WORKING OUT THE REHAB - 2ND EVALUATION DAY

Greetings and welcome, welcome, welcome! Thanks so much for the support and for hanging with me. You guys are the best! Well, for obvious reasons, it was a rough week last week all the way around. But, life does go on and Pulmonary Rehab is going to improve mine ~ and yours, too, I hope!!

Our 2nd trip to rehab was the 2nd half of evaluation. This is the part of the program where they take the vitals and make the determination that one is fit enough to continue as well as determine how aggressive the program will be. Sort of customize a rehab program for each person.

My vitals are as follows:

Blood Pressure: 142/69

Pulse: 100

FEV1: 22%

Oxygen Flow: 2 Liters per minute (LPM)

My 02 saturation is at 97% until I start walking and /or exercising, then it begins to drop markedly. My 02 liters per minute (LPM) will have to be adjusted during walking and exercise from 2 LPM to 3.5 LPM for the moment. As we progress on the exercise side, the LPM will be adjusted to wherever it needs to be to keep my 02 sat at 91 or above. It will be very interesting to see exactly where my 02 requirement falls on my next visit compared to where my 02 requirement will be at the end of rehab, won’t it?

We got weighed as well but I’m not putting that here. Not gonna.

The six minute walk was, as usual, horrible as far as my performance. I have never lasted 6 minutes. I don’t think I’ve ever lasted over 2 minutes. And this time was no exception. My 02 dropped to 86 within 2 minutes time and they had me stop, sit and breathe. The diaphragmatic breathing is just incredible and brought my 02 sat back to 95% very quickly. It took about 1 and ½ minutes for me to reach 95%. The six minute walk is on my agenda again for next session. My heart rate goes high on this walk, too. So they are keeping an eye on that but tell me that as I become more conditioned, the heart rate will decrease comparatively ~ decrease and then stabilize.

Then, they introduced us all to the treadmills and we were allowed to stay on them very briefly ~ for 5 minutes. This was not to exercise but to acquaint ourselves with the machine for next session. I think mine may have snarled at me. The RT put me on the one closest to her. Not sure if that is to keep an eye on me due to my being so deconditioned or to whack me with the ruler if I act out. We’ll see.

Seems that I may be the youngest in the rehab group. The youngest and the least fit. LOL This will be fun, I can tell. It's been a long time since I've been the youngest in any group! Woo Hoo!

That was it for this session as they had to get all of us checked in and checked out. So am totally looking forward to next session.

Please stay with me, guys. Still pretty scared here so I need all the support I can get.
Till next session, then, which is Wednesday.
God bless and stay safe!
Kasey
Working out the rehab, everyday! Working out the rehab, everyway! Working out the rehab, it’s alright! Working out the rehab, our lungs on overtime!
Have a great weekend, guys! Love to all! You guys rock!

WORKING OUT THE REHAB - EVALUATION DAY

Welcome and big 'ole hugs to each of you! Thank you for sticking in here with me and for the encouraging comments and emails. You guys rock!

The first trip to rehab left me a little mixed ~ excitement and a little bit disappointment. You see, this was the Evaluation part. There was paperwork, paperwork, paperwork that had to be completed which took up a lot of time and that disappointed me. (That and the fact that my RT did not see the humor in my pointing my M6 holster at her and pretending to launch a missile her way. I was just clowning around because I am nervous! Some of my classmates "got it" though and that was pretty cool.) Now I know the paperwork is a necessity and an important tool to let the medical professionals know at a glance exactly what meds I take, my vitals, my diet, etc. It's just that I am raring to get on with the actual exercises and such as that. I am ready to go! (Idea! Maybe they could add a page to their website and rehabbers could input that needed data online and ahead of time. That way, they could have it right there in their file on the rehabbers very 1st session, already reviewed. Time saved! Think I ought to mention that, guys? Really, I would appreciate your input!)

On the excitement side of the coin, the RT, Peggy, gave us a class on breathing techniques that was enlightening and incredibly helpful. She discussed, demonstrated and then had us all participate in Pursed Lip Breathing or PLB as it is called. BBLW has this info on their Basics page and, after you have finished here, please go there (link is below) and learn this technique. It certainly helps to gain control of breathing, especially when I panic. Rather, if I concentrate on the breathing method and my own breathing, this deters the panic and gets my 02 level back up quickly and my breathing back to normal. PLB is a very useful tool and one that I rely on a great deal. We are also working this week on PLB while walking to ascertain if this will allow us to continue the walking without having to stop and lean on something to regain our breath. A trial study for our group, if you will.

The second breathing method she taught us is diaphragmatic breathing. This method, too, is on the Basics page of BBLW. I tell you a truth right now. This one takes some practice, at least it does for me, but the rewards are tremendous so I'm jazzed about this breathing tool. This one actually helps to vent out the C02 which improves 02 saturation which helps to decrease the SOB. Results! Results at last! :-) Now, I thought I had already been doing the diaphragm breathing but.....not so. At least not correctly. I was simply exhaling the air that I had inhaled into my abdomen. The chest remains still and one inflates their stomach area then uses the stomach muscles to exhale while using the PLB method as well. My error was that I was simply exhaling and not using the stomach muscles to push out the air. Using those stomach muscles and pursed lips not only expels the air just inhaled but also helps to get rid of some of that old, stale, used up air that is trapped in our enlarged air sacs. This allows room for new air and the sob is decreased somewhat and the gas exchange improves which helps 02 saturation and, generally, makes me feel better. Maybe that is because I am getting rid of the C02 and the old air. I'll have to ask about that. In any event, the diaphragm breathing method, while taking regular practice and some dedicated time and concentration, is so totally worth the effort in its rewards to our respiratory and cardio systems, not to mention just feeling better and getting around better. Yes, I am definitely jazzed over diaphragm breathing. I encourage each of you to visit BBLW's Basics page, click on "breathing techniques" and you will find the step by step instructions. Or use this address: http://www.breathingbetterlivingwell.com/basics/breathingtechniques.php
I want you guys to have this experience right along with me. Deal?


If I am to be totally honest and that is what you will find me to be, I must tell you that I am still a little intimidated and worried about this whole rehab undertaking. Mostly, the fear is that I won't get the results I desire. So that still hangs on me. You guys are the only ones I've told about this misgiving so please keep my confidence, OK?

Next rehab session, I will get my vitals and will post them here for you guys, too. And I hope they will start me on the exercises but, if not, then at least give me the outline for the following session. I will be going 3 times a week, each session for 2 hours. Is that a lot? You guys are going with me, yes?

Hang with me, my friends. I appreciate your support and I NEED your support and your input.
Thanks so very much and please look for my updated blog later this week. I look forward to hearing from you, too.

Sweetest blessings!
Kasey

Working out the rehab, everyday! Working out the rehab, everyway! Working out the rehab, it's alright! working out the rehab, our lungs on overtime!

WORKING OUT THE REHAB

Hi there and welcome. It's so nice to have you here. Do you want to step into the challenge of Pulmonary Rehabilitation with me? I could use your support, frankly.

I am Kasey and I have COPD ~ chronic bronchitis, emphysema, asthma ~ all "severe" and having been diagnosed in Nov 2004. I am terribly short of breath (SOB) and my oxygen level drops (desats) pretty rapidly when I move about, walk from room to room. My last FEV1 is 23%. I am 5'2" and I'm not telling you my weight but Prednisone has caused me to pack on some pounds. So ~ I'll just say, I've got to lose these 2 Thanksgiving turkeys that moved into my belly when I wasn't looking! :o)

I have been trying to get into rehab for more than a year and finally have the green light to do it! Woooo Hooooo!! Truthfully, I am really jazzed about going but am also a bit apprehensive about it. All the material I have read and the folks who have been kind enough to discuss pulmonary rehab with me have convinced me that pulmonary rehabilitation makes a marked change for the better in a COPD'er's quality of life, enabling us to be more active which, in my mind, would create a positive cycle, a healthy upswing. It lessens shortness of breath, strengthens muscles, improves the blood gas exchanges and circulation and gives a good education on enhancing quality of life and our health even further. I hear they even give tips on nutrition. Now, this is what I've been told so we are going to see ~ together ~ if I get these wonderful results. OK?

However, I can't help but wonder what if....what if I can't cut it? What if I can't keep up with the others? What if I do not pass the evaluation? What if my 02 supply runs out? What if I have one of those embarrassing episodes of gasping for air while clinging onto something....anything....for support? What if, what if, what if is a record that plays repeatedly in my head. Makes me crazy! And then, what if I go through rehab and the results are disappointing? My SOB hasn't improved? My "can do" activities have not been expanded? What then? Does that mean I'm doomed? That for the remainder of my life, I cannot breathe, walk, talk, shower, change clothes any better than I can now? My quality of life can't be enhanced? This is it? Is it the beginning of the end of me? ... Yes, one can say I'm a wee bit worried and apprehensive about this pulmonary rehabilitation. I know it has helped countless respiratory patients. But will it help ME?

FYI, I am on oxygen 24/7 at 2LPM and have been for several months now. Prior to that, I was on as needed and then at night. Same 2LPM. Lately, I have increased the flow to 2.5 or 3 LPM due to the excessive heat and awful air quality we've had. My oximeter tells me that when seated and still, my 02 sat is 95 - 98. When I start walking around, I desat to 88 very quickly. By using the PLB, I can get it back to 91 pretty quickly and then there is a slower increase from there. So, the 6 minute walk for me is ..... awful!!! I've been sedentary, which is a huge disadvantage. No one told me to exercise until I found BBLW. Now, when they give me the current FEV1, 02 Sat, etc., at rehab, I will post that info here and you all can see my progress in real time for yourselves. (Say a prayer, please?)

I take many medications: Adviar 500, Spiriva, Albuterol, Singulair, Albuterol rescue, prednisone, Advil, Xanax, Atacand, Atenolol, Synthroid, Claritin D. I also take supplements and the ones that I take specifically for my cardiopulmonary system are: Co-Q10, Omega 3, B12, Zinc and Bone/Body Factor for Women. My doctor told me last week that he is considering Xolair for me as I continue to have far too many asthma symptoms. Maybe rehab will facilitate getting off of some of these ~ I hope!


I've prepared myself (I think) for the 1st day of rehab by packing my little tote bag with my "necessities" and making sure I am wearing light, loose clothing. Also bought myself a new pair of Reeboks. Got a couple extra M6's (tell the truth - doesn't that sound like a kind of missile?!) and a fancy new shoulder holster to carry my 02 missiles along with me. I packed a PB&J in my tote, too. :o) Maybe I should make that carrot sticks and celery, eh?

I hope you'll stick with me because I sure can use your support. Thanks for being here with me. Ready to go? Let's roll!
You know that song, Taking Care of Business.....
....working out the rehab, everyday! working out the rehab, every way! working out the rehab, it's all right! Working out the rehab, my lungs on overtime!
(silly, huh?) ;)
::::::::::::: grabbing my bottled water (H20) on the way out the door :::::::::::