Why pulmonary rehab?

[Gma_Bernie]

I signed up to go to pulmonary rehab after an exacerbation. The paperwork they sent me has mostly to do with diet and cholesterol and things that have nothing to do with lungs. And breathing. I'm not sure this is going to help me at all. I have moderate COPD. I don't think that this program is going to do anything for me. Why do they assume that everyone who signs up has a weight problem? I was underweight for a long time from smoking. My cholesterol is good. So that's at least half of their program that is going to be wasted on me. Not feeling like wasting my money.

[JACKIE1-25-15]

I don't have any answers, but it is good to see you again.  Do they ask any questions other than weight and diet?

[elvan]

That's just the beginning...yes, they do talk about a healthy diet because eating right helps with COPD.  My COPD is also considered Moderate...that sort of blows my mind because I CAN'T BREATHE.  Pulmonary rehabilitation has many aspects, diet is one, exercise is one...rating how hard the exercise is for you is really important.  They monitor your oxygen saturation as they have you use various machines and they increase your exercise time according to your response.  I did not find all of it to be what I felt I needed but I understood that they have their protocols.  I had to meet with the dietitian and I also had a meeting with respiratory therapy.  The people who worked with me were cardiac care/ICU nurses.  Most people had to wear monitors to watch their heart activity but I am allergic to the adhesive so after the third time when I showed them how badly I was reacting, they said I did not need to be monitored.  There was nothing wrong with my heart...just my lungs.   I went during the summer when it was hot and humid and every time I arrived there, my oxygen saturations were dismal until I could breathe in some air conditioned air.  I needed to be put on oxygen to do the treadmill and the bike, at first but I got stronger as time went on.  My insurance covered it so that was not something I considered.  

I wanted direction about exercising and I did feel that I benefited from that.

I hope you can get something from it.  I have very high cholesterol but I am thin...mine is genetic.

Hugs to you,

Ellen

[Thomas3.20.2010]

When you say diet - it doesn't necessarily mean losing weight. It is just as important not to lose too much weight so diet means nutrition and I can testify that you want to hang onto moderate as long as you can! I am stage 3 and there is nothing I do in my daily living that doesn't focus on oxygen therapy - from taking a shower to riding in a car, from sleeping to shopping when I can ignore my oxygen therapy. Pay attention! Nutrition makes a whole lot of difference, exercise makes a whole lot of difference in keeping you healthy and preventing the loss of lung capacity.

https://www.thoracic.org/patients/patient-resources/resources/pulmonary-rehab.pdf 

You get out of it what you put into it and it can become a new guideline for daily living.

[Gma_Bernie]

Jackie, Ellen and Thomas, thank you for your replies. I guess you can tell I was feeling pretty rotten when I posted that. Day after Thanksgiving and just feel empty and sad. I had my kids over here yesterday and my grandkids and it was wonderful and everyone had a good time. But I am in a lot of pain and totally drained.

I seem to have this black and white thinking, like I'm either a player in the game, or I'm not. And I feel like more and more I'm not. My limitations are such that I feel left out a lot because I have to say no, that's too late in the evening for me. Or no, because I have a busy day before that or a busy day after that. I know . . . Waaaaa.

Anyway the rest of the form was the phq-9 which I do every time I go to the doctor, a rate your overall health, and something I've never seen before: the prochaska readiness to change questionnaire. I was not able to answer the questions on that one because none of the answers fit. For example do you want to lower your cholesterol? The answer that best fit for me was no and I do not intend to in the next 6 months. Well that makes it sound like I don't want to change. But my cholesterol is not high so the question is not relevant. Most of them in fact all of them have answers like yes or no but I intend to in the next 30 days, 6 months, etc. I guess I don't really have much faith in questions that talk about intentions especially concerning health. Because truth is, when you have chronic pain, RA and just really really bad health, along with mental health problems that aren't being treated (because I've tried almost everything there is and none of it works for long) intentions don't mean anything.

I guess I am willing to go through the rehab. It's going to cost me a lot of money, but something's gotta change.

And Ellen, I know that you have some of the same physical maladies as I do, and have endured much greater consequences from smoking. I guess I'm just not very strong mentally and emotionally. Pretty much I've lost interest in everything except reading. I had to quit yoga because of my knees and the RA in my wrists and hands. Same with knitting. They're not going to be able to test me on a treadmill. My knees won't take it. I suppose they'll individualize the program.

Thank you all for bothering to respond. If nothing else, it will get me out of the house a few days a week. Right now I'm searching for meaning.

[elvan]

The treadmill was Hell on my back AND my breathing but I gave it my best shot.  I really LIKED the elliptical which was like my bike and a recumbent version.   Most of the other patients hated it but I could not figure out why.  They had a stationary bike that was not recumbent so again, that was a challenge but I did it.  They also had an arm bike and I had no issues with that, it seems like there was something else but I can't remember what.  In any event, it kind of gave me a place to jump off from if that makes any sense.  I was also using the pool regularly at that time because, as I said, it was summer.  I understand the depression, so does Thomas3.20.2010 some of it goes with the diagnosis, some of it can be at least helped with exercise.  Bernie, you can do this.  I cannot begin to tell you how many times I have to say no to invitations because I HAVE to rest...balancing rest and exercise are both vital with RA and with COPD.  You will find your way.

Big hugs...I always used to get depressed after kids were here and then they left.  I did not do Thanksgiving this year so it wasn't all of that chaos and then BOOM, empty.  My youngest will be home for Christmas, it always kills me to have to tell her that I cannot do things because I don't have the energy.  She used to come into my room to watch movies but I fell asleep so many times that she insists we sit in the living room (I can STILL fall asleep in the living room). 

XOXO,

Ellen 

[karenjones]

Sorry, I have to disagree with you. Intentions do mean something. you would never get out of bed in the morning unless you intended to , at least I wouldnt. Intentions are powerful.  In yoga nidra, one of the most important things we do is set our intentions.

[Gma_Bernie]

Karen, thank you for your input. My intentions tend to be fleeting, and very much tied to feeling. Ultimately yes, I had to set the intention to feel better by quitting smoking to even start on this journey. But now that I'm almost a year into it, I hurt more than ever.

I agree with Thomas that you get out of it what you put into it. I pick up the form, which I had snarkily thrown on the floor in my bedroom--I don't need no stinkin' rehab!--and looked at it again after reading all your comments. This time I took it more seriously and I do want to cut down on butter and sugar.

I thought that biology would take over once I started eating more. I HAVE gained weight which is good. But after 11 and a half months, I still don't feel better. I have been to the gastro doctor several times over the last year and they can't figure out why I have excruciating pain in my digestive tract. Wakes me up in the middle of the night. God forbid I have an appt. on a "bad" day.

My point is that comorbidities such as Ellen and I have, and probably many on this site have, makes it much harder to overcome resistance to anything that will increase your pain.

I WANTED TO GO TO REHAB! I wanted to do anything that would encourage my staying quit and feeling better. But when I checked it out this summer it was very expensive and I decided against it. Plus, I hate exercise for exercise sake. If it's enjoyable or serves a purpose, such as riding your bike to get somewhere, that's one thing. But going to the gym? No thank you.

Now . . . I'm just so tired all the time. I'm going, this morning, for the intake appt. I am determined to at least try it.

Thank you all. I will let you know if I find pulmonary rehab helpful.

[Barbscloud]

Well, I'm glad you're giving it a try.  You can always quit if you want, but you might find out it's helpful and you enjoy it.  I can understand the initial frustration of "having" to do something.  Hope it goes well for you.

Barb

[Thomas3.20.2010]

" I hate exercise for exercise sake.." Believe me, it is not just for exercise sake! It is so you can maximize the usefulness of the lung capacity that you do have and that's no small potatoes! Having strong muscles means using less oxygen to do more. It means that you won't experience muscle atrophy - a true threat for COPD. It means strengthening your heart and your diaphragm - two very, very important muscles in the respiratory system. It means not getting congestive heart failure, strokes, and and other pesky comorbidities like depression and anxiety. It means hanging onto Stage II instead of falling into Stage III which sucks eggs and makes me absolutely know that Stage IV sucks even more.

I exercise so I can breathe!