Day Two At Rehab

Sore as I was, I made it through another day at rehab. My blood pressure went down, and my O2 sats were good, and for that I'm thankful. It was a good session and I hung out longer than I needed to, having good conversation with the other participants and Rose. Between machines we hang out at a round table catching our breath and talk about COPD, oxygen and all sorts of things.

I did learn that Audrey, a 12 year old who has cystic fibrosis, is still on the list for a transplant. I met her last year while attending pulmonary rehab and was blown away by her courage and spirit. Since I've seen her, she has declined somewhat and is now on 8L of oxygen during the day and 10L at night with a Bi-Pap. She's been on the tx list for 4 years because the only state that her insurance will allow is her home state. She has been ok'd for a live donor lobe transplant, with her mom and a teacher as donors, but the doctors won't do it until she absolutely needs it (so as not to put 3 people at risk at the same time). So she goes to school and still attends rehab and still is smiling.

When I first got to rehab today, I had to sit a bit to catch my breath. I had to park farther away and it took a toll. BP: 168/78 Pulse: 120 O2 Sats: 94%

I did the treadmill for 10 minutes at 1.0 and it wasn't as bad as Tuesday. I was able to go longer. When I finished, I was at 96% O2 Sat; 122/73 BP; 112 Pulse.

Next was the Nu-Step. I went for 15 minutes at work level 3. I had to decrease the work level from Tuesday because I had adjusted the seat to better work my legs and it was HARD once I was actually in the right position! When I was done, O2 sats were 96%; pulse 114; BP 141/77. I really felt the workout in my thighs this time. In the 15 minutes I did 1,340 steps. The picture at the top of the page is the Nu-Step machine.

Finally I did the UBE, or ergometer, which works on the arms. I did 8 minutes again, 4 forward, and 4 backward at the same resistance. This was pure torture for my arms!! I can still feel that soreness in my biceps and triceps! My mom used to use "Aspercreme" for arthritic pain - I wonder if they still make it; in the meantime, I'll take some ibuprofen! Please excuse the whine and pass the cheese, please...

When all was said and done, my sats were 95%; pulse 118; BP 141/71. My pulse was running in the high 120's while doing the exercises. I have a normally high resting pulse, in the 80's to 90's, which is because I'm out of shape.

I'm so glad that I've finally gotten back into the rehab and look forward to next week! I really think, no, I know I feel better already! Breathe better, everyone and see you next week!

~Eileen

First Day Back

So yesterday was my first day back to pulmonary rehab maintenance. It was great to see Rose and there was another lady there that I remembered from previous classes. She, too, was returning after a long hiatus. There were several others there, too; some with oxygen, some without.

I started out getting baselines of my O2 sats, pulse and blood pressure. They were: O2 sat: 96%; pulse: 111, BP: 162/93. I had walked in with my O2 at 4L and kept it at that because I was going to go right to the machines. I don't take anything routinely for high blood pressure, but when I have swelling in my feet, I take lasix, which also helps my blood pressure. However, on this day, I had not taken any lasix.

I went first to the treadmill. I managed to do only 6 minutes at 1.0. My calves were doing the burn and I just couldn't go another minute. I went back to the table to rest and my numbers were: 92% O2; 126 pulse; 129/77 BP. I have to say, I was a little disappointed in myself that I couldn't do more.

Next was the Nu-step. This works your arms and legs while you sit (I like this one). I did 15 minutes at work level: 5. I felt alot better about this machine but my arms really got a workout and boy, were my upper arms were burning! When I went to sit down, my sats were 94%; pulse 113; BP 117/77. So this was a much better blood pressure. I was anticipating that at the end of the session, my BP would be even better.

I then went to my nemesis: the UBE(ergometer), where you sit and 'bicycle' your arms back for half the time, and then forward for the other half. OH MY GOODNESS! I just dread this piece of equipment! Even though I have been working out with weights (albeit sporadically) this just KILLED me. I did 5 minutes forward and 5 minutes backward at level 2, which is 30% resistance. Oh the burn.....the burn...I've never been so happy to be done with a piece of equipment! BUT, although I hated the machine, by the end, my O2 sats were 95%; and my BP was 116/75.

Thus went my first day back at rehab. Already I feel better just by going. And I'm looking forward to tomorrow's visit. See you back here tomorrow!

~Eileen

Pulmonary Rehab Maintenance

Hi everyone!

Kasey asked me to post my experience with pulmonary rehab as I've just begun (again) a maintenance program. Kasey's doc still hasn't cleared her to continue, so I'll share my experiences until she's back at it, which we all hope is very soon!

My name is Eileen and I'm a moderator on the Breathing Better Living Well communitity forum. I was diagnosed with COPD in 1999 after a hospitalization for respiratory failure. I have what is considered severe COPD with an FEV1 of 34%(4/06); my FEV1 was 29% in 2005 and I can only conclude that quitting smoking and going to pulmonary rehab are responsible for the improvement from very severe to severe. I am on Advair, Spiriva, Albuterol and Theophylline.

I have had motivation problems when it comes to exercise. It seems that unless I'm accountable to someone, I very easily talk myself out of getting any good exercise. I went to pulmonary rehab in 2001 and again in in late 05/early 06. I've been in and out of pulmonary rehab maintenance ever since then.

So it isn't any great stretch to determine that I am quite deconditioned. In October, I called our local hospital where the rehab is, and asked to get back into the maintenance program. I was disappointed to learn that all the classes were filled and that I would have to go on a very long waiting list. I have been exercising on my own sporadically.

Just after Christmas, Rose, who runs the program called me to say that because there were so many on the wait list, our pulmonologist insisted that she start another class! Wahoo! I started today and go Tuesdays and Thursdays.

I will continue this tomorrow, as I am VERY tired and sore tonight. I'll be able to think clearer and therefore write clearer on a good night's sleep. So sweet dreams,all, and breathe easy!

~Eileen

WORKING OUT THE REHAB ~ THANKSGIVING

Welcome, my Friends! Thank you for checking in on me. It's Thanksgiving time and I wish you and yours the happiest and healthiest Thanksgiving ever. For our international friends who have their thanksgiving at another time or in another way, please feel free to join in giving thanks right along with us. All are welcome here!

Well, the doc has not cleared me to restart rehab but I have an appointment Monday and truly believe he will release me to restart. I'm feeling better, weak but better. The fever is mostly gone but boys am I ever short of breath and I know it has a lot to do with inactivity. So....I'm looking forward to getting restarted but know that it is also going to be difficult. That was some mean infection I've had. Whew! I don't want it any more!!!

In the meantime, I am practicing my PLB and diaphragmatic breathing, hoping to build those muscles and strengthen my lungs for what lies ahead in rehab. WOO HOO! Have you guys been doing your breathing exercises, too? Walking? TM? Resistance training? I am starting the resistance training here at home on my own with cans of soup. Hahahaha. Hey! Whatever it takes to make it work. Now, I am using the cans of soup as free weights lifting one on each side. I'm not tying them to my ankles...yet. :-) Now, over on the www.Breathbetterlivingwell.com site, there are two new forums that work well with rehab. One is The Village Gym and then there is The Day Spa. Of course, the Gym is all about physical fitness and the Day Spa is about beauty methods ~ mostly natural, and relaxation/stress relief ~ mostly meditation and massage. Please visit and feel free to add you own thoughts, methods or ask questions. Things are really happening over there at BBLW and having you add your input makes it all the better.

Another one of my goals in rehab (or out of rehab for that matter) is to better my nutritional input and lose at least 8 pounds by the 1st of the year. There it is, peeps. Right there in writing. My commitment of 8 # by year's end. Think I can do this? Oh, I think I can....I think I can....I think I'd better!

Notice all the ghosties and goblins have gone back into their mysterious world for another year. Did anyone get tricked this year? Treated?

All the little elves and sprites are out and running about town gathering all the tools and materials to create those wonderful Christmas surprises for everyone. Don't you love those squeals of glee on Christmas morning after Santa has visited? Such joy! A truly magical time of year.

OK you guys, Stay with me, please and be sure to check back because I need you all to come with me to restart the rehab. Here I go getting nervous again! YIKES!!!

Love you all. You guys totally Rock~~~

Working out the rehab, every day, working out the rehab, every way, working out the rehab, it's all right, working out the rehab, our lungs are gonna fly~

Till next week, my lovely friends. Rock on!!! I celebrate each and every one of you this Thanksgiving. I am so very blessed to have you and so very thankful for you!

Sweetest blessings!
Kasey

WORKING OUT THE REHAB - CRIMEY!

Hi Gang and thanks for checking in on me. Guess you've noticed that I have not blogged in a couple of weeks.

Due to a rather nasty lung infection brewing in my lungs, the doc has taken me out of rehab but.....WAIT...WAIT...... it is only temporary and I should be able to start back in rehab next week if my lungs continue to improve. If not next week then the following week for sure. Just in time to celebrate my birthday. :-)

It is getting to be "that" season when ragweed is flying, bus exhaust fumes are soaring, and the elves are beginning to work over time, 'round the clock, to get all the holiday goodies ready. The ghosties and goblins are already grumbling and moaning and clanking chains. Can you hear them??

While I complete my healing from this infection ~ and thank God I am healing ~ please do come visit us at the Community Bulletin Board. Here is the link/address for you.

http://www.breathingbetterlivingwell.com/community/

There's a lot going on over there and we are organizing a "Newbie Chat" which will be hosted by 2 of our newbies, Karen and Sable. It is a 'let's get to know each other, ask copd questions, chat amongst ourselves' kind of open chat and there is no pressure. You can just log in and sit and watch if you like. You won't be pressured or made to feel uncomfy. So check in and see which evening Karen and Sable will be holding the first "Newbie Chat."

OK, back to the rehab. I'm really sorry for this unplanned hiatus and rest assured that I will return in the next week or so and we will be....

Working out the rehab, Everyday! Working out the rehab, Everyway! Working out the Rehab, It's alright! Working out the rehab, our lungs in overdrive!!!

WOOOO HOOOOOO!!!

Love you guys ~ every one of you!!!!

Sweetest blessings,
Kasey

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 :::::::::::