Motivation

One of the hardest parts of rehab is staying motivated. I have been having trouble over the past month because I haven't been feeling so great. I had an infection and was on antibiotics and prednisone and just started another course of steroids with a slower taper. The doctor thinks that this time I might need to stay on a maintenance dose but I am hoping not to.

An exacerbation of COPD causes severe shortness of breath and that is just the hardest thing to deal with for me. Just going into the kitchen from my livingroom causes distress and the harder it is, the less I do it. The fear of the shortness of breath is profound. With COPD, the less you do, the less you can do.

This week is almost over, so next week I am going to get back to rehab while I'm on the prednisone and have some energy. I need to get over the fear and back to the exhilaration that I feel when I am doing something good for myself. If I stay stagnant, I get depressed and it's even harder to do anything.

I know that life can be good, and I want it back!

~Eileen

Pulmonary Rehab and ME

Hi,

My name is Peg and I am part of the BBLW Team, telling my story about my introduction to Pulmonary Rehab.

I was first diagnosed with COPD in March of 2001. Never had heard of it before! I knew I got winded sometimes, and that I was a "shallow breather" like my Dad had been, but serious illness? No way! At times, the thought would wake me out of a sound sleep with "fear chills" thinking I was dying, and at other times I was just me. The doctor said "Quit Smoking". What doctor doesn't? But did it mean anything? No...just another scare tactic. But I went on the inhalers and they helped some and of course, I went right on smoking my pack a day.

Then, in June of 2002 I had a simple colonoscopy and my spleen was ruptured -- I nearly died. Who ever thought my spleen would have been attached to my colon? - duh! It's just not supposed to happen that way! So after losing about 3 liters of blood into my abdomen (I only had about 5, anyway) and being cut from sternum to belly button, I'm recovering without any physical therapy or rehab - no strength recovery help that way at all. I hurt no matter what I tried to do, so I became sedentary and began my ritual of reading a novel a day, smoking and drinking coffee all day. My once strong muscles completely atrophied and I lost a lot of weight and had absolutely no appetite.

In 2006 I had my first exacerbation of COPD. Into the Emergency Room - first and I hope last ambulance trip, by the way! By this time, I had developed such a horrible relationship with my Pulmonary Specialist that I could not even listen to him. I believed he was just an alarmist! I had to ASK HIM about Pulmonary Rehab (I had been reading about it). He felt he had told me about it, I felt I had never heard of it before, but I wanted to try it now. I knew I had to do something!!So, I made an appointment to go in and talk to Jane, who is the Respiratory Therapist in charge of our program here.

I walked in and looked at all those people on the various machines, even the ones wearing oxygen, and nearly charged back out the door! Believe me, I was petrified! No way was I ever going to be able to do this exercise machine stuff!! I just couldn't see how I could ever do any of it. (And I wasn't even on oxygen yet!!)

Pulmonary Rehab is the best thing I have ever done for myself! The education, training, and the friendships and bonding have helped me so much in the last couple of years. I truly believe I would not be here today without it. My "group" is as important to me as my family. They are my support family. They are what keep me motivated to keep on, and some days I need the lift of their caring more than I need the exercise, because there, we all know what we are dealing with. No recriminations, only caring support. I also know that my participation has helped to encourage others along the way. We are The A Team, trying to do the very best we can with what we have to work with, and Pulmonary Rehab is the means to do it with.

Before this turns into a book, I'll just say that if you have the ability and opportunity to get into a Pulmonary Rehab Group in your area, by all means, at least give it a try. I am positive you will not be disappointed at what you will learn. And it certainly helps now that Medicare helps with the expense of it. The beginning level is called Phase 2 (and we all wonder what exactly Phase 1 was...) and the rest of us are in Phase 3 (which we all have to pay for out of pocket), and that is for a lifetime!

Oh, and a P.S. After my father passed away, his Death Certificate stated that he had COPD! We, his 3 daughters, never knew anything about it. Shallow Breather, huh, Dad? Duh!!!

PULMONARY REHAB AND ME

Hi all,

My name is Peg and I am part of the BBLW Team, telling my story about my introduction to Pulmonary Rehab.

Rise and Fall of My Pulmonary Rehab

By way of introduction I am Darrell, part of the BBLW Team and I hope to be posting here occasionally. Thanks for reading.
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I'm happy to hear that many of us are active now in pulmonary rehab programs. These programs provide so much for us. The exercise is essential but the education, friendship and support are so important to keep us on an even keel. Plus they motivate us to do the best that we can.

Today was sort of like the rise and fall of a PR program for me. Our maintenance group is being moved to a new facility at the local YMCA and rearranged in several ways. The new program will require a YMCA membership and will provide a walking track and all the usual gym equipment and amenities. I'll go there on a trial basis one day next week to see what my wife and I think of the place. The PR side of the service will include one day per week scheduled visits with an RT who will monitor our status, performance and progress. The deal for me would be to drop my current gym membership and start a Y membership with a little bit of savings. The deal breaker for me is that (1) it seems few if any of my current maintenance group members will continue at this new venue and (2) I'm not prepared to drop my current gym friends who I have been working out with almost daily for the last few years.

The rise of my PR program started over two years ago when my doc referred me there for the full basic 8 or 10 week program. I learned alot and befitted greatly from that experience not only in knowledge and exercise but in finding a better acceptance of my condition and a level of comfort in dealing with the issues we as COPDers face. Following that "graduation" I went on to their "high performers" program which was to continue my own regimen and check in once a month for monitoring at PR. That program went away after a number of months and a recognition that most of the high performers were self motivated and likely to do well even without the program. The program was eliminated to make way for those who needed it more.

Then last year after a nasty exacerbation I was recommended for a lung transplant evaluation which required that I go back to rehab. That was good news for me and I was pleased to go back to my twice weekly PR maintenance sessions at the hospital. I established good relationships with the other patients and with the staff and PR became a part of my personal "wellness program" together with my three or four days each week at my gym. The lung transplant evaluation was completed and it was determined that I am currently functioning at a high level, regardless of my clinical results, and was not recommended for transplant now. So I continued PR because it seemed to be working for me.

Then another "good" thing happened when Medicare decided to cover PR expenses. Good for basic rehab where they now have a six to nine month waiting list for the program. I don't think there was much if any waiting list prior to the Medicare decision. Naturally with the expanded demand they have to maximize the use of the facility and the number of patients they serve. So here we are being rewarded for our success by being referred to a new program which as far as I can tell no current patients are signing on to yet. Who said "nothing succeeds like success"? It seems today that to be rewarded all you need to do is make loans that can't be repaid or build cars that nobody wants to buy. Maybe an occasional ponzi scheme or accounting fraud.......................

I am very grateful for the opportunities I have had to work these programs and the benefits I have received and I'm sure I'll do quite well in the future, with or without them, but I am concerned for most of the others in the PR maintenance who may not be self motivated. They need the structure and the commitment to the program, staff and to the other members who won't hesitate to say "Hey! where were you last week". For these people it has nothing to do with resource utilization and efficiency. I wish them all the best in their quest to keep on breathing.

Darrell

Improvement

Week two back at pulmonary rehab has seen an improvement in my endurance with the exception of the treadmill. My hip is burning by the time I reach 5 minutes on it so I'll have to take that one very slowly.

I increased the NuStep time to 15 minutes, doing 1200 steps. I felt okay with that, with only a little pain in my right shoulder. I continued doing about 84 steps per minute.

The Upper Body Ergometer really burned my right shoulder and arm, but I stuck it out for 15 minutes. When I was done, I realized that the resistance was cranked up pretty high, so I'll pay more attention next time. I think I'll be sore tomorrow.

My blood pressure went from 142/79 after the TM, to 99/65 when I was done with all of the exercises. My sats when I started were 94% and when I was done, were 97%. I think it's pretty apparent that exercise helps the heart!

I left rehab with a sad heart. I just found out that Audrey, the 12 year old who got a double lung transplant 2 years ago, is very ill. She is now 14 and had 2 really great years. In the past couple of months, her PFT's have steadily decreased and her shortness of breath is increasing. The hospital in Boston has done everything that they can, including some experimental things, but have had no luck improving her condition. They have apparently opted not to retransplant. I can't imagine what her parents are going through right now - Audrey has made her own funeral arrangements and this must be a very difficult, if not impossible time for them.

If I ever needed to appreciate my own health status, this would be a good start.

~Eileen

Back at it

I am finally springing out from winter. My time had finally come to return to Pulmonary Rehab yesterday. I had had a couple of false starts, but this week it was all systems go!

I had reservations about the long walk from the parking lot through the hospital to the rehab room, but I did it with just one stop by the Gift Shop to catch my breath. I think I have finally learned the wisdom of walking more slowly no matter what it costs me in pride. Pride is so overrated anyway.

Walking into the rehab room was like going home, I know it so well. From Rose, who runs the program, to the members who having been going for years - I felt very welcomed back into the fold. Rose always sets us up with water, and then it was time to work.

I went to the treadmill and set it for .5, but after about 30 seconds, I turned it up to 1.0 because it just felt too slow. I did not, however, last for very long. 5 minutes was my limit this time. By the end of it, my hip was burning so I stopped.

I was actually feeling pretty whipped by the time I sat down and had a drink of water, and I decided to called it a day. This was a huge step for me and I'm ready for more tomorrow.

~Eileen

Lesson Learned

If I've learned one single thing over the past year, it's been to PACE myself. I honestly never realized just how much I needed to slow down in order to breathe better.

In the beginning, that is, before COPD, my normal pace was to walk fast. Anything I did was at a rapid speed, and I took pride in being able to get things done quickly. This was something I did without any conscious thought and there were innumerable times when someone would ask me if I always walked that fast. I'd always reply that I didn't realize that I was.

After COPD, I had the hardest time breathing because my pace hadn't slowed to accommodate the decreased lung function. After several years of stubbornly refusing Pulmonary Rehab, and being miserable with my declining health, I finally surrendured and let go of the denial.

I enrolled in Pulmonary Rehab in my area, and it made a huge difference in the quality of my life. I learned how to breathe out during exertion and breathe in for recovery. I learned breathing techniques and finally learned the importance of pacing myself to make my life easier.

Over the past year, I have been forced to move even slower, now at a snail's pace. The surprising benefit that I found is better breathing. It took broken bones to make me pace even more, and move even more slowly while doing things. I feel pretty comfortable doing the snail's pace, and I don't feel embarrassed as I had previously. I guess there's been that pesky pride thing going on that didn't want anyone to think I was less of a person because I had to go slow. I had to learn the hard way, as most lessons are learned, that pride never helped me breathe better.

I am learning on a daily basis, ways to take care of myself, and make lemonade out of lemons.

~Eileen

Journey to recovery

When I get discouraged, I have to remember how far I've come from a year ago. I am able to do just about everything for myself now and rely only a little on outside help. For me, this return to independence has been very uplifting, and I have learned so much over the course of this past year.

I have always been comfortable with being by myself, and prized my privacy. However, I had to let go of most of my privacy by allowing others to come into my home to help me out. I had to leave my door unlocked so that they could get in, and people were coming into my space many times a day. My life became an open book. At first this was very difficult to deal with, but over time I became used to it, and even enjoyed the diversions during the day.

Allowing others into my world held some really great rewards for me. The first was that I had to reach out to others and actually ask for help. For someone as fiercely independent as I am, it didn't come easily, but it helped me to learn that it is not a sign of weakness to ask for help, and that people actually WANT to help and it gives them a good feeling in doing so.

I have a tendency to isolate myself and spend long periods alone with just my thoughts. This is a dangerous place to be. Not being allowed to isolate was another reward for me. When you're alone, and your thoughts tend to gravitate toward the negative, they can spiral downhill rapidly without someone to counter those thoughts. I have received enormous amounts of support from family, friends and therapists during this past year. Just having them around has been a constant source of light in my life. The big surprise for me was that I am not quite the loner that I thought I was!

I know I will continue to have challenges and disappointments on my journey to recovery, but I will also lean on the people around me and learn many more life lessons along the way.

~Eileen

Inching Forward

It is now almost 3 months since surgery on my left hip. Progress has been slow but it has been building steadily.

I have many exercises to do daily and they include upper and lower body strengthening, stretching by using weights and therabands, and resistive exercises. Resistive exercise might sound funny, but I sit with my feet flat on the floor and my knees apart. I push in with my knee, while holding my hand against it, so that it is harder to do. I do this both pushing in and out. I also add some standing exercises where I hold the back of a chair and stand on tiptoes and back onto my heels. From that position, I also kick out my left leg and hold it there to a count of 5, then repeat 10-20 times.

I had permission to use a walker and crutches, but recently I have been gradually testing out a cane. I am VERY slow with it, and not very confident. I didn't realize how dependent I had become on the comfort of the walker. Funny, I despise that thing, and can't wait to get rid of it, but it holds security for me.

I have another appointment with the surgeon in a couple of weeks and I'll have an x-ray. I am hoping that this visit will confirm my suspicions that things are going forward as they should!

~Eileen

After Surgery

This is a picture of a rainbow from my window at the rehab hospital, the evening before I left to come home.

I had surgery on May 12 to repair my fractured, impacted hip with great results. I had a bone graft done and a total hip replacement. I had to wait 9 months to get the surgery, and I am now feeling like it was worth the wait. When I stand now (although I'm not supposed to) I don't lean anymore! Both of my legs match in length again.

I don't remember much about the first several days post op. I do have a couple memories of them getting me out of bed and how heavy my leg felt and how much pain I was in. They got me out of bed every day and I was faithful about doing breathing exercises every 2 hours. By the 5th day they were ready to send me on my way and off I went to a rehab hospital. By this time, my hip was already starting to feel better than at any time since I had broken it!

My six days at rehab were great. I went kicking and screaming but soon found myself enjoying it very much. The staff made me feel welcomed and good about any progress that I made and there was lots of laughter and work. They even incorporated elements of their pulmonary rehab program into my PT and OT programs. This particular hospital actually has an inpatient pulmonary rehab program and if I should have an exacerbation and need pulmonary rehab, I will certainly do that.

I had PT and OT and nurse visits for about 3 weeks after I returned home. The nurse would check my vital signs and assess my suture line, which was healed by the time I got home. PT and OT did exercises with me and just a couple of weeks ago, put me on hold until I get permission to progress with weight bearing. So I spend about a half hour to 45 minutes each day doing exercises on my own.

So that is my journey so far. I hope to be walking by fall, but that's getting ahead of myself and I will continue to exercise so that I'm ready when the day arrives!

~Eileen

Where I'll be

After 9 long months, I will be having surgery on May 12 to repair my broken hip. They will do a bone graft and total hip replacement.


I have just begun to feel better, walking better with crutches, no longer taking pain pills, & moving around more, so I am kind of sorry to give all that up again. But I will be very happy to be on the other side of this and I am looking forward to walking on my own again, hopefully within the next 6 months.



I have needed a lot of help over the past 9 months, and it was a good lesson to teach me how to ask and accept it. I have always been the caretaker, not the one needing it, and I was too proud to ask. Throughout all of this time, I learned that there were people who needed to help me as much as I needed their help. This has been a very humbling experience and I will always be grateful for the life lesson.

I am ready to fight to gain back what I've lost to deconditioning. My doc already has told me I have an excellent attitude and will do well surgically so it's onward I go!



I'll see you on the other side of this.

~Eileen

Where I have been

I don't know where to begin. I haven't blogged and I haven't been online much in the past 5 months. I'm going to just give the very short version so I don't bore everyone to tears with my tale of woe.

In August, I tripped in my livingroom as gracefully as I knew how, and fell, breaking my right shoulder and my left hip. I walked on my broken hip for several days until I could no longer stand the pain and went back to the ER. The ER had never x-rayed the hip because they gave me so much morphine that it didn't hurt anymore! It had been 10 days and they discovered serious damage to my hip because I walked on it. It wasn't just broken, it was, well, traumatized is the best word I can come up with.

After a LONG separation from my home while I was in the hospital and then in rehab, my hip is still not healing. My shoulder is coming along okay. I walk with a walker and sometimes crutches but using the crutches just leaves me so much more breathless. I have been home since the end of October and have been out of my house twice since then. You can imagine my state of mind these days.

I haven't had surgery yet on my hip because there hasn't been any healing at all there. My orthopedic surgeon told me it would be about 6 months before something could be done. I will need a custom piece that they can fit a hip replacement to. I have been referred to a large teaching hospital near Boston, where I will see the head of the ortho department. That is on the 31st of this month, so I am hoping that they will be able to do what my ortho surgeon doesn't feel qualified enough to do.

I am very deconditioned and discouraged. I can get along okay in my apartment with help from my family and a great neighbor family who all pitch in so that someone is over a couple of times a day. There's no doubt that I would be in an institution were it not for all of them!

So that's where I've been this fall and winter. Of course this is all taking much too long in my estimation but I'm looking forward to being able to walk again and get back to rehab to get some more breath.

~Eileen

Pride followed by Grace

I realized that there is more that I want to say. It is only marginally related to pulmonary rehab but I think it's important as I'm making myself healthier to continue to be independent.

My sister called me today. We talk almost every day but today impacted me so much. A few weeks ago, she came over to visit. Once she got here, she saw that my dishes were dirty all over the counters and the litterbox was overdue for a cleaning, and the floor needed sweeping. She said to me "Eileen, I know you don't want me to do this, but I am going to do it anyway." As I cried in the livingroom ( I really did, like a baby), feeling helpless and needy, she did all of my dishes and the litterbox and swept the floor. I tearfully thanked her and we went on to have a good visit. I had really needed help with my housekeeping and I was so very grateful for her help, but I was actually physically unable to ask her for it.

Today, when we talked, she told me that she would like to come and help me out some more. She told me that she had felt so good that she was able to do something for me, and even though I cried, it was too good a feeling not to do it again. SHE made ME feel like I was doing a favor for her. Go figure. She was sincere, too. She then told me if I could physically stop her, she wouldn't do it. We had a good laugh over that.

My friends at BBLW kept telling me that some people need to do for others, and my sister is one of those people. But I couldn't accept it while I was wallowing in selfpityland under the influence of toomuchprideism. I see where my inner work lies...

But I think I'm recovering now and I will look forward to having my sister come over and help me out. What a gift she has given me and I pray that I will have the grace to accept it.

Thursday, August 23

I just wrote and then deleted two long paragraphs about why I didn't go to rehab today. I deleted them because there just isn't an excuse good enough not to attend rehab. 'Nuff said.

Tuesday August 21

I was so happy to have my friend Gail with me today when I went to rehab! I had topped off my O2 tank, which I really should not have done, and by the time we got to the hospital, it froze up. I walked from the parking lot to the lobby with just a dribble of oxygen making it through the canula, and my O2 sats were 84%. I was kicking myself because topping off the tank is a sure way to freeze the works up. I usually use my own tank when at rehab, and I wanted to make sure that I had enough. So Gail had to wheel me into the rehab room. I laughed all the way because she was going 65 MPH to get me to some oxygen, and we were flying past everyone in the halls. Everyone must have thought I was on my way to delivery... When I stopped laughing, I told her that it was ok not to panic because just by being still and breathing, my sats would come up. We both had a good laugh talking about the looks on the faces that we sped by.

I got hooked up with a rehab tank and my sats came right up to 95%. I was feeling tight in my chest and achy all over so I figured I would take it easy today. I started on the Nu-step and did 20 minutes, and 1,700 steps. After a rest, I did the UBE. I did 18 minutes on that one. Then on to the TM. I did 10 minutes today at .9mph. Not very good, but at least I got that 10 minutes in. My blood pressure was good today, 124/71 and my sats ran around 95-96%.

If my chest still feels tight tomorrow, I will call my doctor and run in to have him listen to my lungs. Just to be safe. But I really think that it will be fine tomorrow.

See you Thursday!

~Eileen

Thursday, August 16

The week winds down with me feeling good about how things are progressing. I am seeing good results in my daily life that are directly the result of rehab. I am able to move more freely with less shortness of breath, showering is so much easier, and when I'm moving around, I can use less oxygen. When I got out of the hospital, I was using 5 - 6 liters of oxygen to move around, but now I usually just use 4 unless I'm exercising.

I started out on the Nu-step and pumped away for 20 minutes, completing 1,800 steps on Level 5. Then I went to the TM and did 15 minutes on 1.0. After another rest, I went to the UBE and worked my arms out for 20 minutes. My O2 sats were consistently around 95-96 and my pulse didn't go over 120. My blood pressure was still a little high, at 144/88. If it's still up next week, I'll have to call my doctor to see if he wants me to start lasix, a diuretic, again. But I really think it'll be okay.

Once again, after rehab I felt so energized. I worked for several hours in the afternoon and while I'm tired, I still feel better than if I didn't go!

~Eileen

Tuesday - August 14, 2007

Ahhh, the sweet smell of progress! Rehab has felt like it's been going at a snail's pace for the past few weeks; my recovery from pneumonia and this most recent exacerbation has been tortuously slow. But by the end of last week, and more so this week, I have felt better and more able to tolerate movement without disabling shortness of breath.


My friend Gail has been bringing me to rehab since I got out of the hospital and wheeling me from the entrance to the rehab room. Today I walked from the parking lot, into the hospital and to the rehab room by myself. I rested once about half way through. I also walked all of the way back to my car. How sweet it is!


I rested for a few minutes once I got to the rehab room and my BP was 155/87. This is pretty high for me, but I figured the effort of walking in might be the cause. I have a history of high blood pressure, but it's been down since I don't work full time anymore. It was a stressful job and my blood pressure has been good since leaving the job.


First I went to the UBE and worked my uppper arms for 20 minutes. I rested and headed over to the Nu-step. I worked my arms and legs for 20 minutes, and did 1,660 steps on Level 5. Up 5 minutes from last week!


Then on to the treadmill and I finally made it to 15 minutes at .9MPH. Sweet, sweet, sweet! 5 minutes on it had been torture for weeks and now at the slower speed, I am able to do better. This makes me feel so much better about how it's all going!


I can't say enough about being persistent and consistent with trying. I thought I might be in for a decline but it looks like I will be able to come back and even be better if I keep trying and be patient!


Progress, not perfection!


~Eileen

August 9, 2007

While rehab didn't happen on Tuesday because of continued oxygen problems, Thursday was great. There was progress and my oxygen issues have been resolved.

I went for 20 minutes on the UBE without experiencing any muscle burn. For some reason, the time just seems to fly by when I'm sitting there peddling my arms. I'm relaxed and I listen to conversations around me and let my mind just wander wherever it wants to go.

Next was the Nu-step and I did it for 15 minutes, doing 1,200 steps on Level 5. I would probably gone 20 minutes, but there were about 11 of us at rehab and someone was waiting for the machine. For the lot of us there are 4 treadmills, 2 UBE machines, 3 recumbent bikes and 2 Nu-steps. There is also a gazelle and a rower and multiple bikes that are rarely used, at least in our class.

When I went to the TM, I decided to try it slower to see if I could do better and sure enough, I was able to get to 10 minutes. For me this is a huge improvement. I really think that now that I've discovered my speed for now, (1.2 - .9)I will be able to get to 15 minutes next week and who knows from there.

My O2 sats ran around 95-96%, my pulse would get up into the 120's, but the best was my blood pressure which ran around 103/64! My pulse did come down during rest periods and maybe by next week it will be lower still.

I can't wait to see how I do next week!

~Eileen

August 2, 2007

This week has seen improvement! Maybe not much, but it all adds up.

I finally discovered at the beginning of this week that my marathon portable oxygen tank was malfunctioning. For almost a week, I thought it was me. I was short of breath much of the time and had some really terrible episodes of extreme sob when trying to do things. But much to my surprise, it was my tank, not me! It was delivering only a fraction of the O2 I need. I received another tank which is also malfunctioning. Hopefully, this will be reconciled so that I can continue my outside activities.

I didn't go to rehab on Tuesday because it was the last day of class for our current group. But on Thursday, I felt ready and was excited to be going. I only had the small portable Helios 300, but at rehab, I was able to use their oxygen. I walked in this time, rather than being wheeled in by Gail. I was short of breath, but my sats were around 94% when I checked.

First I did the UBE, and was able to do 18 minutes this time. I didn't even feel any burn in my upper arms or forearms, which was a happy surprise. My sats and blood pressure were good after this.

Then I went to the TM, but was only able to do 7 minutes before I pooped out. But it was better than 5 minutes!

The Nu-step was my next machine and I did 15 minutes, another improvement. At the end, my BP was 134/70 and my sats were 96%

It was hot and humid outside, so there weren't as many people there as there would normally be. I have discovered that there are a couple of other nurses in the group and we always have something to talk about. Libby was there with her great big laugh which I always enjoy and several others that are becoming such a big part of my life. Janet has broken a couple more ribs coughing, which is distressing to her. She's such a little bitty woman and I'm sure that has something to do with it. She also has osteoporosis which contributes to her fragile bones but she doesn't miss many rehab days and is an inspiration to me.

The foundation that I work for has obtained a grant to develop a program to bring free home visits to certain COPD patients and Rose, who runs the pulmonary program and I are very excited about getting it going. She will be a great referral source for us, knowing the rehab patients as well as she does.

I'm looking forward to next week and moving even more!

~Eileen

Week of July 22 - Tuesday and Thursday

With the help of my daughter's mother-in-law Gail, I went back to pulmonary rehab this week. I am so grateful for her time and effort to get me into the building so that I can begin to recover from this most recent exacerbation. The long walk surely would have discouraged me from going.

Just entering into the rehab room was wonderful! Seeing everyone after almost 2 months was so comforting to me. The welcome back was sincere, and I had such a feeling of belonging that is hard to describe. I sat at the table and just looked around for a few minutes. Then I checked my BP, 159/92. This isn't good. My pulse was 98 and my O2 sat was 92%. The numbers showed that I wasn't in good shape but I had expected that. I have to start somewhere.

I went to the Nu-step and worked for 10 minutes on Level 5. I was able to complete 870 steps. My sats didn't rise above 92%. I was disappointed but I know that this will improve and I have to be patient. Next I tried the treadmill. I was only able to walk 5 minutes at 1.0mph before I was gasping for air. My oxygen was up to 6L but I just couldn't continue. Another disappointment. Again, my sats didn't rise above 92%, but at least they didn't drop either. I finished the session on the UBE, and did 10 minutes. I went to sit again at the table and I was really tired. This little workout was tough. But I felt that it was a good start and I wasn't as bad as I could have been, given the pneumonia that accompanied this exacerbation. My ending sats were 92%, BP 141/84 and pulse 96.

Thursday came and I was quite breathless in the morning. My shower was difficult and hard to complete. I think that the shower will be my guage to determine my progress. I hated showers and they were the single hardest thing that I ever had to do with COPD. But eventually they became easier and I was really enjoying them again. Once the shower becomes pleasurable again, I'll feel that I'm making good progress. It is amazing to me how quickly we decompensate during an exacerbation! I've bounced back very quickly in the past 2 years, but I think that this time the pneumonia was what did the damage this time around. I need to remember that it will take time and patience to work back up to my "normal" again. But I'm willing to do the work!

Today, Thursday, I started out with a BP of 150/83, pulse 72, O2 sat of 96%. Aha! A sign of improvement! I went to the UBE first and did 10 minutes. My O2 sat ran 96%. Next I attempted the TM, and could only get to 6 minutes. I was ready for a nap after that! My O2 sats ran around 95% for the 5 minutes I walked. I am taking this as a big improvement because last week, my sats would drop when I got up and moved around the house. This week they are staying up. I finished up on the Nu-step and did 12 minutes at Level 5. My sats were 96% and my pulse ran 96.

I am optimistic that I will be able to see an improvement next week, and I am determined to have a good attitude no matter what I accomplish! I am motivated and I am very fortunate to be able to exercise at all!

I learned today that our little friend Audrey, who had a double lung transplant, just had a checkup and her fev1 is 100%!!!! Way to go, girl!

See you next week!

~Eileen