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Is Pulmonary Rehab for Me?

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Dear COPD Coach,
My doctor advised me to start going to pulmonary rehabilitation. I have never been much into exercise, and the thought of going really scares me. I get so out of breath just walking, I can’t imagine being able to do any of the exercises. Here is my question. Will it improve my breathing, and how will I be able to do any sort of exercising if I get out of breath just walking from the car to the facility?

-Out of Breath

Dear Out of Breath,
I can certainly understand your fear of exercise. The fear and panic of SOB (shortness of breath) is very intimidating even for those who have dealt with COPD for a long time. Interestingly enough, these reasons are exactly why you should participate in a pulmonary rehabilitation program!

Why? First of all, pulmonary rehabilitation will not improve your lung function. It will, however, enable greater endurance and cause you to feel less out of breath during exertion. How can this be? Actually, it is pretty basic. The air we breathe provides fuel for not only our various organs, but all the muscles in our body. At any given time, all of our muscles are demanding their fair share of oxygen. With limited lung function, our brain “goes into survival mode” and prioritizes where the oxygen is needed most which in most cases is our vital organs. As a result, when we exert ourselves, there is not enough oxygen available to properly saturate the muscles we use during the exertion. That’s why we experience being short of breath.

Now here is the key point: by keeping our muscles toned (which is a major component of pulmonary rehabilitation), they will require less oxygen to perform, which in turn will allow for more exertion without feeling out of breath. Your lung function doesn’t change, but the amount of oxygen required by your body becomes significantly less thus you are able to increase your endurance.

There are other benefits of pulmonary rehabilitation:

  • Oftentimes your respiratory therapist can alert you to a coming exacerbation long before you can recognize the symptoms.
  • Many pulmonary rehabilitation programs can teach you helpful hints to go about daily tasks in the most efficient manner, like walking up stairs, cleaning, and in some cases cooking…all tailored to your individual lung function.
  • In just about all programs, you will develop camaraderie with others with COPD or other lung diseases which can be a great source of support. Many programs also offer support groups.
  • Even if you can’t attend the program for an extended period of time or on a regular basis, your respiratory therapist can develop an individualized exercise program that you can do at home!

Pulmonary rehabilitation has been the reason for many success stories. I recall one man whose biggest goal was to dance at his daughter’s wedding. Another friend wanted to be able to participate in a long walk. One man, who had COPD as a result of his work at the 9/11 wanted only to be able to play with his grandchildren. All of these people were able to accomplish their goals as a result of pulmonary rehabilitation. In fact, the man who wanted wished to dance at his daughter’s wedding was even taught how to dance with his portable concentrator by his respiratory therapist!

We all use various therapies to improve our COPD symptoms. We take medication, we may use supplemental oxygen, try to eat a healthy diet, and always endeavor to maintain a positive attitude. Exercise should be an integral part of our therapy!

Best regards,
The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.

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  • I am on 24/7 Oxygen. I began Pulmonary Rehab in April. Because I didn't completely understand the objective of the Rehab, I hoped/thought I might be able to improve enough so I would not require oxygen all of the time. Just as the COPD Coach above says...my physical endurance/stamina will greatly improve, but my lung function cannot be reversed.

    I did improve over the 36 sessions. I knew that if I did not find a way to continue rehab/exercise, my strength and endurance would fall away even faster than I had gained it. One month after finishing Pulmonary Rehab, phase II, I got into a Phase III program at a hospital near me. I monitor my own statistics and decide which equipment to use and for how long. Now I have been going (2x/week) since the beginning of August. I can honestly say that I actually have more strength than I did before I got sick in the first place. I do have to put my oxygen at 8 liters when doing the Treadmill and at 6 liters when doing exercycel or other recumbent arm/leg machines. I push myself harder than the therapist probably would...most times I do a 20 minute mile and do 2+ miles on the stationary bicycle. I am thinking of making myself go for a 3rd day. Yes, it is worth going to. I may never (probably won't) get off supplemental oxygen, but I will continue to get as much out of life as I always have.

    Reply
    • Jeanne,
      Absolutely go for a third day. I try to hit the gym every day; that's how I maintain my energy level and continue to do all the things I want to do. The more you go and continue pushing yourself, the more you'll improve. I started exercising 15 years ago and I know I'm in much better shape now than I was when diagnosed in 2000, and probably than I was in 1985, when I knew I had COPD from reading a couple of medical reference works.
      Reply
  • I've have very severe COPD for a decade now. I had my Pulmonary Doctor say, give it up there is nothing we can do for you.
    Needless to say I got a new Pulmonary Doctor who told me if I wanted any quality of life that I should move to SEA LEVEL and join a PULMONARY REHAB PROGRAM. Best advice I was ever given. I am on several nebulizer medicines, as well as oxygen 24/7.
    When I first started the program I was 55 years old. I could hardly make it into the hospital to take the classes. What an experience, as I was decades younger than the other patients who were in much better shape than me.
    Well a few years down the road now and still out of breath upon exertion. I am now going to a regular gym with excellent results. I moved again and no pulmonary rehab in this little town, but the gym is keeping me going. Not much of a gym person before but I am a BELIEVER now. Don't hesitate. Baby steps. Turn up that oxygen while you are working. Keep a pulse oximeter to track your stats. If you fall below 90, stop and do deep breathing until they come back up. You will see as time goes by it gets better. I can now walk across the grocery store with out having anxiety attacks because I couldn't breathe. A couple of years from now if you follow the program you will be patting yourself on the back because you got back to the land of the living. All the best of luck to you. Feel free to email me for encouragement. BTW I use a backpack so I'm not tripping over the tubes while I am out in public. Use an oxygen concentrator with a long tube while at home.
    Reply

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