TOTE DAT BARGE, LIFT DAT BALE
Hi Folks: I�m taking an extended trip to a part of the country that I haven�t previously explored. Hence, for the next several issues of the COPD-NEWS I will be traveling and unsure of ISP connections. In that respect I have stashed items and interviews that I hope are interesting. I am eternally grateful to John Windhorst who has consented to posting them.  We are dispensing with the regular format, because for the next few issues we will deal with a single topic. Today it is EXERCISE! Groan! Please continue to write whenever you run across something of interest. I will always respond to my email if I can find something other than a tree to plug my laptop in. <G>

First a reminder to BIRMINGHAM ALABAMA
Now is the hour for the Alabama COPD/Alpha-1 Education Day at the Birmingham Marriott in Birmingham, AL on September 10 and 11.  There is a social event tonight Friday, September 10, from 7-9 pm.  The program on Saturday, September 11, is from 8am-5pm and includes patient and physician sessions, along with lunch and sponsor exhibits.  The physician workshops qualify for CME credit.  Participants will learn about the latest breakthroughs in treatments for COPD and medical management of COPD.  RSVP to 866-229-2768 or [email protected].  Contact Diana Patterson at 866-556-6622 for further information.
 
 

This spring, in response to a bout of dyspnea, I had a lung function test done.  The results showed my FEV1 to be 43% of predicted.  Needless to say I was shocked and concerned.  I've been on an inhaler, but thought my occasional symptoms were due to mild asthma!  Now, I'm on a maintenance program of Spiriva and Symbicort.

To the point!  Doing research on COPD I came across the very large body of literature dealing with respiratory muscle training, both strength training using resistive breathing devices and endurance training pioneered by Urs Boutelier in Zurich.  This Spring I purchased a strength training respiratory device designed primarily for endurance athletes and secondarily for COPD sufferers.

As a result I've increased the strength of my accessory muscles such as the diaphragm, intercostals, etc. by about 50%.  Endurance wise I'm able to sustain very high ventilatory rates (50 - 62 breaths per min) for up to 30 minutes.  My minute ventilation has risen from 48 l/min to 116 l/m.  Symptomatically, my sensations of breathlessness during exercise bouts have reduced dramatically.  Although my tidal volume is about 2/3s that of a normal person I'm racing my bike better than ever!  So far this Spring I've been able to set or equal course personal bests on local time trials, even though my respiratory patterns are nearly 50% shallower than they were 5 years ago.

I realize that in the world of COPD I may be an anomaly, but I believe my experience is instructive for others.  I'm of the opinion that if COPD sufferers could adopt the mindset of an athlete and begin to aggressively condition themselves, both generally and specifically, as above, that many symptoms could be mitigated and quality of lives could be substantially improved.  While much is being done in the area of medical research to discover symptomatic relief and cures, there is a lot that we can be doing for ourselves, rather than waiting passively for a medical miracle.

In Tom Petty's monograph to the American chest physicians he notes that type-II muscle fibres in the diaphragms of COPD patients deteriorate, as a result of lung hyperinflation and disuse.  The type-II muscle fibres in our bodies are the strength producing fibres.  Consequently, strength training the diaphragm and other accessory breathing muscles may prove to be an absolutely vital therapeutic adjunct.  I obviously think that it is. Conversely, peripheral skeletal muscles lose their aerobic capacity because of the COPD patient's lack of activity.  So once again, overall activity levels need to be pursued on a programmatic basis to the limits of each individual's capability, if quality of life is to be maintained.

Hope this may shed some light on a not too often discussed approach to our therapy.

Editor�s note: While Jon names several products, we cannot. To find a list of what is available in respiratory strength training please type �Respiratory Strength Training Devices� into your browser window. I got 50,600 hits in Google.
 
 

IMPORTANCE OF EXERCISE
From PERF, forwarded by Joyce/Toronto:
 A little over a year ago he (Kenneth) went to a VA hospital for a check up and collapsed in the waiting room. They put him on a breathing machine, which was a wake up call for him. He knew he had to do something. The doctor told him his condition was serious but didn't suggest anything but some inhalers. So, he started to help himself all on his own. At first, he couldn't walk more than 50 ft. He is now up to 5 miles a day! While walking, he does pursed lip breathing, which he learned from his niece, a nurse. He knew his weight was a factor in his breathing difficulty so, while sitting at the computer, he puts his hands behind his head and has worked up to 50 sit-ups while sitting in the chair. [We'd suggest starting with hands down, or even braced on the chair arms, or your thighs.] He also bends forward and alternates touching each elbow to his knees. Was he able to do all of this when he first started? Of course not! He started very slowly. With exercise and a diet, he went from a 45-inch waist down to a 31-inch waist, and has regained 10% of his breathing ability. Scroll Down:
https://www.perf2ndwind.org/html/news/2004/June/Page5.html#Importance%20of%20Exercise
 

ITS NEVER TOO LATE TO IMPROVE YOUR FITNESS
University of Michigan Health System -- For many older adults, even a walk to the car tires them easily. A research program, sponsored by the VA Ann Arbor Healthcare System and the University of Michigan Health System, is measuring the effects of a moderate intensity aerobic exercise program among older adults. Through aerobic circuit-training, these older men and women will help researchers determine if this type of exercise program can help older men and women more easily perform basic tasks of daily living. Researchers note many older adults have problems with their joints or get too short of breath or fatigued to participate in standard high intensity aerobic activity. For them, a less intense program might still be beneficial.

"The purpose of this study an exercise program as a circuit can improve daily functional performance and physical activity. The program utilizes stations, putting together types of activities that you might have to string together in a consecutive manner, to simulate the stresses and demands daily activity might require. We also have some additional measures of oxygen uptake, which is done in the laboratory to see if the participants ability to utilize oxygen has improved as a result of this program." Each station simulates a typical daily demand task, such as having to pick up something, walk in place or step up. The idea is for participants to maintain a certain heart rate level while performing these tasks.

Another goal of the program is to translate some of these exercises into actual daily physical tasks at home. Alexander says, "We work with the participants to start doing more stairs, walking further distances, walking down to the mailbox maybe more then once a day."

An effective exercise program: According to the National Institute on Aging, four "building blocks" comprise an exercise program that will help older adults achieve significant health benefits. These components are Endurance, Strength, Balance and Flexibility

Endurance exercises increase breathing and heart rate, which in turn benefit the lungs, heart, and circulatory system.

Strength exercises build muscle mass and give an individual more strength to complete tasks on their own. One of the most positive aspects of strength training is a small increase in muscle can translate into a much greater increase in ability, especially in a frail person.

Improved balance is perhaps the single-greatest exercise benefit to an older adult.

Flexibility, the last of the four building blocks, help to keep the body flexible and retain range of motion by stretching muscles and tissues that hold the body�s structures in place.

University of Michigan
https://www.med.umich.edu/1libr/aha/aha_hmexerci_crs.htm

AARP: Get Ready, Get Set, Get Moving!
https://www.aarp.org/health/Articles/a2003-03-06-getset.html

National Institute on Aging: Exercise Can Boost Cardiac Fitness in Conditioned and Out-of-Shape Older People
https://www.nia.nih.gov/news/pr/1996/08-02.htm
 
 

EXERCISE FOR PEOPLE WITH DISABILITIES
HealthDayNews -- Exercise is good for everybody, but it's especially important for people with disabilities, since they often have less-active lifestyles. Regular exercise improves lung and heart function, protects against development of chronic diseases, decreases anxiety and depression, controls weight, and lowers cholesterol and blood pressure, says the National Center on Physical Activity and Disability.

If you're disabled, consult your doctor before you start an exercise program. Find out about any potential effects of medications on exercise. Set realistic short- and long-term exercise goals. Wear appropriate clothing, drink plenty of fluids and stop exercising if you experience pain, discomfort, nausea, dizziness, lightheadedness, chest pain, irregular heartbeat, shortness of breath, or clammy hands. ArcaMax HealthTips, no referral

WALKING...A STEP IN THE RIGHT DIRECTION
Is It Okay for Me To Walk?
How Do I Start a Walking Program?
Safety Tips
How Do I Warm Up?
Taking the First Step
A Sample Walking Program
Walking is one of the easiest ways to exercise. You can do it almost anywhere and at any time. Walking is also inexpensive. All you need is a pair of comfortable shoes. ANM
https://www.intelihealth.com/IH/ihtIH/EMIHC267/14220/24128/198992.html?d=dmtContent

THIS IS MY LIFE AND I AM STICKING TO IT!
Steve/WV: My Own Experience with Exercise: At 280 lbs and very SOB I began to walk, not far at first, but a little further when I felt like it at times. I paced myself so as not to cause any discomfort. I have to admit that I didn�t like this walk and dreaded the thought of it at first, however, the pounds started to drop off and my energy level went straight up. Believe it or not, I look forward to my walk more than I do anything else that I have to do for the day. I feel much healthier, and my mind even feels sharper. I also use that walking time to concentrate on things that I need to or want to do with my life with COPD. I love life and I want to enjoy the best quality of life that I can have for my family and me. By the way, with walking and the diet I weigh 170lbs and my lungs stabilized almost a year ago with no sob. I now walk for over an hour every day, weather permitting. With exercise machines I only last about 20 minutes. If you still have the ability to start, go at it. I didn�t know I could do it for years, till I heard it over and over from our senior family here at COPD. Some of them are gone now, but their advice still rings in my head. We are all different, but you gotta give it a shot; exercise, diet, meds, and no smoking is definitely our recipe for life. This is my life and I am sticking to it!

Richard/Upstate NY: Steve: I read with much interest your email because I found myself following the same procedure, diet, exercise, etc. I started at 238 pounds and gained when I stopped smoking two years ago.  I go to a rehab center gym three times a week after completing COPD therapy at the hospital where I was a patient for three weeks when I first came down with COPD.

As you noted, I now am enjoying the best quality of life that I can have.  We have come a long way. It can be done.
 
 

Word Jumble
https://www.lolfun.com/index.cfm?action=fun&c=daily&id=13

A Test
https://www.tarasfunpages.com/pstresst.html

Couch Potato
https://www.tarasfunpages.com/couchpotatoesd.html

Exercise or Not
https://www.tarasfunpages.com/excersiseor.html

Ol Man River
https://easylistening.freeyellow.com/easy80/olmanriver.htm

This page will be next updated on September 17, 2004.