How does asthma and emphysema develop?

A fellow caregiver asked...

I have been diagnosed with chronic asthma and empyhsema. I am female. Have not smoked one day in my life of almost 79 years. When approximately 19, I had my first attack of asthma and emphysema from living in a basement apartment. Thereafter, only certain conditions and humidity would trigger an attack. I developed a bad case of hyperthyroidism at age 24, resulting in removal at age 33. After surgery,the attacks lessened and eventually disappeared.

However, I've had several bouts with bronchitis in the last few years and had "some pneumonia" in 2007 and have never been the same physically and was diagnosed with "asthma/emphysema" in January 2008 after a spirometry test. Why would I develop asthma and emphysema being a non-smoker and negative for a genetic inheritance?

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Unfortunately, you have found out that just because you are a non-smoker doesn't mean you will not get lung disease.  Asthma is one of the major causes of obstructive lung disease, also known as emphysema.  The course of asthma often starts in childhood and/ or young adulthood, when it will cause trouble.  Then, it usually gets better throught the middle age years.  It will then return again in later adulthood, as you have found out.  But remember, just because you had no symptoms, it doesn't mean that the asthma "went away".  It is a chronic problem and it is always around- just sometimes it is better than others.  In fact, your episodes of "bronchitis" were probably asthma flares, meaning that it had returned.  

Asthma is caused by irritated airways.  This causes problems, as the irritated airways swell, restricting airflow and trapping the air in your lungs (hence the obstructive part).  This is why you will wheeze- the whistle is sound caused by the air literally whistling through your tightened airways.

 Now, how can you help yourself now that you know you have this disease?  The answer is proper management.  You may have already seen a pulmonologist (lung doctor), and if you have not, you should.  You probably need to have inhalers and/ or nebulizers to make sure your breathing is the best it can be.  When you get ill, especially with a respiratory infection, you should make sure to get treatment right away to further prevent breathing problems.  Good luck!