Will your lungs heal?

HEALTH

In this series of articles every Friday I will explain your body to you, and how you can use this understanding to improve your health, and hopefully live a longer and more enjoyable life. You will learn how your body works, and how you can avoid damage to it. You will also learn how we doctors examine you and treat illnesses. And most importantly, you will learn how you can change your lifestyle to stay healthy. The articles will help you to know more about your body, about health and disease. PIH doctors will answer your questions in a column every Thursday. Send your questions to: [email protected]
IF you are smoking cigarettes it will have terrible health effects on your body. Your lungs and airways are two of the hardest-hit areas.
But the good news is that after you quit smoking, the lungs can heal to a certain extent.
As soon as a person inhales the chemicals found in cigarette smoke, the lung’s delicate lining becomes inflamed and irritated. For several hours after you smoked, the tiny hair called ‘cilia’ that line the lungs slow down their brush-like movement. These tiny hair are the automated cleaning mechanism of the lungs. The cigarette smoke causes them to become temporarily paralysed and less effective at cleaning out mucus (or phlegm) and other substances, such as dust particles, from the airways.  
Another change observed in the lungs of smokers is an increase in the thickness and production of mucus. Because cilia cannot sweep mucus out of the lungs as quickly as it’s being formed, it accumulates in the airways, clogs them up and triggers a cough. The typical cough of heavy smokers. A build-up of mucus can also cause more lung infections, such as chronic bronchitis (infection of the airways) or pneumonia.

How lungs heal
Generally speaking, some of the short-term inflammatory changes to the lungs can be reversed when you quit smoking. In other words, swelling subsides on the surface of the lungs and airways, and lung cells produce less mucus. New cilia can grow, and these are better at clearing out mucus secretions and dirt.
In the days and weeks after you quit smoking, you will notice that you have less shortness of breath when you exercise. It’s not exactly clear why this happens, but part of it stems from getting carbon monoxide out of the blood. Carbon monixide is a highly poisonous gas found in cigarette smoke and interferes with the transport of oxygen which the body needs to survive.
Poisonous carbon monoxide binds to red blood cells instead of oxygen which your body needs for a healthy life. This fact may account for the breathlessness some smokers experience.
Another reason why stopping to smoke improves breathing is because the inflammation in the lining of their airways starts to heal; this happens because the lining is no longer exposed to smoke’s chemical irritants. This reduced swelling makes more room for air to flow through the passageways.
Paradoxically, former smokers may cough more during the first few weeks after they quit than when they were smoking. But this is a good thing; it means the lung’s cilia are active again, and these fine hair can now move excess mucus secretions from the lungs into the airways and towards the throat, where these secretions can be coughed up and leave the body.
“Coughing is cleaning up the phlegm in the lungs,” one of the PIH specialists told us. The longer you have gone without smoking, the more your body can repair the damage your smoking has caused, and the lower your risk of developing cancer, although some risk always remains from the time you have smoked.
Ten years after you quit smoking, your odds of developing lung cancer are about half as high as if you had continued smoking, according to the Center for Disease Control and Prevention of the University of Vienna, Austria. But someone who has smoked in the past and stopped smoking, is still more likely to die of lung cancer than someone who has never smoked.

The body is very good at repairing some of the damage to lung cells and tissues caused by smoking, but unfortunately the body cannot repair all damage. Damage to the lungs and a deterioration in lung function are directly related to the number of packs of cigarettes a person typically smokes per day times the number of years the person has smoked, a measure known as “pack years”. The greater the pack years, the more likely the lungs will have irreversible damage.
Although the lungs have ways to protect themselves from damage, these defences are reduced with long-term exposure to the harmful chemicals inhaled from cigarettes. As a result, lung tissue can become inflamed and scarred from smoking, and so the lungs lose elasticity and can no longer exchange oxygen efficiently.
Long-term smoking can lead to emphysema, a type of chronic obstructive pulmonary disease (COPD). This condition destroys a portion of the lungs known as the alveoli, the little bubble-like structures that basically form the lung tissue, which is where the exchange of oxygen and carbon dioxide takes place. People with COPD have shortness of breath and difficulty breathing.
Once a person’s lungs are damaged to the point of emphysema, the walls of the airways lose their shape and elasticity, making it difficult to push all the air out of the lungs. Such lung damage is permanent and irreversible.

Warning signs
Sometimes people think having trouble breathing is just something that comes with getting older. It is important to pay attention to these symptoms as they could be the first signs of lung disease, including lung cancer.
Knowing the early warning signs can help you receive treatment before the disease becomes serious or even life-threatening.
If you experience any of the following warning signs, make an appointment with the specialists at PIH as soon as possible. Early detection could save your life.
Chronic cough: A cough that you have had for a month or longer is considered chronic. This tells you something is wrong with your lungs.
Shortness of breath: It›s not normal to experience shortness of breath that doesn›t go away after exercising, or that you have after little or no exertion. Laboured or difficult breathing—the feeling that it is hard to breathe in out—is also a warning sign.

Chronic mucus production: Mucus, also called sputum or phlegm, is produced by the airways as a defence against infections or irritants. If your mucus production has lasted a month or longer, you should see your doctor.
Wheezing: Noisy breathing or wheezing is a sign that something is wrong. Coughing up blood: If you are coughing up blood, it signals a health problem.
Chest pain: You should see a doctor right away if you experience unexplained and lasting chest pain.
Next week: What we should know about tuberculosis

• Dr Fasol, the Medical Director and Chief Cardiac Surgeon at the Pacific International Hospital in Port Moresby, is an academic surgeon from the University of Vienna in Austria, and has worked, built and managed hospitals in Europe, Africa and China operating and treating thousands of patients.