Respiratory Diseases

Having survived long enough to become seniors, we fully realize that every breath we take is a real treasure!

Breathing is a necessary function of human life.  If we lose that function, our lives can suddenly be measured in minutes.  It also follows that any condition that compromises the ability to breathe should require our immediate attention.

Diseases of the lung are some of the most common diseases in the world.  In the US alone, tens of millions of people suffer from lung disease.  The greatest causes of lung disease are smoking, infections, and genes, in that order.  

Our lungs are part of a very complex system, expanding and relaxing thousands of times every day to bring in oxygen and send out carbon dioxide.  Problems in any part of this system can promote lung disease.

Our Windpipe (trachea)

Our windpipe (trachea) branches into smaller tubes called bronchi, which in turn branch into still smaller tubes throughout our lungs.  Diseases that can affect these airways can include:

• Asthma.  Our airways are constantly inflamed and may spasm which causes wheezing and shortness of breath.  Allergies, pollution, and infections can trigger asthma symptoms.
• Chronic, obstructive, pulmonary disease (COPD).  This lung condition does not allow us to exhale the way we usually would, which makes it more difficult to breathe.
• Chronic bronchitis.  Another form of COPD which produces a long-term wet cough.
• Emphysema.  This is a damaged lung that allows air to be trapped in our lungs and is a form of COPD.  Difficulty blowing air out marks this condition.
• Acute bronchitis.  A sudden infection of the airways that is usually caused by a virus.   
• Cystic fibrosis.  When we have trouble clearing mucus from our bronchi.  This leads to ongoing lung infections.

Our Air Sacs (Alveoli)

Then there are lung diseases that affect the Air Sacs (Alveoli).  Our airways branch into tiny tubes (bronchioles) that end in clusters of air sacs called alveoli (see picture above).  These air sacs make up most of our lung tissue.  These diseases include: 

• Pneumonia.  An infection of our alveoli, usually from bacteria or virus,
• Tuberculosis.  Pneumonia slowly gets worse and is caused by the bacteria  Mycobacterium tuberculosis.
• Emphysema.  A condition that occurs when the fragile links between the alveoli are damaged.  The most common cause is smoking.
• Pulmonary edema.  Fluid leaks from the small blood vessels in our lungs into the air sacs and the area around them.  One form is caused by heart failure and backpressure in our lung’s blood vessels.  In another form injury to our lungs is the cause.
• Lung cancer.  It has many forms and may start in any part of our lungs.  Most often it starts in the main part of our lung, in or near the air sacs.
• Acute respiratory distress syndrome (ARDS).  A severe, sudden injury to the lungs from a serious illness.  Covid-19 is one example.  Many people who have ARDS need help to breathe with a ventilator until their lungs recover.

Pneumoconiosis.  A category of conditions caused by breathing something that injures the lungs.  Examples include black lung disease from coal dust in mining operations or asbestosis from asbestos dust.

Our Interstitium

Now, let’s talk about lung diseases that affect the interstitium.  The interstitium is the thin, delicate lining between our alveoli (again, see the picture at top of the page).  Tiny blood vessels run between the interstitium and allow gas transfer between the alveoli and our blood.  Lung diseases that affect the interstitium include:

• Interstitial lung disease (ILD).   A group of lung conditions including sarcoidosis, idiopathic pulmonary fibrosis, and autoimmune disease.
• Pneumonia and pulmonary edema also affect our interstitium.

Our Blood Vessels

On to lung diseases that affect our blood vessels.  The right side of our heart receive low oxygen from our veins.  The heart pumps blood into the lungs through the pulmonary arteries.  These blood vessels can also have diseases.

• Pulmonary embolism (PE).  A blood clot breaks off and travels to our heart and gets pumped into our lungs.  The clot sticks in a pulmonary artery, which often causes shortness of breath and low blood oxygen levels.
• Pulmonary hypertension.  Many conditions can cause hypertension in our pulmonary arteries.  This may lead to shortness of breath and chest pain.  

The Pleura

Lung diseases affecting the pleura.  The pleura is a thin lining that surrounds our lungs and lines the inside of our chest wall.  A tiny layer of fluid allows the fluid on our lungs surface to slide along the chest wall with each breath.  Diseases of the pleura include:

• Pleural effusion.  Fluid collects between the lung and the chest wall.  This is usually caused by pneumonia or heart failure.  Large pleural effusions can make it difficult to breathe and may need to be drained.
• Pneumothorax.  Air may get into the space between our chest wall and the lung, collapsing the lung.  
• Mesothelioma.  A rare form of cancer that forms on the pleura.  It tends to occur several decades after we come in contact with asbestos.

As we have seen above, there are plenty of threats to our health, many of which pose great risks and expenses.  Thankfully, we have missed many of them and are now grateful to have qualified to be seniors and, hopefully, enjoying reasonably good health.

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