Emphysema - Dr Qaisar Ahmed MD, DHMS, Islamic Jurisprudence. Dr Qaisar Ahmed MD, DHMS

Emphysema is a chronic obstructive pulmonary disease (COPD) [sometimes called “Chronic Obstructive Lung Disease {COLD}], that presents as an abnormal and permanent enlargement of air spaces distal to the terminal bronchioles. It frequently occurs in association with obstructive pulmonary problems and chronic bronchitis.

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It is unusual for someone to have pure emphysema unless it is a result of genetic abnormalities. Most people have some combination of emphysema and chronic bronchitis with varying degrees of airway bronchospasm.

Symptoms of emphysema occur because the body is not being supplied with adequate oxygen and because it takes significant effort to take deeper breaths. These both contribute to the very miserable sensation of constantly feeling short of breath.

Types of Emphysema

There are three morphological types of emphysema including:

Centriacinar begins in the respiratory bronchioles and spreads peripherally mainly in the upper half of the lungs and is usually associated with long-standing tobacco smoking.
Panacinar predominates in the lower half of the lungs and destroys the alveolar tissue and is associated with homozygous alpha-1 antitrypsin deficiency, a genetic disease.
Paraseptal emphysema preferentially localizes around the septae of the lungs or pleura, often associated with inflammatory processes, like prior lung infections.

Emphysema does not affect the quantity of life, but rather the quality of life. The BODE score can help measure the quality of life and prognosis for future functions.

The BODE score can help measure the quality of life and prognosis for future functions.

B = Body Mass Index (BMI).
O = Obstruction. Lung function based on pulmonary function tests.
D = Dyspnea (breathlessness)
E = Exercise capacity. How far the emphysema patient can walk in 6 minutes

BODE scores can’t predict longevity or mortality but are guidelines to assess the severity of emphysema and how it may affect future lifestyle.

What Is Causing Your Chest Pain?

Chest pain is a common symptom of many diseases and conditions. Examples of potential sources of chest pain, depending upon the medical problem include:

The chest wall
The back
The lungs and pleura (the lining of the lung, for example, pleural effusion), or trachea
The heart
The esophagus
Referred pain from organs in the abdominal cavity etc.

Stages

There are four stages of emphysema. Emphysema staging helps determine how much lung damage is present and how severe it is.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) uses FEV1 measurements to help with this determination:

**FEV 1 Staging for Emphysema Chart**
Stage	FEV1
I = mild	greater than or equal to 80% predicted
II = moderate	less than 80%, greater than 50% predicted
III = severe	Less than 50%, greater than 30% predicted
IV = very severe	Less than 30% predicted, or less than 50% of chronic respiratory failure

Causes

There can be many causes for the development of emphysema. However, the majority of cases of emphysema (COPD) are caused by exposure to tobacco smoking. Although genetics may play a role, the inflammation mediated by the body’s cells (neutrophils, macrophages, and lymphocytes) is usually triggered by exposure to inflammatory compounds, many of which are found in tobacco smoke. The response of the body’s immune system leads to the destruction of elastin and other structural elements in the lungs, ultimately producing areas in the lungs that cannot function normally.

People with alpha-1 antitrypsin deficiency have an inherited autosomal condition that results in increased breakdown of elastin in the lungs, resulting in COPD (emphysema). When foreign irritants and substances enter the alveoli, usually by inhalation, an inflammatory process is initiated. Chemical messages are sent out recruiting white cells to remove this foreign material. These cells release enzymes that destroy this substance. Normally, these enzymes, often trypsin (protein dissolving enzymes) work to remove this material.

The body has anti-trypsin enzymes that destroy the trypsin when the foreign substance is no more. In the case of the genetic alpha one antitrypsin deficiency, these enzymes continue to work unabated destroying normal adjacent lung tissue, resulting in emphysema. This is often referred to as the “innocent bystander” effect.

Risk factors

The major factors that increase the risk of developing emphysema are:

Smoking: Smoking is one of the major risk factors for developing emphysema; the risk increases as the number of years the person has been smoking increases and is related to the amount of tobacco smoked (for example, three cigarettes a day versus a pack and a half per day); smoking is a major risk factor also for developing lung cancer.

Exposure to secondhand smoke: the risk factors for emphysema increase for people exposed to secondhand smoke according to the number of years exposed to secondhand smoke, and the amount of smoke the person is exposed to.

Exposure to fumes or dust in the environment: People that work in close association with chemical fumes or dust generated in mining, chemical plants, or other industries are at higher risk for developing emphysema; these risks are further increased if the person smokes tobacco. emphysema-dixe-cosmetics

Pollution: Air pollution caused by fumes from vehicles, electrical generating plants that use coal, and other fumes produce increases the risk of emphysema.

Indoor air pollution primarily from open wood flames used for cooking is the primary mechanism for acquiring emphysema.

Signs and symptoms of emphysema

Emphysema is a progressive disease with the most common and characteristic symptoms of cough and shortness of breath caused by prolonged smoke exposure.

Affected individuals with alpha-1 antitrypsin deficiency tend to develop symptoms of emphysema at earlier ages. Emphysema is a subtype of chronic obstructive pulmonary disease (COPD).

Most patients, except those whose disease is the result of a genetic deficiency (alpha-1 antitrypsin deficiency), have variable manifestations of the different components of COPD which include:

chronic bronchitis,
asthma,
emphysema, and
bronchiectasis.

Each of the subtypes has characteristic symptoms; those primarily associated with emphysema are shortness of breath and wheezing. Initially, the shortness of breath (dyspnea) occurs with activity; as time continues and the disease progresses, the episodes of dyspnea occur more frequently eventually occurring at rest making routine daily activities difficult to perform and thus altering the lifestyle.

Diagnosis

The healthcare professional will take a careful history to learn about the lung and breathing symptoms.

How long has the shortness of breath been present?
What makes it better?
What makes it worse?
Has there been an infection recently?
Have the symptoms been getting more severe?
Does the patient smoke?
Does the patient have exposure to secondhand smoke or other toxic fumes?
Are there other exposures to diseases that may be contributing to the shortness of breath?
Is there a family history of lung disease?

Physical examination

A physical examination will concentrate on the lung findings, but may also include the heart and the circulatory system.

Is there an increased respiratory rate?
Is the patient short of breath just sitting in the examination room?
In addition to the ribs and the diaphragm, is the patient using the intercostal muscles (those between the ribs) and neck muscles to breathe? When used, accessory muscles cause the appearance of indrawing, where there is observable sucking in of muscles during the breathing cycle. This is normally seen in people who have just exerted themselves as the body recovers from exercise or work. In patients with emphysema, it may be observed at rest.
Does the chest appear enlarged or barrel-shaped?
Does the chest cavity sound hollower than it should?
Does exhalation take longer than it should? Since the elasticity of the lung has been lost, it takes longer for air to be forced out in the breathing cycle.
Is the movement of the diaphragm decreased?
Is the patient cyanotic (having a blue tinge to the skin color signifying lack of oxygen in the blood)?
When listening to the lungs, are there wheezes present, especially if the patient is asked to exhale quickly?
Is clubbing present? (This is a characteristic change in the fingernails and tips of the fingers associated with lung disease and chronic hypoxia).

Exams and tests required

Oximetry

Oximetry is a non-invasive test, in which a sensor is taped or clipped onto a finger or earlobe to measure the percentage of red blood cells that have oxygen. This value is usually greater than 92%. Results less than 90% may signal the need for supplemental oxygen for home use.

Blood Tests

A complete blood cell count (CBC) may be performed to check for an increase in the number of red blood cells. In response to lower blood oxygen concentrations (the body manufactures more red blood cells to try to deliver as much oxygen as possible to cells).

Alpha-1 antitrypsin levels may be measured to look for the genetic form of emphysema.

An arterial blood gas test will measure the amount of oxygen and carbon dioxide in the blood and combined with other measurements can help the healthcare provider decide whether the body has been able to adapt to the lower oxygen concentrations in the body. In some laboratories, the arterial blood gas result will include a carbon monoxide percentage, most often found in the body because of smoking. For each hemoglobin molecule that has carbon monoxide attached, there is one less available that can carry oxygen.

The arterial blood gas can also give parameters to establish the diagnosis of chronic respiratory failure. The diagnosis of chronic respiratory can be made when the measured oxygen level drops below 60 mmHg (millimeters of mercury) and the carbon dioxide level rises above 50 mm Hg, the diagnosis of chronic respiratory failure can be made.

Radiology

A plain chest X-ray may show lungs that have become too inflated and have lost normal lung markings, consistent with destruction of alveoli and lung tissue.

A CT scan can reveal more detail regarding the amount of lung destruction but is not a normal part of the evaluation of patients with emphysema.

Pulmonary function tests

Pulmonary function tests or spirometry can measure the airflow into and out of the lungs and be used to predict the severity of emphysema. By blowing into a machine, the amount of air that is moved and how quickly it moves can be calculated and provides information about lung damage. Results are compared to a “normal” person of the same age, sex, and size.

Some measurements include:

FVC (forced vital capacity): the amount of air that can be forcibly exhaled after the largest breath possible.
FEV1 (forced expiratory volume in 1 second): the amount of air that is forcibly exhaled in 1 second. Even though total air exhalation may be less affected, as the lung loses its elasticity, it takes longer for the air to get out and FEV1 becomes a good marker for disease severity.
FEV (forced expiratory volume): can be measured throughout the exhalation cycle often at 25%, 50%, and 75% to help measure the function of different sized bronchi and bronchioles.
PEF (peak expiratory flow): maximal speed of air during exhalation.
DLCO (diffusion capacity): measures how much carbon monoxide can be inhaled and absorbed into the bloodstream within a period of time. A small amount of tracer carbon monoxide is inhaled and then quickly exhaled. The amount of carbon monoxide in the exhaled air is measured and determines how well the lungs work in absorbing the gas. This helps determine and measure lung function.

Allopathic treatment for emphysema

The first treatment for patients with emphysema is smoking cessation if they are currently smoking tobacco. This is a difficult lifestyle change for many patients, and without support from their doctors, family members, and friends; this most important treatment will likely fail. The best way to accomplish this difficult task is outlined in the “quitting smoking” section. In addition, there is pharmacological and surgical therapy available for emphysema patients.

Drugs:

Bronchodilators

Bronchodilators are used to relax the smooth muscles that surround the bronchioles, allowing the breathing tubes to dilate and air to flow more freely. These medications can be inhaled using an MDI (metered-dose inhaler), powder inhaler devices, or a nebulizer machine These medications can either be short or long-acting.

The short-acting bronchodilators include the albuterol agents and the anticholinergic agent, ipratropium bromide.

As an aside, in the past patients have been instructed to count the number of puffs used from these devices or “float” the inhaler in water to determine the amount of remaining medicine available. The HFA devices cannot be floated, and counting the number of puffs is the only available method of determining the continued presence of medication.

One device, Ventolin HFA, has a built-in counter. It is important to understand that the mere presence of propellant coming from the inhaler does not necessarily mean that medication is present.

The long-acting agents include salmeterol, formoterol, and tiotropium. Often the long-acting bronchodilator is used for controlling the symptoms of emphysema as maintenance therapy, and the short-acting one is used when symptoms flare up (rescue therapy).

It is important that the patient know which medication is prescribed, since long-acting inhalers cannot be used for rescue, because of their delayed onset of action. Sometimes, patients will seek medical care in an extremely ill state because they have been using the long-acting controller drug as their rescue inhaler. There are 120 or 200 puffs in a short-acting MDI, and one puffer should last a significant amount of time. If not, the emphysema is not under control and the patient and health care professional will work on long-acting solutions. Many patients with emphysema also have home nebulizers that can deliver albuterol and ipratropium as part of their control regimen.

Corticosteroids

Since most patients do not have pure emphysema and usually also have other components of COPD, combined therapy is often prescribed which includes a long-acting bronchodilator and an inhaled corticosteroid. The inhaled corticosteroid (ICS) helps suppress the inflammatory components of COPD. While the bronchodilators work to relax the smooth muscle surrounding the breathing tubes, steroids decrease the inflammation within the walls of the tubes themselves.

These agents like Advair, which is a mixture of salmeterol (Serevent) and fluticasone, an ICS, simplify treatment by combining both therapies into a single inhaler device. Another combination inhaler is formoterol and budesonide.

Corticosteroids have a direct action on the lung tissue and absorption of inhaled corticosteroids into the bloodstream is minimal. Prednisone, an oral corticosteroid, can be taken in addition to the inhaled steroid should further anti-inflammatory effects be required. Moreover, these may be prescribed to be taken only during an acute flare of the emphysema or may be required to be taken on a daily basis by those patients with more severe disease.

In emergency situations, corticosteroids may be injected intravenously.

Antibiotics

Since patients with emphysema are at risk for infections like pneumonia, antibiotics may be prescribed when the usually clear sputum changes color, or when the patient presents with systemic signs of an infection (fever, chills, weakness).

Oxygen

As the disease progresses, patients may require supplemental oxygen to be able to function. Often it begins with nighttime use, then with exercise, and as the disease worsens, the need to use oxygen during the day for routine activities increases.

The decision to prescribe oxygen depends upon the patient’s symptoms as well as the results of other tests, including oximetry, pulmonary function tests, and arterial blood gas measurements.

Surgery for emphysema

Bullectomy, the removal of bullae (thin-walled air-filled areas that may compress normal lung tissue) is one method to reduce some of the symptoms of emphysema/COPD.

Lung volume reduction surgery is another surgical technique. It may be an option for patients with severe emphysema symptoms that do not respond to attempts at medical therapy. In this technique, about 20% to 30% of tissue from both lungs is removed; the area removed is usually the lung tissue sections that have minimal or no function.

Finally, lung transplantation is a possibility for certain selected patients. Patients with COPD/emphysema are the largest category of patients that undergo lung transplantation.

Homeopathic Treatment for Emphysema

Antimuonium Arsenicum

Emphysema with excessive dyspnea and cough, much mucous secretion. Worse on eating and lying down. Catarrhal pneumonia associated with influenza. Myocarditis and cardiac weakness. Pleurisy, especially of left side, with exudation and pericarditis, with effusion. Sense of weakness. Inflammation of eyes and edema of face.

Ammonium Carbonicum

Hoarseness. Cough every morning about three o’clock, with dyspnea, palpitation, burning in chest; worse ascending. Chest feels tired. Emphysema. Much oppression in breathing; worse after any effort, and entering warm room, or ascending even a few steps. Asthenic Pneumonia. Slow labored, stertorous breathing; bubbling sound. Winter catarrh, with slimy sputum and specks of blood. Pulmonary edema.

Cuprum Metallicum

Cough as a gurgling sound, better by drinking cold water. Suffocative attacks, worse 3 am (Am c). Spasm and constriction of chest; spasmodic asthma, alternating with spasmodic vomiting. Whooping-cough, better, swallow water, with vomiting and spasms and purple face. Spasm of the glottis. Dyspnea with epigastric uneasiness. Spasmodic dyspnea before menstruation. Angina with asthmatic symptoms and cramps. Severe cyanotic.

Arsenic Album

Unable to lie down; fears suffocation. Air-passages constricted. Asthma worse midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Wheezing respiration. Hemoptysis with pain between shoulders; burning heat all over. Cough dry, as from Sulphur fumes.

Kalium Carbonicum

Cutting pain in chest; worse lying on right side. Hoarseness and loss of voice. Dry, hard cough about 3 am, with stitching pains and dryness of pharynx. Bronchitis, whole chest is very sensitive. Expectoration scanty and tenacious, but increasing in morning and after eating; aggravated right lower chest and lying on painful side. Hydrothorax. Leaning forward relieves chest symptoms. Expectoration must be swallowed; cheesy taste; copious, offensive, lump. Coldness of chest. Wheezing. Cough with relaxed uvula. Tendency to tuberculosis; constant cold taking; better in warm climate.

Lobelia Inflata

Dyspnoea from constriction of chest; worse, any exertion. Sensation of pressure or weight in chest; better by rapid walking. Feels as if heart would stop. Asthma; attacks, with weakness, felt in pit of stomach and preceded by prickling all over. Cramp, ringing cough, short breath, catching at throat. Senile emphysema.

Sambucus Nigra

Chest oppressed with pressure in stomach, and nausea Hoarseness with tenacious mucus in larynx. Paroxysmal, suffocative cough, coming on about midnight, with crying and dyspnea. Spasmodic croup. Dry coryza. Sniffles of infants; nose dry and obstructed. Loose choking cough. When nursing child must let go of nipple, nose blocked up, cannot breathe. Child awakes suddenly, nearly suffocating, sits up, turns blue. Cannot expire. Millar’s asthma. Face turns blue with cough.

Silicea Tera

sputum persistently muco-purulent and profuse. Slow recovery after pneumonia. Cough and sore throat, with expectoration of little granules like shot, which, when broken, smell very offensive. Cough with expectoration in day, bloody or purulent. Stitches in chest through to back. Violent cough when lying down, with thick, yellow lumpy expectoration; suppurative stage of expectoration.

Silphium Lacinatum

Cough with expectoration profuse, stringy, frothy, light-colored. Excited by sense of mucus rattling in chest and worse by drafts of air. Constriction of lungs. Catarrh, with copious, stringy, mucous discharges. Desire to hawk and scrape throat. Irritation of posterior nares, involving mucous membranes of nasal passages with constriction of supra-orbital region.

Mephitis Putorius

Sudden contraction of glottis, when drinking or talking. Food goes down wrong way. False croup; cannot exhale. Spasmodic and whooping-cough. Few paroxysms in day-time, but many at night; with vomiting after eating. Asthma, as if inhaling Sulphur; cough from talking; hollow, deep, with rawness, hoarseness, and pains through chest. Violent spasmodic cough; worse at night. A great medicine for whooping-cough. Suffocative feeling, asthmatic paroxysms, spasmodic cough; cough so violent, seems as if each spell would terminate life.

Millefolium

Hemoptysis. Incipient phthisis. Bloody cough.

Digitalis Purpura

Desire to take a deep breath. Breathing irregular, difficult; deep sighing. Cough, with raw, sore feeling in chest. Expectoration sweetish. Senile pneumonia. Great weakness in chest. Dyspnea, constant desire to breathe deeply, lungs feel compressed. Chronic bronchitis; passive congestion of the lungs, giving bloody sputum due to failing myocardium. Cannot bear to talk. Hemoptysis with weak heart.

Bromium

Whooping cough. Dry cough, with hoarseness and burning pain behind sternum. Spasmodic cough, with rattling of mucus in the larynx; suffocative. Hoarseness. Croup after febrile symptoms have subsided. Difficult and painful breathing. Violent cramping of chest. Chest pains run upward. Cold sensation when inspiring. Every inspiration provokes cough. Laryngeal diphtheria, membrane begins in larynx and spreads upward. Spasmodic constriction. Asthma; difficulty in getting air into lung. Better at sea, of seafaring men when they come on land. Hypertrophy of heart from gymnastics. Fibrinous bronchitis, great dyspnea. Bronchial tubes feel filled with smoke.

Iodum

Hoarse. Raw and tickling feeling provoking a dry cough. Pain in larynx. Laryngitis, with painful roughness; worse during cough. Child grasps throat when coughing. Right-sided pneumonia with high temperature. Difficult expansion of chest, blood-streaked sputum; internal dry heat, external coldness. Violent heart action. Pneumonia. Hepatization spreads rapidly with persistent high temperature; absence of pain in spite of great involvement, worse warmth; craves cool air. Croup in scrofulous children with dark hair and eyes. Inspiration difficult. Dry, morning cough, from tickling in larynx. Croupy cough, with difficult respiration; wheezy. Cold extends downwards from head to throat and bronchi. Great weakness about chest. Palpitation from least exertion. Pleuritic effusion. Tickling all over chest. Iodum cough is worse indoors, in warm, wet weather, and when lying on back.

Iodoformium

Sore pain in apex of right lung. Feeling of a weight on chest, as if smothering. Cough and wheezing on going to bed. Pain in left breast, like a hand grasping at the base of the heart. Hemoptysis. Asthmatic breathing.

Kalium Bichromicum

Metallic, hacking cough. Profuse, yellow expectoration, very glutinous and sticky, coming out in long, stringy, and very tenacious mass. Tickling in larynx. Catarrhal laryngitis cough has a brassy sound. True membranous croup, extending to larynx and nares. Cough, with pain in sternum, extending to shoulders; worse when undressing. Pain at bifurcation of trachea on coughing; from mid-sternum to back.

Spongia Tosta

Great dryness of all air-passages. Hoarseness; larynx dry, burns, constricted. Cough, dry, barking, croupy; larynx sensitive to touch. Croup; worse, during inspiration and before midnight. Respiration short, panting, difficult; feeling of a plug in larynx. Cough abates after eating or drinking, especially warm drinks. The dry, chronic sympathetic cough or organic heart disease is relieved by Spongia. Irrepressible cough from a spot deep in chest, as if raw and sore. Chest weak; can scarcely talk. Laryngeal phthisis. Goiter, with suffocative spells. Bronchial catarrh, with wheezing, asthmatic cough, worse cold air, with profuse expectoration and suffocation; worse, lying with head low and in hot room. Oppression and heat of chest, with sudden weakness.

Carbo Vegitabilis

Cough with itching in larynx; spasmodic with gagging and vomiting of mucus. Whooping cough, especially in beginning. Deep, rough voice, failing on slight exertion. Hoarseness; worse, evenings, talking; evening oppression of breathing, sore and raw chest. Wheezing and rattling of mucus in chest. Occasional spells of long coughing attacks. Cough, with burning in chest; worse in evening, in open air, after eating and talking. Spasmodic cough, bluish face, offensive expectoration, neglected pneumonia. Breath cold; must be fanned. Hemorrhage from lungs. Asthma in aged with blue skin.

Pothos foetidus (Putorii)

Sudden anxiety, with dyspnea, troubled respiration and perspiration. Sudden anxiety, with dyspnea and perspiration, followed by stool and relief of that and other complaints. Inclination to draw a long breath, with the sensation of emptiness in the chest ; later, constriction in the larynx and chest. Asthma, aggravated or caused by dust. Millar’s asthma. Spasmodic croup. Sneezing with chest pain.

Hepar Sulphuricum

Loses voice and coughs when exposed to dry, cold wind. Hoarseness, with loss of voice. Cough troublesome when walking. Dry, hoarse cough. Cough excited whenever any part of the body gets cold or uncovered, or from eating anything cold. Croup with loose, rattling cough; worse in morning. Choking cough. Rattling, croaking cough; suffocative attacks; has to rise up and bend head backwards. Anxious, wheezing, moist breathing, asthma worse in dry cold air; better in damp. Palpitation of heart.

Calcarea Acetica

Rattling expiration. Cough loose, with expectoration of large pieces like casts of bronchial tubes. Breathing difficult; better bending shoulders backward. Constrictive anxious sensation in chest.

Phosphorus

Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air. Sweetish taste while coughing. Hard, dry, tight, racking cough. Congestion of lungs. Burning pains, heat and oppression of chest. Tightness across chest; great weight on chest. Sharp stitches in chest; respiration quickened, oppressed. Much heat in chest. Pneumonia, with oppression; worse, lying on left side. Whole body trembles, with cough. Sputa rusty, blood-colored, or purulent. Tuberculosis in tall, rapidly-growing young people. Do not give it too low or too frequently here, it may but hasten the destructive degeneration of tubercular masses. Repeated haemoptysis (Acal). Pain in throat on coughing. Nervous coughs provoked by strong odors.

Bryonia Alba

Soreness in larynx and trachea. Hoarseness; worse in open air. Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored sputa. Frequent desire to take a long breath; must expand lungs. Difficult, quick respiration; worse every movement; caused by stitches in chest. Cough, with feeling as if chest would fly to pieces; presses his head on sternum; must support chest. Croupous and pleuro-pneumonia. Expectoration brick shade, tough, and falls like lumps of jelly. Tough mucus in trachea, loosened only with much hawking. Coming into warm room excites cough. Heaviness beneath the sternum extending towards the right shoulder. Cough worse by going into warm room.

Ipecacuanha

Dyspnea; constant constriction in chest. Asthma. Yearly attacks of difficult shortness of breathing. Continued sneezing; coryza; wheezing cough. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Bubbling rales. Suffocative cough; child becomes stiff, and blue in the face. Whooping-cough, with nosebleed, and from mouth. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Croup. Hemoptysis from slightest exertion. Hoarseness

Digitalis

What is the life expectancy and outlook for emphysema patients

If treated with allopathic drugs emphysema affects the quality of life and not the quantity of life; While with Homeopathic treatment patient recovers absolute health and quantity of life too.

Homeopathic medicines not only prevent further lung damage but recovers its damaged areas and maximize the function of overall healthy lung tissue.

For consultation, about your disease and Treatment, Diet etc; visit our clinic.

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emphysema-dr-qaisar-ahmed-dixe-cosmetics Dr Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS, Isl. Jurisprudence); Works at “senior research officer Dnepropetrovsk state medical academy Ukraine”; is a leading Homeopathic physician practicing in

Al-Haytham clinic Risalpur. K.P.K, Pakistan.

(0923631023, 03119884588), K.P.K, Pakistan.