could monitor my progress hourly, daily, weekly etc. (Timetable page) and stay inspired.....I did it cold turkey too; you believe that! I bragged to people about my progress where ever I went in conversation and I got a lot of congrats; I was even treated to free desert once you can't beat that. I did gain some weight but the benefits out weighted that so now that's my next mission because being over weight can also affect your breathing. Well, this cheer leader hopes you all have a wonderful day and days to come!

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Hi 1968

its a question I have asked before, myself.

I even did a couple of weeks of intensive research and could not find an answer that I found plausible considering the nature of the progression.

I gave up smoking two years ago when i was diagnosed

( I was told i had a couple of years left . by a nurse)

At the time i had moderate disease now its severe

. i have moved to live by the sea.

i have replaced the two stone below normal body weight that had lost.

I have a good life and strangely i am a happy bunny most of the time

We are told that its the smoking that causes the COPD not the ordinary pollutants of life and yet a lot of people on this site blame many of these ordinary pollutants, air fresheners, perfumes, industrial pollution and their like for continuing the destruction of their lung cells. Are they right?

We kind of understand how cancer and other diseases destroy our body cells but why when the main agent (cigarette smoke) is removed why do those holes carry on forming in the lungs of people with emphysema, (mine)

Why? are all our lung diseases lumped together as COPD when they are all so radically different.

The only thing linking them is that we have the same symptoms (roughy) and need the same medications but physically they all manifest themselves in different ways.

The other thing that is the same, is that all people with COPD are blamed for causing their own illness by smoking.

The media always say its caused by smoking......as we all know! a large proportion of people with COPD have never smoked

(in that case the buck is passed to their smoking loved ones LOL)

(IF i had never smoked I would be so angry for being blamed for causing my own illness)

Why do so many of us have co-morbidity's?

( other serious illnesses that happen at the same time as the main disease)

This is often blamed on lack of oxygen to the other effected organs, in my case the heart attack came before the diagnosis of COPD

Why? as a group of sufferers are we so ignored?

why is research into finding cures so underfunded.

COPD the second major killer and most people have never even heard of it. WHY NOT?

I have so many questions and I feel like i am been fobbed of with the sort of answers I am given.

My Darling brother recently died from mesothelioma I am livid that he was exposed to asbestos and that the government knew (at the time that he was exposed) that asbestos caused mesothelioma/ lung cancer.

sorry 1968 for jumping on your bandwagon, I did not know i was going to rage on so much

take care and breath easy linda x


Hi Lindiane

Thanks for your input. Did you ever include examining diet and different diets during your researches? There are claims by some that special certain diets can even cure COPD! I read somewhere recently that a man had cured his Mother using a combination of raw vegetables and total absence of sugar among many things in a specially contrived diet. He claimed that she recovered after two years of this diet. I will kook for a link and send it on.


Excellent rant!

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I'm more focused on asthma but the cause might be treated in the same way. Careful use of aspirin has allowed me to stop daily preventer inhalation, to identify what my strongest trigger is (and to manage things accordingly), and now I don't rely on conventional reliever either - bit.ly/salamol


I was told it should not get any worse, with alpha one, and has improved with medicine. But stay away from smokers is the trick!. And cities etc...


I saw a documentary on tv claiming diesel fumes were a menace. Just as bad if not worse than tobacco. so many counties leaped on the anti smoking bandwagon. Conveniently ignoring all the many other types of pollution.

My great great grandfather lived to be 100 and another great great grandfather lived to be 90. Both pipe smokers.

Not smoking has made me worse, not better. However that is beside the point. what I am trying to say is not enough countries are doing anything to cut down air pollution.

The dreadful pollution in China and India must surely find its way around the world. What about the high octane fuel jets dump of the have to land early? Plus the fumes? the list is endless. There are huge fire holes that have been burning for over 40 years. One in Russia another in Africa. They are burning natural gases. There may be more.

Smoking tobacco is only part of the story.


It's co-factors which make the difference. Genetics play a major part in how much/whether we are affected by copd. Exposure to pollution, second hand smoke, chemical household products vary from person to person, as does inflammation which plays a major part as mentioned above. So the fact that 20% of smokers get emphysema and that it develops differently shouldn't be a surprise given all of that.

Pre-existing co-morbities such as asthma can make copd much worse - a double whammy. (My local respiratory education network - all the healthcare people including GPs and consultants - did a whole day's training session on this.)

There is no one size fits all - I smoked 10 cigs a day from age 20 to 40 when i gave up. Diagnosed at 55 at moderate stage. Now severe - 38% fev1 but living a good life. (Im very lucky not to have conditions which cause pain at present, i know this makes it easier.)

Since we (most of us) live in the west, we tend to forget that copd is rising exponentially in women in developing countries where smoking is culturally unacceptable for women, but cooking indoors in unventilated spaces using polluting fuel which makes fumes and smoke is commonplace. As said by AzureSky, smoking is only part of the picture.

Nothing is fair about this, its something we just have to get used to and learn to manage our health as proactively as possible. Ive noticed the term "sufferer" being used a few times above. I loathe this term and could never use it for myself, with its connotations of victim or martyr. I don't "suffer" from copd and asthma despite them often being very disabling. I live with it, simple. I don't expect everyone to agree with me but seeing myself as a sufferer would not enable me to have a positive and proactive attitude to my life and its challenges which is crucial for both my physical and psychological survival.


Sir James, from the North West of England to the South West ...best thing I ever did! Just wished I done it a great deal sooner...hindsight etc. Dumba alpha one is a very serious condition not sure the info you received is totally correct although smoking is a big no go zone, we are much more complex than the lungs , in fact the lungs are a secondary to the actual source of the disease, condition, as the 'liver' is essentially our main area of concern, if you wish to find out more pm me we run a support group on facebook for alpha one patients globally and I have a wealth of knowledge through experience of living with this for some 9 yrs now, so happy to help you out, but its naive to state smoking is our way, for a better life. We lack a vital protein that keeps the lung area protected and that cannot be released from the defunct liver we inherit through 2 bad genes passed down to us through our parents, there is currently no cure and we can and should have the liver monitored equally with the lungs, as this can develop cirrhosis due to the back up of the protein unable to be released into our overall system, this is the biggest protein the body makes so our whole body needs it, hope this helps give you a better picture of what alpha one is and what the patients face with it, very arduous disease and deadly ...please be very aware of this ..happy to answer questions off anyone and I recommend everyone diagnosed with COPD age 40 to 45 to ask for the alpha one test as 3% of the COPD population actually suffer with alpha one and have been misdiagnosed! Shocking but true, alpha is a little known condition, but a stealth one, and a killer disease, so if you doubt they are wrong and mostly medics do not test unless prompted ask! Its vital you are given the right diagnosis... :)

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Fascinating read, I was tested for Alpha 1 a few years ago, it came back fine, mine's is Bullous Emphysema stage 1 very mild. The now say I could have been born with it and slight symptoms and diagnostics only picked up when I stopped smoking.

Very interesting read, thanks.



Fantastic debate going on hear. Love the answers.



I've been diagnosed with very severe emphysema for nearly 4 years now and I haven't got any worse in those 4 years going by arterial gases. Also my FEV1 hasn't changed. In fact, when I was given the proper medicines I felt a whole lot better. I seem to be able to do more now then I did then. It took me 4 stops to get to the top of my stairs ( 14 steps ) and by the time I got there I was really short of breathe, now I do it in one go without even getting a bit puffed most times. :)


Hey puff...are you on oxygen?

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I know exactly what you mean. I quit smoking in 1992. Not too many problems, maybe a little breathless if I ran for a bus. 22 years later, after two hospital admissions in the space of 4 weeks.(no admissions before) I have 'end stage emphysema.' OK, I still function. I work 3 days a week. Am on 1/2 litre oxy 15 hours daily that's because now I am a CO2 retentive. I am a little annoyed because I was told way back in 1992 by a GP in New York (lived there for 15 years) that my breathing wouldn't get any worse because I had quit smoking. Obviously I am a lot older (64) still, I am a little angry. Apparently this disease has baffled the entire medical profession.




In my opnion, a lot has to do with infection being trapped much more easily in the lungs with not much escape route.

Who knows? I gave up smoking 26 years ago and could walk fine with a stick. Now I'm on 24-hour oxygen, cannot walk or stand without holding onto things both sides, and cannot go out without help. It's a slow

horror story I'm afraid, and I guess the worsening can only be caused by ageing. Keep looking after yourself!

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