(Reprinted from ADVANCE for Respiratory Care Practioners, Volume 11, Number 4, February 23, 1998, Page 30)
by Ron Peterson
I stopped smoking on Jan. 9 two years ago. Since then, I have coupled my stop-smoking efforts to an exercise program and brought my peak flow meter readings from 303 lpm in 1996 to 344 lpm in 1997. For you therapists out there, I hope you can use me as an example of hope when you encourage your COPD patients to try harder. My peak flow increase comes despite what should be a normal yearly loss of 2.6 lpm for someone my age and height. My yearly averages are based on twice-a-day measurements.
Smokers are told they can never repair lung damage; but if they quit smoking they will not get any worse. But it is possible to improve your peak flow meter readings if you quit smoking and exercise regularly. I speak from experience. I was diagnosed with emphysema in 1987. My FEV1 reading was 21 percent of predicted in February 1997. Eight months before > that, my FEV1 level was only 18 percent of predicted.
You cannot get this increase inn peak flow values by quitting smoking alone. I also exercise vigorously almost every day for 60 minutes. Exercise also helped me quit smoking. There is no luck involved in quitting smoking; it is a decision. But the decision is easier to stick with if it is coupled with exercise.
FEELING GOOD At age 53, my regimen has helped me feel better than I have for years. But, before starting, be sure to discuss any planned exercise program with a pulmonologist. Get the medical profession involved, because caregivers offer sound advice, write prescriptions and provide rehab services.
The most important aspect of exercise is to do it daily for an extended period of time. I worked my up slowly to a hour a day. For those with emphysema, the longer period of exercise is important because it takes a long time for our respiratory systems to work at maximum efficiency. A side benefit is prevention of lung infections. I haven�t had one in over 28 months.
I use supplemental oxygen when exercising because muscles (including the heart muscle) function more efficiently with an adequate oxygen supply. I monitor both my blood saturation level and cardiac rate. My oxygen dispenser fits in a backpack and provides nearly two hours of supplemental oxygen at 3 lpm when I exercise outdoors. When I use a treadmill, I use a conventional concentrator unit.
Here is my basic routine. I start my exercise program about two hours after I get up in the morning. I eat lightly (hot water mixed with honey and vinegar, vitamins, and an apple) so oxygen is not being diverted for use to digest food when I exercise. Because warming up and cooling down are important, I do a set of stretching exercises to start my warm-up.
BREATHING TRAINING Proper breathing while exercising is the most important element of all. I�ve broken breathing into four parts: inhaling through the nose (to warm and filter the air before it gets to the lungs), inhaling while expanding the stomach, exhaling through pursed lips, and attempting to breathe as slowly as possible. Pursed lip breathing naturally slows down exhalation, but it is also helpful to learn to inhale as slowly as is comfortable. Inhaling while expanding the stomach is not easy since all our lives we have been inhaling by expanding our chest. You can learn to use your stomach by lying on your back and putting a small book on your stomach. Now try to raise the book as you inhale. Once you can master that, teach yourself to extend your stomach while standing.
Many exercise experts claim walking is the best possible exercise. Others recommend swimming. For those with severe emphysema, swimming may be too vigorous, however, because many muscles are being used simultaneously, depleting oxygen supplies. I currently get my exercise by walking on a treadmill or walking outdoors. The combination allows all-weather exercise opportunities. If you use a treadmill, put it in a position so the walking surface is level, because even a little uphill slope is difficult to walk up continuously if you have emphysema. Make sure the treadmill will operate with you walking on it as slow as 0.3 miles per hour.
SLOW, STEADY PROGRESS Health improvements can be felt in as short a time as six weeks. The best way to initiate an exercise program is to attend a pulmonary rehabilitation class. You must be referred by your doctor. Don�t push too hard. It is important that you start slow and increase your exercise level by no more than 5 percent a week. Exercise gives me a second wind. My oxygen levels are always higher when I�m done than they were before I started. I start my walks very slowly, increasing my speed not sooner than every 10 minutes. I slow down during the last 10 minutes of my walk.
The bottom line is exercise benefits those with breathing problems. This is important for patients to realize. And it is vital for caregivers to realize. Those in the health care trenches are the ones who have to offer help, hope and encouragement. Rehab programs are a good first start, but patient dedication remains the key. It is my hope that respiratory care professionals will copy this article and give it to their patients.
Ron Peterson can be reached via e-mail [email protected]
Mailing address, P.O. Box 190616, St. Louis, MO 63119.
Back to Exercise Information Page