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Doctor's Diagnosis: Emphysema


Growing up in the Bronx, I would frequently visit my friend Mike’s apartment to see if he could come out and play. Invariably, his mom would first make us go to the store and buy her a pack of cigarettes. It was a different era: Smoking was sophisticated, and the man behind the counter wasn’t interested in checking ID cards.

It wasn’t until years later that I figured out why my friend’s mom didn’t go buy her own cigarettes. She was suffering from emphysema and the short walk to the store was already much more than she could handle.

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The main function of the lungs is air exchange
. Lungs have millions of “alveoli”: microscopic balloon-like sacs, where oxygen is extracted from the air, attached to the red blood cells and sent via the blood to the rest of the cells in the body. Emphysema is the destruction of these alveoli.
There are many causes: air pollution, industrial exposures, even a congenital form exists, but the vast majority of cases are caused by smoking cigarettes.
Consequently these patients cannot get the oxygen they need. Medication and exercise can help them maximize the function of the remaining lung tissue but will never bring back the alveoli that have been destroyed. These patients slowly restrict their activities, often becoming unable to leave their houses. Even just talking or blowing out the candles on a birthday cake may be too challenging for them. Many of these patients require supplemental oxygen to stay alive.
Nowadays, there are many effective programs and medications to help people with emphysema to quit smoking that were not previously available. Too bad Mike’s mom had to suffer so.

Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at

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