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Coping with COPD
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JIM: I was a smoker for many years - even though I quit a long time ago - and I have now developed COPD. I'm finding myself more and more unable to do anything except sit around like a lump on a log because I can't breathe, and I am tired all the time. I'm using a little inhaler now which helps a little when I'm short of breath, and my doctor says I will probably have to go on oxygen eventually. Is there ANYTHING I can do? -- BREATHLESS IN BIRMINGHAM
DEAR BREATHLESS: My dad would have known exactly how you feel. You see, he, too, was a heavy smoker and quit more than 40 years before developed COPD. He finally expired in June 2008 after a battle of several years with the disease. He had difficulty breathing and was constantly tired from the lack of oxygen, but he exercised up until the day he died which greatly enhanced his quality of life until the end.
I asked him once why he started smoking in the first place, and he said that, during the war (WWII), they gave everyone five packs of cigarettes a day and three cigarettes with every mean in place of dessert and, since no one thought they would be coming back anyway, everyone started smoking. Obviously the cigarette companies knew what they were doing even then because many of our soldiers did come back, and by then they were addicted (and, of course, after the war they had to start paying for their cigarettes too).
COPD, or Chronic Obstructive Pulmonary Disease www.lungusa.org/, is a progressive disease that gradually reduces the air flow in and out of the lungs such that the amount of oxygen in the blood gradually decreases, and the amount of carbon dioxide gradually increases creating an imbalance and very often progresses into emphysema causing the eventual destruction of the airways and air sacs. Unfortunately, there is no known cure for COPD, but there ARE certain things that you can do to better manage your disease and maintain your quality of life.
Believe it or not, exercise is one of the most important components for managing COPD. Now, I'm not going to tell you that you are going to FEEL like exercising because it is probably the last thing in the world that you feel like doing when you are fighting for every breath, but it can make a difference in your ability to live with this insidious disease. Of course, before you embark on any exercise program you should consult with your physician who may have some recommendations with regard to specific exercises or, perhaps, can refer you to a physical therapist or personal trainer for consultation.
Learning to breathe properly is critical in your day-to-day living with COPD, but it is even more important when exercising - and there IS a difference. Normal breathing is through the nose - not the mouth - so that the nose can "filter" the air and prevent the tissues in the mouth and throat from drying out and becoming irritated. Learn to control your breathing to avoid panicking when you experience a shortness of breath, and breathe slowly and deeply using your diaphragm - not your chest - to take in as much oxygen as you can with each breath. Yoga is an excellent way to learn how to relax and control your breathing.
Endurance and resistance training exercises usually require more oxygen, and since most people cannot typically take in enough oxygen through the nose while exercising without the danger of hyperventilating, you should breathe through your mouth. However, you should purse your lips and draw the air in slowly through your mouth - pretend that you are blowing up a balloon - until you have reach your capacity, then slowly exhale. It takes some practice, but eventually you will get the hang of it.
Walking is one of the best forms of endurance exercises - you just put one foot in front of the other and start walking. Set your own pace - how fast you walk is irrelevant - and gradually try to increase your distance a little bit at a time. Move your arms in cadence with your legs to establish a rhythm.
Weight training or resistance training is important to maintain your strength, muscle mass, and muscular endurance, and it can greatly enhance your breathing capacity. I would recommend exercises such as bent-arm pullovers, lat pulldowns, bench or cable flyes, and other movements that will encourage chest and lung activity. A competent personal trainer can show you the proper form on these and other exercises. My dad installed a bar across the top of his bed so that he could do “pull-ups” with his upper body every morning from a reclining position.
Proper nutrition is important too so that you do not gain weight (which can make breathing even more difficult) or, conversely, lose weight (unless you are already overweight) by allowing your body to waste away. Stay properly hydrated, and eat smaller, more frequent meals to maintain your optimum weight.
Medication is also an important factor in managing COPD whether it be in the form of bronchodilators, anti-inflammatories, oxygen, antibiotics, expectorants, or any combination prescribed by your physician.
Listen to your doctor, but take charge of your disease and don't let it control you. Your quality of life depends on it.
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