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Post by Joyce7 on Aug 18, 2007 8:50:43 GMT -5
Hi Everyone...I will be starting pulmonary rehabilitation on Tuesday, August 21, 2007. I thought this thread might be interesting information as to the process one goes through, step by step, in rehab. Even I don't know what to expect, but I will post daily from today until I start on Tuesday and then after that, I will probably post on the days I have rehab to say what I have done, what was told to me, etc. For those who don't know me, my name is Joyce and I live in South Carolina. I am age 58, live alone, divorced since 1988, and I have two wonderful children and two cats that are "sort of" wonderful..maybe. I work in DNA Forensics but am now on medical leave of absence for the time being. I was diagnosed with copd October'2006 and at that time was moderate to severe. Recently I had an exacerbation and soon thereafter saw my pulmonologist. Currently my info is as follows: I will just type this as it is written. Flow Volume Loop: The FVC is severely decreased. The FEV1 is severely decreased. The ratio is decreased at 64%. The contour of the flow volume loop is obstructive in appearance. Overall these studies reveal a severe obstructive ventilatory defect. Exercise Oximetry: O2 sat at rest was 94%. The patient exercised three laps and she did drop to 88%. She returned to 95% in recovery. She did have an arterial blood gas done at Lexington Medical Center on 08/03/07, which was OK. Oximeter study shows O2 sat less than 80% on 36 minutes and 4 seconds. Impression: COPD with recent exacerbation. Depression. Exercise induced hypoxemia as well as nocturnal hypoxemia. I am currently on Spiriva, Advair, Ventolin, xanax, bp med and 2 liters of oxygen during sleep and upon daytime exertion. So, these are the statistics that I am at right now. I am excited about starting rehab, learning how to breathe properly, exercising and getting myself into better shape, learning about good and proper nutrition for copd patients and just learning anything I can about this disease I now have. I will post the good, the bad and the ugly and I will post my feelings about rehab physically and mentally. I have high hopes and look forward to starting this new adventure called Pulmonary Rehabilitation. Until tomorrow--Breathe Gently, Joyce
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Post by morningstar on Aug 18, 2007 10:52:16 GMT -5
Good job. I enjoyed reading it. Keep up the good work. Jackie has Stuck it so it will be up front and easy to find.
Rose
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Post by Joyce7 on Aug 19, 2007 6:45:29 GMT -5
I thought it might be a good idea to post my physical and mental status prior to rehab and after rehab. I feel confident that the "after rehab" will be much better than the "prior to." My mental status is not the best due to anxiety and depression. My anxiety is however well controlled with xanax. But my depression is difficult to handle and unfortunately antidepressants have bad side affects with me, and I have taken many types since the 1980's with no success. So, although my dpression tends to keep me in the house a lot and not motivated to get out and around other people, I work on it and just take one day at a time. Physically I have not kept myself in shape at all. The last exercise program I was on was about 15 years ago. I always felt that due to working all day and taking care of my children in the evenings with all their after school activities was all the exercise I needed. Once my youngest child left for college, I no longer could use that excuse Right now my legs tire so easily and my muscle strength is not good in my legs for any long walks. I do have some arthritis in my feet but not enough to keep me from walking more than I do. My upper body is weak also. I don't have any items yet such as reachers or a shower chair, etc., but in time might get them to save energy. So, for now, a shower and washing my hair exhausts me completely. Doing things that require forward reaching is difficult. Years ago I did have an injury to my right rotator cuff and it acts up on me sometimes even now. I also have severe osteoarthritis in my right thumb and need a joint replacement, so I hope that won't hinder my rehab. I hope I can use bags of beans instead of weights. I tire easily and find that I have to rest or recover more frequently now than four months ago. I nap once or twice during the day. I do awaken early but have always been a morning person. I get sob easy and look forward to learning correct PLB and overall good breathing methods. That would help a lot. Also, although I know good nutrition is important, I tend to eat a lot of sandwiches, frozen dinners and take out. I know that as long as I sit here and do very little physically that I will only decline. What do they say?.. no pain no gain, but I look forward to doing it the right way and the healthy way. After rehab I hope that my body will be stronger with greater endurance. I hope to increase my ability to do things and exercise and take better care of myself. I also think that being around the other people in rehab will be good for my mental health. It will get me out of the house, into the world of people..not just family and friends, but strangers..people who one day might be friends and definately people who are their for the same reasons as I. Tuesday will be the interview at 1:30pm. I will write the details of that and what it entailed. I assume I will pass the Interview and be hired into Rehab!! Until tomorrow, have a good day...Joyce
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Post by Joyce7 on Aug 20, 2007 7:07:09 GMT -5
Well, tomorrow (Tuesday) is my interview day for pulmonary rehabilitation. I am excited about getting started and have high hopes. I know it will be a lot of hard work and probably some sore muscles, but that's OK. All they can do is teach, and it's up to me to learn and do. It amuses me that in my mind I already can imagine myself walking 20 or 30 minutes on a treadmill although right now, just trying to take a slow walk around my cul de sac is tiresome. I read about using and conserving one's energy, and I want to know more about that. I ordered an oximeter, and it should arrive today. No one said I should take anything to the interview, but I will probably take my medication list and my most recent PFT results. Tomorrow I will post the details of the interview. I hope everyone has a good Monday..Joyce
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Post by morningstar on Aug 20, 2007 10:45:34 GMT -5
Joyce,
Honey you are going to do just fine. And a list of medicines is always a must in anything new we do and I would think you latest PFT test results would be also. So here wishing you well and remember to just pace yourself, you din't get sick in just one day you can't get well in just one day either. We will all be with you in thoughts and prayes. When you feel tired it will be us holding you to take that one more step. Let us know when you get back. We will leave the lights on for you.
Rose
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Post by maryaz on Aug 20, 2007 22:55:41 GMT -5
Hi Joyce. I bet your career is interesting. You are on a good mix of meds it looks like. I think the rehab will really benefit you. Most rehabs are good and sure hope this one will be for you because it can do all the things you expect it to. Maybe getting around others like yourself can encourage you to get out a little. These people will understand better what you deal with than family does.
have you ever tried Paxil CR. My husband won't take depression meds but he did do ok with that and I guess the release is different. Just a thought if the rehab doesn't rid the depression.
You are out of shape and rehab should help. Weights and an ergometer really help the arms and lifting. The Nustep in addition to the TM helps the legs. If the staff is good, you should learn a lot and can work it at home too. You should, for sure, see improvements.
I bought the reacher but finally got to where I didn't need it anymore unless the items is under something. I can now wash my hair but I relate to all that you are saying. This will be a slow process. You work for endurance. I am not good with food but, I have found that take out and frozen dinners are not as healthy. Maybe some cooking and freezing of things. They say in our case 'Use it or Lose it'.
They will not be over-working you like a well person's rehab. They try to be careful not too. I couldn't even do the TM in the beginning but I just had been in the hospital too. In a few weeks I started at 1.2 mph for 2 minutes. I finally reached their 20 minutes and got to 35 or 36 at home once. I am down again. They wouldn't let people overdo.
Joyce you will do great at rehab. Just keep it up. Good Luck to you.
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Post by muffin on Aug 21, 2007 1:42:40 GMT -5
Bet you will love it and totally surprise yourself. It does so much for you, helps breathing, strengthens those muscles etc. of course it does not come in one day but you will get there. I feel the determination. You will be their prize student... Have fun!!! Blessings
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Post by lindab on Aug 21, 2007 7:26:48 GMT -5
I know you will do alot better then you think. Be determined to improve and you will, just remember Rome was not built in one day and it takes time.
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Post by Joyce7 on Aug 21, 2007 17:04:25 GMT -5
I had my orientation today at 1:30, and I'm even more excited about the program than ever before. The interview lasted about one and a half hours. The Respiratory Therapist that worked with me today was Holly, and she was more than nice and very professional. I arrived a little early to check things out and sat in the gym for about ten minutes. Everyone there was wearing oxygen and using the equipment. I was very impressed. There was a lady riding a bicycle, and I do believe she must have been at least 80 years of age, and her legs were just flying on that bike. Also, people of all ages were using the treadmills, and they too were walking very fast, not all but many. Right now, I couldn't walk that fast for that long. I would give out completely. But, I was told that many of them also have my area of "numbers", and I would just start out slow and work my way up. Holly informed me that they treat not only pulmonary patients but also cardiac, and said that the copders were the most talkative group of all. That doesn't surprise me...we are a friendly group of people for certain.
I was weighted, height taken, every part of my body was measured (I now know for a fact that I have no waistline!!), my body fat was measured and several other things. I was shown a walking track because some people prefer to do a lot of their exercises and walking there instead of inside the gym. Holly asked me a whole lot of questions about my copd, what I could and couldn't do, how I felt both physically and mentally, my goals in this program, and other pertinent questions. She wants me to get a handicapped tag for my car and told me to call my doctor about it in the morning. She also wants me to have a shower chair and a reacher, and she will let me know what else. The best part of all this is that she is going to call my insurance company to make sure these things are covered and if not, she says maybe since I'm still employed Vocational Rehabilitation might cover it, or she just said "We'll work it out..we always do." I hope so and feel confident that all will work out well.
Holly and I talked a lot about food and nutrition, and I filled out a four page form of what I eat and don't eat, side dishes, condiments, fat or non-fat choices I make, etc. She stressed the importance of good nutrition, and a dietitian will look over the food forms I filled out, and then someone will sit down with me to help me set up a better diet plan. She frowned somewhat when I discussed the wide variety of food items Stouffer's carries, and she said my love of Doritos and good old southern fried foods has got to go...not all of it but most of it. At Orientation next Tuesday, August 28, 2007, one of the things I will be doing is attending a class entitled "Learn How to Eat Heart Healthy." This is for copders as well as cardiac patients. If I want to, I can sign up to attend a special class where they take you shopping for healthy foods. It is called "House 2 Find Healthy Foods." I'm sure I will sign up for that too. There is a class for diabetics also. I can sign up for their "Focus on Food Series" which is on Mondays in between exercise times.
Now, on to the "Book." I was given a book to read called "To Air Is Human." It's not large. It is a guide for people with copd. There are four chapters.
Chapter 1 - How to Get Control of Your Breathing Chapter 2 - Normal Lungs and Lung Diseases Chapter 3 - Managing COPD Chapter 4 - Living With COPD
I will be reading this book this week, and I know I will learn a lot about this disease that I have. I also have to fill out a six page questionnaire regarding my past and present health which I will turn back in to them next Tuesday.
She gave me a calendar which I will get each month, and said that I could attend for free any of the classes or activities on there. On Fridays, they have T'ai chi classes. There are stretching exercises mixed in here somewhere. There is also something on Wednesdays called Rhythm Check which I don't know what that is. These is a class on salt and fiber. Also, for free I was offered and did sign up for two extra classes...one next Tuesday and the other next Thursday. They both are called Pulmo 101, and that's all I know about them, but I'll be there will bells on.
They had so much to offer that I was amazed. I also noted that everyone in the gym worked at their own pace. It's true that many looked as though they had no health problems nor breathing problems at all, but there were others who did their work out slower and more gently. She told me not to compare myself with others in the area of progress...each progresses at their own rate and pace.
I feel very positive about this whole program, and will do my homework and will post next week right here to tell you about the Orientation. It's been a good day...Joyce
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Post by bobbioh on Aug 21, 2007 17:47:23 GMT -5
Sounds like you have the right attitude, Im so glad you felt so comfortable there. Keep up the good work. bobbioh
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Post by morningstar on Aug 21, 2007 21:00:21 GMT -5
Joyce what a great day you had. Sounds like you will be running with your son before you know it. The interest in your talk was such joy to read. You did well and I am so glad you are going to get to do this. Good Job Joyce it was a good report. Thank you.
Rose
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Post by Guest on Aug 22, 2007 16:13:29 GMT -5
FANTASTIC AMAZING WONDERFUL STUPENDOUS AND LET ME REPEAT AMAZING Thank you so much for your "blog". I don't know if you have ever been to any rehab before, I have a feeing that you have not, so I want to let you know how fortunate you are to have such a great program available to you, and that you are smart enough to take full advantage of what has been offered. You have not only found a place that does PULMONARY (many places do cardiac rehab but not pulmonary) but you have found one that is right at the very top of the rehab mountain. You are indeed fortunate. Very few rehab facilities offer what yours does, but they still call themselves pulmonary rehab, and charge top dollar for what little they give you. I have been to two and neither one of them comes close to what you are getting. Do you know yet what your copay is? I hope you enjoy, I know you will benefit. I benefited from a program that was not nearly as comprehensive as yours. Keep posting, I read every word and will continue to. I am sure many are reading and enjoying that you don't even know about.
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Post by Joyce7 on Aug 22, 2007 17:52:42 GMT -5
Thank you everyone, and Guest, I do feel fortunate to have all this located so close to my home. I don't know what the co-pay is yet but the respiratory therapist talked with the voc rehab man and I see him Friday. He said they could help me with any co-pays or other costs that my insurance doesn't cover. I didn't expect this much help and assistane, but am so very grateful for it. I will be posting here after each visit to rehab which is on Tuesdays and Thursdays, and when I attend special classes, I will also post about them too. Sleep well everyone..Joyce
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Post by muffin on Aug 22, 2007 20:03:34 GMT -5
joyce am very happy for you and you will be amazed I am sure as to how much it will help you. You sound so eager and positive it's great!! I will follow you and cheer you on. Just remember if I don't post, I'm thinking of you on the treadmill or bike, cheering you on. Blessings and happy excercising.
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Post by maryaz on Aug 23, 2007 0:02:19 GMT -5
Hi Joyce; It does sound like you have found a good rehab. Great News! Sure you will do well. This will be good for you. At our place they do cardiac M, W & F and Pulmonary on Tues. & Thurs. Sounds like yours are together. Will be interested in hearing about that. I have never heard of one that does so much. Sounds great.
I thought I attended the best rehab in town for a few years and bragged about it. I guess business got in the way or something (my term) but things went downhill about as far as they could go. Some are trying to build it back up but I don't know what I think yet. I am thankful at least it is there.
At my rehab if you want the classes you go and workout from 9 to 10 AM or 11 to 12 PM. Tuesdays we have class 10 to 11 AM and on Thursday we not have Harmonica. We used to split Thurs with Support group but the lady quit. Our rehab does not get a lot of attention. Think it might be changing.
There is a little difference in the cardiac and pulmonary. With COPD we are not cureable. Some people with a heart disease just need to make exercise a part of their life and they continue on as before. There is a different outlook. We are glad our group is separate. We only have one room. Sounds like there may be more space available to you. Great if that is the case. I shared all that to tell you that 'we have a lot of laughs in our group'. I know strangers have to wonder. We do have a serious disability but wouldn't know it by our group. We do carry and enjoy ourselves.
I am wondering how long your classes are each day. There is a lot to learn about nutrition. Hard for me to grasp but I do know to eat 6 small meals opposed to 3 large. We had one Tai Chi demo and I enjoyed that. Stretching exercises are important. Pulmo 101 is probably all about pulmonary disease. It would take me forever to post all of what you are going to be learning. You are going to be a busy girl.
Rhythm one might be very interesting. Let us know what it is later even if you don't go. A student RT at our rehab one day was telling me about everyone needs to find their own rhythm and I know what she meant but I can't do it. You learn to breath and walk and do it a certain way. I could slow myself down if I could do it. I don't mean to be overdoing on your topic but just want to share some differences.
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Post by Joyce7 on Aug 23, 2007 6:32:29 GMT -5
Thank you Mary for your input. I think some of the pulmonary and cardiac are done together but some separately. I'll know more as I go on, and I will let all of you know what I learn and what I'm told at each step. Thanks again for your support...Joyce
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Post by Blossom/Jackie W. on Aug 23, 2007 18:56:56 GMT -5
Joyce; I'm just so dang pleased for you....I truly am. And for us too who get to share with you. I think I'm going to make this a "sub board" if no one minds. I know from personal eperience the need and the postive efects of exercise. You go girl!
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Post by John on Aug 23, 2007 21:35:13 GMT -5
Thanks for sharing with us Joyce
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Post by maryaz on Aug 23, 2007 22:31:30 GMT -5
Jackie; I agree with you. This would make a nice sub topic. The fortunate part is that Joyce writes it so well. I hope you realize Joyce that many will appreciate the time you put into putting your experience into words.
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Post by Joyce7 on Aug 24, 2007 17:00:11 GMT -5
Holly (the respiratory therapist that worked with me) found out that my insurance does "not" cover "any" pulmonary rehab costs unless I've had a lung transplant. Wouldn't you know!! But, today I met with the man, Don, who runs the vocational rehabilitation section, and he says he will do the paperwork involved in voc rehab covering all the costs for my pulmonary rehab. I was so happy about this and so appreciative. The paperwork will take a few days, so instead of starting my rehab this coming Tuesday, I will start Tuesday, August 4th. However, I still can attend for free Pulmo 101 which will be held this coming Tuesday and Thursday. I will let you know what those classes entailed. Also, Don is a counselor, and he gives free counseling to anyone who wants it in rehab. He already made one suggestion for me, and that was that if I tend to watch TV or keep it on, don't watch mainly the news. He talked about exercise and laughing being tremendously helpful in copd patients. I knew about the exercise but not the laughing. He suggested I watch only a brief amount of news programs and things that are serious, and devote more time to comedy and light hearted shows. He says in the long run, it does make a difference. So, I'll try it for certain. He said that for those who cannot afford counseling if they are anxious or depressed, that having just one person who is willing to be a listener can help a lot. Sometimes we just need to vent or talk about how we feel, and just that makes us feel better, but it would have to be someone who you trusted and a non-judgemental person. I told him about this website and what we do here, and he thought this was great for all copders to have a support group such as this one. I do have a total lifetstyle change to make, and plan to make it. It can only help, and my life can only be better for it. Bye for now, Joyce
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Post by maryaz on Aug 24, 2007 21:22:47 GMT -5
Hi Joyce, I hope you don't mind that I am following your adventure so close, but I can relate and you bring out points that are important and I never think to mention. That was bad news for you but good news. Glad it worked out. Coverage for Pulmonary Rehab is very difficult issue. They say it is really hard sometimes to get the people qualified. I see they do all they can to get you in and that is great. The type of forums that this is gives a very good opportunity to really share your feelings. What he says is so true of any problems. All forums do, but this type gives us more opportunity to build on friendships. We have actually had at least 3 classes in my five years covering Laughter. That is how important it is. The world and my world had been negative enough long enough that I started looking for upbeat, inspiration and laughter long before COPD. I have lost the people in my life that brought me good laughter and so I have to work harder on it. You are still right on track Joyce and learning and you have not even started. There is a new show on and I think Monday or Tuesday night. 7 PM our time MST. It is called Make Me Laugh or Just for Laughs. It strikes us funny and my husband doesn't laugh easy. It is like a Candid Camera but no dialogue. I hurt from laughing this week at it. We laughed soooo hard. Try to find it.
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Post by Blossom/Jackie W. on Aug 25, 2007 12:29:08 GMT -5
You're doing GREAT Joyce! And a great attitude to boot! I found this statement interesting...."He suggested I watch only a brief amount of news programs and things that are serious, and devote more time to comedy and light hearted shows. He says in the long run, it does make a difference."
I'm personally guilty of doing that.....the news etc. You see; I just learned something; and that's what this is all about!
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Post by muffin on Aug 25, 2007 14:36:21 GMT -5
You're doing great Joyce and you will only get & feel better your attitude tells me that. I am so very happy that you can get that paid for. You would think the insurance companies would catch on as to how much it helps us. Take care and keep on keepin' on
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Post by cocojax on Aug 25, 2007 21:20:36 GMT -5
You are doing great Joyce and you are learning early we have to go through a complete lifestyle change, not all bad, it is really a good change as we have talked plenty about it, I love that program just for laughs, nothing like sitting in a room by yourself and laughing so hard you almost pee your pants, some of the crazy stuff they do. That is another thing I love about my Grandkids ( they don't have to be your own kids or grandkids any child will do ) you see things so differently through there eyes, we just laugh when they are here. Makes this disease a lot easier to take when you can laugh and play like a kid... Here is a link to the show for some examples: www.justforlaughs.ca/videos/show/3932-policier-revendeur-the-crooked-cop?stag=
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Post by maryaz on Aug 26, 2007 22:58:36 GMT -5
It is not only that the insurance companies should catch on how much it helps us but it also keeps us out of the hospitals. Staying out of the hospitals saves a lot of money. It is just so very very sad that rehab is not more available. Take care all. You would think the insurance companies would catch on as to how much it helps us. Take care and keep on keepin' on
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Post by Joyce7 on Aug 28, 2007 19:17:43 GMT -5
Pulmonary Rehabilitation 101 - Part I was today, and I thoroughly enjoyed it. I packed up my oxygen, my sweater, my bottled water and off I went. There were fourteen of us in the group that met today, and we consisted of everything from asthma to COPD to chronic bronchitis to pulmonary fibrosis to cardiac patients with respiratory problems included and one lung transplant person. I met some wonderfully nice people, some on oxygen and some not, but all interested in the same thing. We all want to know how to breathe better, function better and not be so short of breath. Each of us introduced ourselves and said a little about ourselves and our disease. We got to know each other a little bit.
We spent a large portion of todays Pulmo 101 class talking about how the respiratory system works. Our teacher was named Mark, and he talked and answered questions and was very open to anything anyone had to say. We were free to get up and move around or go to the bathroom whenever we wanted or just sit and listen.
The airways were discussed in detail along with mucus and what causes shortness of breath and how we should react to it. I already knew so much just being online and reading about COPD and other's postings. Mark went into detail and demonstrated Pursed Lip Breathing. We all practiced it, and I now know how to do it properly. I had not been doing it correctly. I had been inhaling too deeply and exhaling too deeply, but PLB should be not that harsh and it will expel more carbon monoxide than regular breathing. I found it to be calming and relaxing and plan to do it much more now. I had been overdoing it.
We looked at pictures of the lungs and the bronchioles and alveoli and learned their function and what inhibits them and irritates them and causes problems. Seeing the inner workings of the lungs made it easier for me to understand the causes of shortness of breath. I realize how irritants can cause a mile tightening and wheezing or could cause an exacerbation, so to always avoid irritants and aerosols, etc. I have read about these things, but seeing exactly what they do inside the lungs made it more realistic to me, and I'm tossing out my aerosol hair spray right now. I thought that just one little bottle wouldn't hurt, but one little bottle can hurt be it hair spray, room spray, roach spray, cat litter or dander, air pollutants, cigarette smoke, etc. I look upon irritants different now. Instead of saying I'll just put on this mask and clean this dust off with Pledge, I won't do that anymore. Irritants to our lungs are like rubbing a sore. It just gets worse and worse and worse, all the little irritants add up throughout the day, and before we know it, we get short of breath or have an exacerbation and sometimes wonder why. I am guilty of that.
We discussed something called a Flutter but also has another name which I can't recall right now. It helps to rid the lungs of mucus sort of like having a Respiratory Therapist cup their hands and beat on your back to loosen phlegm. I'm sure many of you know of it, but this was the first time I had heard of it. I found it very interesting. Also, drinking lots and lots of water a day is extremely important to thin out mucus. However, everyone should check with their doctor as to how much water to drink each day since some people are limited due to fluid retention.
Mark spent a good bit of time expressing the importance of breathing or inhaling through the nose and not the mouth. Apparently this is more important than I realized. I am a nose breather but many are not. The hairs in the nose help to filter out irritants, so inhaling through the nose is important.
We asked a lot of questions, and before I knew it, the two hours was up. Thursday is Pulmonary Rehabilitation - Part II, and I know we are going to watch a video and also discuss breathing from the diaphragm. I'm sure the two hours will fly by as they did today. I got to meet a lot of nice people, and I learned a lot of details which I didn't know before. I'm sure I will see some of these people again in the gym now and then. It was nice to sit next to someone else who was using oxygen. No one was looked at oddly no matter what they said or had been through. I fit right in.
I'm so glad I had the opportunity to attend this class, and I do look forward to Thursday's class. Until Thursday, bye for now, Joyce
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Post by maryaz on Aug 28, 2007 23:22:52 GMT -5
Hi Joyce; I am so happy for you that you have such a good group. There is such a need for more rehabs. The flutter was probably what they call a flutter valve like this. www.healthylifepharmacy.com/product_info.php/products_id/1734There is a word for the clapping on someones back. Percussion or something. Can hurt someone doing it wrong but it helps if done right. Here is a link that tells little about bringing up mucous. www.nationaljewish.org/disease-info/diseases/copd/living/mucus.aspxI am only putting this here because your post made me think of it and thought it might help others. This mucous subject comes up a lot. There was a Vest out if it still is and it helps but very expensive. They may have gone to just using in the hospitals. Our nose does 3 things. It warms, humidifies and filters the air we breath. I think that is one of the first things I learned in my class. Joyce, You should keep all your posts together and somehow put them into a booklet and then one day go back and look at them. I think you will find you came a long way at that time. This is great and I am thrilled for you.
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Post by Joyce7 on Aug 30, 2007 16:51:37 GMT -5
Pulmonary Rehabilitation 101 - Part 2 was today. Mark, the Respiratory Therapist, had a table set up with many different types of medications on it and pamphlets, so I knew today would be a "medicine" type of day. The first thing we did was to watch a short video which basically was a review of the respiratory system which we learned about on Tuesday. It was a nice refresher to start off the session. Mark showed us the different types of inhalers and ways of using them such as using a spacer or just spraying it into your mouth. Just recently I began using my spacer but had always just wrapped my lips around the inhaler and inhaled. If inhaled that way, a lot of the medicine ends up on your tongue or the back of your throat and never makes it to your lungs. Mark demonstrated the spray method holding the inhaler a short distance from the mouth. We had a lengthy discussion on Pursed Lip Breathing and practiced it. Each person found that it helped with shortness of breath. Mark demonstrated how to breathe from the diaphragm which was a bit more complicated, but after trying it a few times, we know how to do it although it would take some practice before it becomes natural for me. I have been breathing the wrong way...always. By breathing from the upper portion of your chest, you only move air in that area. We need to move air deep into and out of our lungs...the bottom part...not just the top. We end up with stale and stagnant air in the bottom portion of our lungs which basically take up space....maybe good breathing space, and we don't want that. We couldn't help but laugh at each other while practicing this, so let's just call it "bonding" of the group. A good bit of time was spent discussing common inhalers/nebulizer meds and their usage. We talked about bronchodilators, anticholinergics such as Spiriva, corticosteroids and other miscellaneous meds such as Advair. I learned that there is an order in which to take inhalers. First bronchodilators, then anticholinergics and finally steroids. It made sense to me. Take the bronchodilator first (if you are on one) to open up your bronchial tubes, and that will enable you to inhale more deeply the other inhaler(s) taken after that. We talked about the importance of antibiotics. Since we have lung disease, we cannot treat any type of illness or infection lightly. We were told to call our doctor at the first signs of infection. If caught early, an infection is usually easier to treat. I found out that the best expectorant is "water." Always check with your doctor about how much water you may drink each day. Expectorants liquefy sticky, gooey secretions which cannot be coughed up. We discussed antihistamines and decongestants, and were told not to self treat because they can sometimes dry the secretions in the bronchial tree causing mucous to become thicker and harder to cough up. So, once again, call your doctor before self treating. Tranquilizers and anti-depressants were thoroughly reviewed, and most people with respiratory problems do take something either for anxiety or depression at some point in time. We talked about vaccines and the importance of taking a yearly flu vaccination and the pneumonia vaccine which many take every six years or as determined by your doctor. We had about fifteen minutes before the end of today's session, so we spent that time getting to know each other better and just talking. It was funny because each of us believes firmly that we will be the most out of shape in the whole group. So instead of all of us being or feeling embarrassed, we decided to cheer each other on, discuss oxygen options and to feel free to vent all our frustrations out on the equipment in the gym. So, gym starts Tuesday, September 4, 2007, and I will write again then. I definitely expect some muscle soreness, but I think the laughter will outweigh the soreness. Bye for now...Joyce
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Post by bobbioh on Aug 30, 2007 19:30:57 GMT -5
Joyce First off Thank you you are doing a great job. I have been to Rehab and you are a good refresher course, I have a flutter, They gave me one in Rehab Ask for one maybe they have them. I use mine daiy twice it really helps. And I blow up balloons. Keep up the good work bobbioh
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Post by maryaz on Aug 31, 2007 0:17:34 GMT -5
Great post Joyce. You are doing terrific and should be thankful for such a good rehab. The diaphragmatic breathing is so helpful but not easy to do. You might also check or review Phil's breathing methods at a later time. Not confuse the issues now. He really helped me get some of it better. I can lay down and get the diaphragmatic breathing fairly good but put me on the TM and there it goes and up go the shoulders. I have struggled with this a long time. Somedays are better than others. You will find up the road in sharing with others that there are various opinions on the frequency of the pneumonia vaccine. Was just discussed on another forum recently. A good bit of time was spent discussing common inhalers/nebulizer meds and their usage. We talked about bronchodilators, anticholinergics such as Spiriva, corticosteroids and other miscellaneous meds such as Advair. I learned that there is an order in which to take inhalers. First bronchodilators, then anticholinergics and finally steroids. It made sense to me. Take the bronchodilator first (if you are on one) to open up your bronchial tubes, and that will enable you to inhale more deeply the other inhaler(s) taken after that. Joyce; Please don't take anything I say in a criticizing way. I am just letting you know what the forums talk about so you don't get caught in a thread one day unaware of what people think. There really has been no study done to verify the best order of taking the meds. Keep in mind these are just the opinions of people. What you posted makes a lot of sense. Open up and then take the others. Advair is a bronchodilator with Cortisteroid. That bronchodilator is considered a B-agonist. This is a choice you can make on a personal level as you use them and what works best. At this point I just have to ask if the R.T. is Mark Mangus. I thought he was housed out of Texas but maybe I am wrong. You mention Mark and sounds like his chart which has created a lot of talk on the COPD forums. If not, take a look at this anyway. Actually he doesn't choose the Spiriva first tho. www.emphysema.net/inhaler_sequence.htmI found out that the best expectorant is "water." Always check with your doctor about how much water you may drink each day. Expectorants liquefy sticky, gooey secretions which cannot be coughed up. We discussed antihistamines and decongestants, and were told not to self treat because they can sometimes dry the secretions in the bronchial tree causing mucous to become thicker and harder to cough up. So, once again, call your doctor before self treating. I am really interested in this paragraph about the expectorant plus. If you ever find any additional literature about this online let me know. Very interesting to me, especially with so many people asking about mucous and how to deal with it. I never heard this and would like to find out more. Gosh, I might have to give you a fee for all this learnin'! !
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