My Pulmonary Rehab Journey

[Blossom/Jackie W.]

Joyce; I've been (or trying to do) a bit of "catching up" on my reading. I give you big time kudos Lady for the degree of honesty you wrote and shared in your second entry here.(dated August 19th)

Something tells me you are going to benefit tremendously from Rehab as will we by your sharing of your experience.

[Joyce7]

Thank you for the feedback, and I really am enjoying the classes and the information.

Mary, the RT's last name is not Mangus, but for the life of me, I can't remember what it is. He has worked at Lexington Medical Center for 11 years and is about forty years old. Maybe he should not have been so specific in stating the order of meds. I hadn't thought about that, but for many, I'm sure their doctor's tell them how to take their meds and for others it may be a personal decision. I know for me, some meds are taken better with food when it comes to pills. Thank you for pointing that out to me.

I am really out of shape, but am ready for Tuesday's gym workout with my bottled water and tennis shoes ready to go. Thanks everyone...Joyce

[morningstar]

Joyce is your RT's first name Mark? If so he is the RT for Efforts and I have found him to be very good at what he does and his knowdledge is beyond many I have come in contract with. You are going to do well at the gym. They will only start you where you are ready to start. One step at a time. And for sure if you have any question of any kind ask your RT and they sometime know much more than even the doctors I think because they have the one on one with the people and alot of them have lived it themselves. Your doing great and I am so proud of you. I know I sure couldn't write the way you are in telling us and it has help me already. I will be waiting to hear from you.

Happy Trails

[Joyce7]

Yes, his name is Mark. I will ask him when I see him if he works with Efforts. He might be the same Mark as you are talking about. He seems very dedicated to his work. He will be teaching the Tai Chi classes too. I'll make sure I try to see him Tuesday if I can. Thanks for all the support....Joyce

[maryaz]

Here is a picture of Mark. I don't know how old it is. There is another picture I had always seen of him before and it was with a clean face. It is in the Pulmonary Paper. Even if it was on their website, it is currently being re-done. You can probably tell by this. I didn't think he was in SC though.

www.emphysema.net/rts_page_1.htm

[morningstar]

Hi Joyce,

I was wondering if y ou would mind giving us a list of the requirements you had to meet before being accepted into Rehap. Like how long have you had to be smoke free. Weight limits and general health and also for me and maybe other. Do you see any there in Wheel Chairs to start the Rehab.

Hi Ho Hi Ho

[stargazer]

I don't know anyone around here who has gone to rehab. (tho I don't know anyone else except my partner who has COPD) He has been referred to rehab and we made one visit to see the respiroligist and are still waiting to hear from them on a start date. Been for a V-Q scan, x-rays and a CT scan. We hope to hear soon...

[Joyce7]

Mary, I looked at the picture but that is not the Mark I know. I will ask his last name when I go Tuesday.

Rose, They did ask me about smoking. I have quit smoking but only for a relatively short time and am still taking Chantix. So, I don't know if not smoking is a requirement. I haven't seen anyone yet in a wheelchair, but I wouldn't be surprised if I did. I do see people coming in with canes and walkers and others helping them on and off the machines. As far as the requirements go, I can only tell you how it came about for me. On the day my pulmonologist did my PFT and told me I was severe, he also referred me to rehab. Maybe it just takes a doctor's referral but I'm not sure. My doctor told me where the rehab would take place and to call them to set up an interview. The only thing that had to be worked out was who was paying for my rehab and since my insurance didn't cover it, the counselor at the hospital arranged for voc rehab to pay the total cost which is wonderful. I would think it would be a wonderful program for anyone in a wheelchair. Rehab teaches exercises you can while sitting but also I saw some bikes that were very low to the floor with wide seats like a chair seat and they were peddling like a regular bike...just positioned differently. If interested, I would certainly ask about it. I really like just being around other copders. We all have something in common.

Stargazer, I do hope your partner gets into rehab. It will help a lot both mentally and physically, and I already feel a big mental lift from it.

Take care everyone, Joyce

[bobbioh]

I had a wonderful women in my Rehab and she had many problems health wise and had a fairly hard time getting around. Used a walker. But she did Rehab and did well. I saw her grow every week she was such a inspration to me. I think anyone can go they just need a stress test first. And I think they start at what ever your able to do. At any rate Im sure you should be entitled to some form of Rehab somewhere. And I would look into it. My Mom was always offered it. And I worked with her three times a week. Getting her up bathed, And we had a set of bars. About 5 feet long we had made to try to help her relearn to walk. She did pretty well. I would put a gait belt on her and keep her chair behind her incase she buckled. But it helped alot. Good luck Rose I know you will succseed! bobbioh

[morningstar]

Thanks Bobbi, but here in hickville there is none. I am just hoping Someone will start one I know my pulmo has talked about it. They say there is not enough interest . Which is Bull Dust like Larry says. I know of four right here in my neighbor that would be willing to drive to Moundsville or Wheeling 3 times a week. So I am trying to learn what will help me and any other the one man still smokes. He tells his wife he don't but it don't work with me because I don't anymore but still have a smokers nose. He will admit it when only him and I talk. So the more I learn and just like cooking I will adjust it to my home life the best I can. I know it is not the best plan but it is the only one on the drawing board.So we adjust and move on.
There is not one Rehab for the lungs in the state of West Virginia. Heart yes but they don't want us. Why I don't know since the heart needs the lungs to work well for it too. None of this medicine stuff makes much sense to me.
Thank you Bobbi for telling me I will succeed I need to hear that sometime.
Now if you can just find a dress>>>>>

[chrisw]

There is no local pulmonary rehab for probably 80% of our population (OK I just made this number up, but I don't think it is too far from being correct!!!) but if there is nothing local then I suggest you download www.perf2ndwind.org/Essentials.html .

ESSENTIALS OF PULMONARY REHABILITATION
A Do It Yourself Guide To
Enjoying Life With Chronic Lung Disease
By Thomas L. Petty, MD, Mary Burns, R.N, BS and Brian L. Tiep, M.D.

The authors are among the very top of the medical profession as far as COPD is concerned.
While you are on this website I strongly recommend that you browse around. PERF (Pulmonary Education and Research Foundation) is an orgaization made up of some the best pulmonologists (respirologists for those who can't read 'American' ) and RRTs to be found anywhere in the world, and their exist to help us.
If your doc is not to experienced with COPD and listens, then this is an excellent site to recommend!!!

Chris

[morningstar]

Thank you Chris. My doctor is a sweetheart and does listen and basily does anything I say is good for helping me stay healthy. I will download this. And I will take a copy to him . Thank heaven he is one of the good guys. I ask him to pass out my last letter and I made copies and told him when they were gone to let me know so he wouldnt'be at any expense. He never called but my last visit there the girls said they had done them twice. I took 50 so he may not be doing every one but he is doing as I ask. Not many would bother.

Thank you again,
Rosemarie

[morningstar]

Chris I forgot. I have read much of Dr. Petty he is a wonderful man. And since he is one of us I think we hold a soft spot in his life. I would trust anything he said. Good Doctor, Good Man.

[maryaz]

I really started to put my post in another new topic and explain that it replies to this thread. However, I was not sure it would be read right. If anyone feels it needs moved, just do so OR maybe Joyce wants to start a continued Thread 2. I just thought I got carried away here and several have commented. This is really good input from everyone tho. It is a big need.

My rehab you needed it prescribed by the doctor. I think some places won't take smokers. I would guess thinking they are not that serious of not quitting smoking. I don't really know. We have had 2 smokers in our group. One didn't stay too long and the other came and went and don't know what happened. The reason we know at first is the odor and if they stay long enough we do ask them ultimately.

There was no stress test for my rehab and I was in awful shape after out of the hospital. I didn't TM for weeks and when I did it was 1.2 mph for 2 minutes. I think in ours the RT was trained enough to know if a heart problem was present. They had all the records for the 2 weeks I was in the hospital.

I doubt there is weight limits in ours because we had a couple real heavy ladies. One who came in a big oversized wheelchair did do the Stepper which she could sit in (arms can flip up and back and leave them). I think some theraband. Even in these cases it can be a big benefit. If the people at rehab are trained in the exercising and the COPD, it is a good program. People come in walkers, wheelchairs. Some eventually even start walking on their own. Not all. I have seen improvement in so many people. If the disease has hit hard enough, any improvement is welcome. Many of the rehabs have like 3 phases and the last phase is often affordable for 'I pay' if not covered. I pay $54 per month now to go twice a week and still have one hour class one day and workout and then one hour harmonica and one hour work out. My first sessions were covered by insurance in that I had paid my $10,000 deductible. I never saw the bills but they are big.

Joyce expressed about 'being around others in a similar situation'. The Pulmonary Rehab is good if the breathing is stressful. I get concerned about people that just go to a gym if they are not aware how far to push themselves. This is all for endurance, not the speed, nor breaking out sweats.

I think the interest in Rehab would be there by the patients if they knew it was avaiable. The problem we see is Number 1: Many patients are never told about rehab. Number 2: It is so hard for the doctors to get the patients qualified under their insurance/medicare. In the US this is another an ongoing, losing battle, in government.

I never used anything like it but people are talking like Chantix is helping to quit smoking. Maybe any smokers might try it. I don't know how much truth to it, but I have been told that there is not money in having pulmonary rehabs but there is more money in Cardiac rehab. I am sick of the losing battle over rehabs and can barely discuss it anymore with anyone.

These are older articles but they sort of explain some of the problem in US. These are interesting reads. CORF is what they are about. These talk some about the money
www.rtmagazine.com/issues/articles/2005-03_13.asp

www.rtmagazine.com/issues/articles/2005-06_11.asp

I brought up the subject to passing out literature at rehab one day and it was brought up that you can run into solicitation laws. I was talking about putting brochures in doctor's offices. That is all I know about that subject.

ONE MORE Big complaint I have while I am on my bandwagone, is COPD Support Groups. We have huge cities with millions of population and one or none COPD Support Groups. Smoking, Drinking, MS, Alzheimers, Cancer, Gambling and many more Support Groups exist. Many of us could even benefit from Support Groups. Good ones could flourish. Oh well, off my rant for tonight. If I got around better I would try to make effort to do more for the support groups but I just cannot get around.

[Blossom/Jackie W.]

Joyce; this is GREAT; especially for folks who've not been, PLUS those who need a refresher course or want to learn especially if they haven't been able to get into a program.

Perhaps you could break it down in "days" from now on (easier to follow) .Give each time you go to Rehab and report back, a "New Day"

Thanks, Jackie

[Joyce7]

"A New Day"--Today was Orientation at Pulmonary Rehabilitation. They started the day off by taking each person's blood pressure, oxygen saturation and a heart monitor was placed on everyone. Some of us are pulmonary people and other's cardiac and some both. We were told the order in which we were to do things and where the oxygen tanks are located and what the day would entail.

We warmed up. We all walked two laps around the walking track at our own pace and then proceeded to do stretching exercises according to a big chart on the wall. It was explained to us how important the warm up exercises are. After that we took a six minute walking test. They checked our blood pressure and oxygen saturation during the walking test and afterward. We took a short sit down break and water break while they discussed with us the two machines we would work on today to get started and how they worked. They wanted to get what you might call a baseline for each person, and were told not to push it but to exercise at a level comfortable for us. Then we headed for the bikes.

They set the bikes to run for five minutes and monitored our blood pressure and oxygen saturation and asked us questions about shortness of breath, discomfort, etc. I did become short of breath a little but not too bad. I kept slipping forward on the seat of the bike and was told that they do have some padding for it if needed. I could feel the muscles in my thighs working fairly hard, and know that I am very much out of shape. When the five minutes was over, we rated our degree of difficulty and shortness of breath. It was then...off to the treadmill.

I felt like a horse at a race waiting for the gate to open! They made sure we had our treadmills set correctly, and every now and then would come by and up the speed. It never got very fast, and they told us not to push ourselves and to let them know if at anytime we had discomfort anywhere or shortness of breath. They documented everything and watched us like hawks. Once again, when we finished, they came to each person and asked us to rate the difficulty we experienced and the degree of shortness of breath.

Then it was time to wind down, and we walked several rounds on the walking track as they again checked our blood pressure and oxygen saturation. For me, today I found the bicycle to be more difficult than the treadmill. I'm not sure why that is, but I could feel more muscles pulling in the back of my thighs than when on the treadmill. I'm sure each machine works different muscles and is for different things. It was all very interesting, and it ended up that all three of the pulmonary people chose to attend rehab at the same time....11:00AM on Tuesdays and Thursdays. Actually, the 10:00AM class was full. There are more cardiac classes than pulmonary. The cardiac classes start at 6:00AM and continue on the hour with a new group of people coming in each hour. The cardiac classes are offered three times a week and encouraged, whereas the pulmonary classes start off at twice a week only, and then as time goes on and our endurance increases, we can attend three times a week if agreed by the Respiratory Therapist. We were encouraged to attend the Tai Chi classes for relaxation and classes using stretching bands. I want to mention that when exercising, I used Purse Lip Breathing and found it to be very helpful when I became short of breath.

Off we went to the classroom. The dietitian reviewed with each person their own eating habits. We had previously filled out a form based on what we eat. I found out that I eat way too much fat....too much mayonnaise, butter, salad dressings and fried foods. Also, I don't eat enough fiber. They gave us a handout to keep regarding foods and food issues which I will keep in a folder for later reference. We learned all about fats... monounsaturated fat, polyunsaturated fat, Omega-3 fatty acids and Trans fatty acids. There is a section on Cholesterol and Tips to decrease fat and cholesterol when cooking such as trimming visible fat off before cooking, don't fry foods---bake, boil, grill, broil, steam, roast or microwave. Use oil-based salad dressing such as Italian and vinaigrettes (rather than creamy) and if mayonnaise is a necessity, use reduced fat. To make it easy, the dietitian suggested that if we can see through it then that is better. We talked about the use of soy and having three meatless meals a week. We were encouraged to never drink whole milk but to choose 1% skin or soy milk, cheese that is part skin or 2%, egg substitutes like Eggbeaters or egg whites and to increase our fiber intake. Someone made the following statement: "I heard fiber helps lower cholesterol." The answer is "Yes, aim for 25g per day." The dietitian thoroughly discussed salt and the importance of drinking water. We talked briefly about label reading and can attend the class at the grocery store regarding how to read labels.

They emphasized to us the importance of adding to our diet fresh fruits and veggies, baked or broiled fish, the use of whole grain bread products and eating more meat substitutes such as beans and soy products.

A summary of our goals is as follows:
Choose a soft tub margarine without trans fat.
Decrease fat in recipes and when cooking.
Include 2-3 servings of Omega-3 fatty acids per week (cold water
fish - 2 servings per week (such as herring, trout, white
albacore tuna, salmon, sardines), walnuts and flaxseed).
Remove the salt shaker from the table and do not add salt when
cooking.

I'm sorry this is so lengthy, but it today's orientation lasted from 7:45AM until 10:15AM, and we covered a lot of material.

Needless to say, I came home and realized after looking through my cabinets and refrigerator that I had very little heart healthy foods to eat. I will have to overhaul my kitchen. So, I had a light lunch of Albacore tuna fish with lettuce in a tortilla wrap. I need to go grocery shopping!! I admit it, I then took a nap. It was a good day, and I look forward to Thursday. After today, I know I can do this, and I know that even if it takes two or three months for me to improve and be more healthy, then so be it. It took a long time for me to get in the shape I am in now, so it will take time for me to get back into good shape and eating more healthy.

Until Thursday---Joyce

[Blossom/Jackie W.]

I've put this under it's own category. Additionally Joyce, maybe you could start breaking your Rehab trips into individuals days so that folks can track your rehab (step by step) better? Many folks could/will benefit

Thanks, Jackie

[cocojax]

Joyce that was a very good read, brought back memories . You have a good positive attitude, and you will do very well, just remember to use the hand sanitizer all the time...you certainly deserved a lay down when you got home. Take Care...

[maryaz]

You are doing a Marvelous Job posting and great attitude. I could never remember it all. You are triggering memories. We lost our walking area when they moved us to smaller area. Warm Up and Cool Down are important and I often think that people working out at home that have never exercised, may not realize that. If I don’t warm up, I don’t last long on the TM.

I was amazed they started with TM. Maybe if someone was in worse condition they would not have. I never could have at first. They need to make new seats for the bikes. We had one bike with a non-slip seat and it was popular. The TM is hardest for me because of the breathing.

PLB is necessary when exercising. The Diaphragmatic one can really help if you can do it. Tai Chi and Therabands would be great.

The food is complicated at times. I don't like the subject and I keep having to go back and learn more. Now we are adding diabetic diet to ours. This was interesting: “To make it easy, the dietitian suggested that if we can see through it then that is better“. I don’t do food well. Never liked to cook. Was not big eater. Sugar free jello is good. I cannot tell the difference. Joyce, Guess I better watch for you in the Recipe section.

I do not know how to possible do this what this quote says..

Include 2-3 servings of Omega-3 fatty acids per week (cold water
fish - 2 servings per week (such as herring, trout, white
albacore tuna, salmon, sardines), walnuts and flaxseed).

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[Joyce7]

I don't know either Mary but I'm going to try. Maybe I will eat a tuna fish patty one day, some walnuts the next and a piece of salmon the next. I will be working on "new foods" and new tastes. I was telling my sister about my dislike for vinigarettes due to the bitterness, and she said there are ones that have a sweeter taste and that I might experiment with Balsalmic vinegar. We shall see and time will tell. This morning I ate egg whites using a little olive oil..no salt..no butter....not too tasty. I'm going to try to remember the following:

Eat to live, don't live to eat.

I'll pass on any good receipes I find that are tasty to me...Joyce

[maryaz]

Joyce, I never have lived to eat. Anyway, I had a thought today! We don't cook fish good here. I was thinking of suggesting that we find a healthy place to eat or a couple and then go out to eat about once a week and do that category. I doubt it would be affordable tho.

[Joyce7]

DAY 1--PULMONARY REHABILITATION

Today was my first day of following my exercise program on my own. My class started at 11:00AM, and they asked us to be there at 10:45AM, so I was on time and ready. They stressed to us the importance of using the antiseptic hand sanitizer prior to and after exercising, so I headed to the sanitizer first thing. I was checked in, given my oxygen tank and tubing and my card which showed what exercises I was to do for today. They then checked my pulse, oxygen saturation and blood pressure, and off I went to warm up.

Warm up included walking the walking track two times at a steady pace...no running and no lolly gagging if possible and preferably no talking since that uses up oxygen. So, down and around the track I went, two times with no shortness of breath. Then it was on to the side room to do my stretches. Some people who had been coming for a while knew what stretches to do when, but I and several others are new, and we had to look at the chart on the wall and go by that. No problem there. I went slow and didn't want to pull a hamstring, so I tried to be gentle with myself but do a good stretch at the same time. I did four rounds of each stretch. I did right and left arm stretches. Forward and backward swings with my arms. A stretch whereby you place your thumbs sort of in your armpits and stretch your arms around forward and then backward. Then there were four lunges each of each leg, and also a good stretch whereby you place one hand on a wall and reach back, hold your right foot in your hand and gently pull and then the left...four times. I could feel that muscle pulling, but didn't push it too hard because I didn't want to get a catch in my muscle and not be able to do more. I then headed for the bicycles.

I went exactly by my card they made out for me (instructions) and worked out today on two machines. First I rode the bicycle. I was to set it at ten minutes and keep the level between 4 and 6. I am age 58 and the lady next to me was age 70, and I noticed that her level was between 7 and 8. So, she was peddling harder than I was, but they told us not to compare ourselves to others, so I didn't and kept to my own instructions. I did become short of breath and started Purse Lip Breathing which helped tremendously. If very short of breath, we were to stop and let someone know. As I rode the bike, a Respiratory Therapist came by to check my blood pressure and oxygen saturation and pulse rate. That seemed like a long ten minutes, but I'm sure I'll get used to it, and they did have two big televisions on the wall to watch. Some people had on head phones, so I assume they were listening to music and others were talking. I completed my ten minutes and my thighs were tired, and I could tell that I had done a work out. My second bike exercise was the same as the first except I was to place my feet on a level area and not work my legs but continue for ten minutes pushing the handle bars of the bike which worked out my arms. The bike took a total of twenty minutes of exercise. I then headed to the treadmill.

The biggest problem I had with the treadmill was how to work it, so someone came by and got me started. My settings were ten minutes on the treadmill at a level of 1.6 I didn't have any problems doing the treadmill at that speed and level, so that ten minutes was very enjoyable, and I watched TV and talked with the ladies next to me. They also came by to once again check my blood pressure, oxygen saturation and pulse rate. It was cool down time, so I had a drink of water and headed for the walking track.

I walked slowly two times around the walking track. After that, I once again did the same stretching exercises as before, and gathered all my "stuff" together, sanitized my hands and sat down to wait on the Respiratory Therapist. I recognized many of the people there from my pulmonary 101 classes. It was good to see them.

The Respiratory Therapist came by and checked all my vitals again and marked them on a chart. He asked me questions about the degree of difficulty of the exercises and how I felt. I told him that I had had shortness of breath on the bicycle when peddling and found it the most difficult of the three workouts, so he is having me maintain the same ten minutes and the same level for next week as I did today on the bicycle. Since I found the treadmill to be fairly easy, he is upping the level from 1.6 to 1.8 for next week.

I headed for home, and felt really good about what I had done. I know that I have a long ways to go, but I don't feel rushed and I don't feel competitive with the others. I want to do this correctly so that I can maintain it without injury and just work my way up to higher levels slowly.

My daughter dropped by this afternoon and brought me the American Heart Association's cookbook, so I will be spending some time looking over that. I have a lot of changes to make when it comes to my eating habits which means changing my manner of cooking and the seasonings I use. I have a tendency when I set a goal, to rush out and purchase all the items or "stuff" needed to do what I want to do, and then not use them. So, when I grocery shop, I'm not going to buy out the store, but will purchase only certain food items and try out only a few new recipes. I don't want to jump into the pool when I'm not sure I can even swim!

I did have a good time today, and yes, I was tired and did take an hour's nap after I got home. Also, rather than my normal lunch meat sandwich slathered with mayonnaise and Doritos, for lunch today I had a chicken wrap, and that's all, and I was full much to my surprise. That nap sure felt good.

One thing I have noticed having done a little exercise on Tuesday and more today, I am not sore at all. I thought for sure that especially my leg muscles would be sore, but they are not. I guess those warm up and cool down stretches and walks really help and are important. I also enjoyed getting to know some of the other ladies there, and we sort of laughed at how not only us but everyone was weaving their oxygen tanks all around and through the machines trying to get to where we wanted to be and the gym was fairly full, so there were frequent clankings of oxygen tanks as people passed each other. It was clank, clank, clank and I only heard a few distant, muffled curse words.

I will mention that I weighed in at 167 pounds, and they have set my weight goal to be 158 pounds in 4 -5 months. However, I would like to weigh about 145 pounds or even 140 pounds. So, we'll see how that goes. I'm not going to starve myself since that will lead to failure, but will just exercise and try to eat healthier and hope that will result in weight loss for me.

As I left, we all said "See you Tuesday" and said to the people coming in with their oxygen tanks or in their wheelchairs for the 12:00Noon class. It was nice....very nice.

Until Tuesday-----Joyce

[maryaz]

Joyce you are just awesome at writing this up. Sounds like you got in a good rehab.

I relate to the cookbook part. My husband had high cholesetrol and I bought the same cookbook. I made a lovely soup from the American Heart Book and threw it away. It called for so much thyme that it ruined the soup. This was probably about 2001 I think. I might look the recipe up if I remember and will tell you what it was. Think it was a chicken soup. We just had those books out again this week.

The warm ups help and you have people guiding you who don't want you to overwork. This is what worries me when people on the Internet just want exercise to do and why it is better to attend a rehab first, or at least buy a COPD workout video. I never exercised my whole life and would not have known.

Sounds like you are able to walk the TM easy enough that you could later build up to burn calories. I have a problem with that. I have to walk 40 minutes and even if in a few tries, to burn enough calories. I cannot breath that good. Keep it up. Good Job.

[bobbioh]

Great Joyce keep up the good work and attitude, bobbioh

[cocojax]

Joyce for years I could not drink water it upset my stomach for some reason. But every since rehab I drink water all the time now, and it is true after awhile your body starts craving it. I found I don't like the flavored waters cause they leave an after taste, now I found a kind I like Nestle bottled water. I keep some by my bed at night cause my mouth gets dry...It is amazing how much rehab will change your life for the good. I told them they probably saved my life.. And you have such a great attitude you will do great, through that it completely changes your outlook on life....keep on laughing....

[Joyce7]

In rehab, they stress the importance of drinking enough water and tell us how the body needs water to survive. Apparently most people don't drink enough water and too much caffeine. I will try the Nestle water. I am drinking more water now but not quite enough. Also I wanted to mention that I wait for a grocery flyer to come out with "what's on sale" and I look for fish that is frozen oftentimes. I would love to buy fresh or eat out but I also find that too expensive to do on any type of regular basis. I find it easy to find Talapia, salmon and flounder individually packaged and frozen but not trout. I will stay in the "what's affordable" range and get the frozen fish when on sale but buy two bags of each to stock up and just keep them in my freezer. Thank goodness I like tuna fish and I bought low fat mayonnaise and it's not bad at all and I only used a small amount. I am using Smart Balance margarine and olive oil (I bought a can of spray olive oil to use to coat not only meats but for cooking in non stick pans). I broke my old George Foreman (I dropped it ) so I might consider buying a new one if they go on sale anywhere. I found that I don't like the fat free cheese, but others might. I'm learning, slowly but surely.....Joyce

[Joyce7]

Day 2 - PULMONARY REHABILITATION

It was off to rehab for me this morning, and much to my surprise, I lost 3 pounds. I now weight 164 and have absolutely no idea how I could have lost three pounds except for last week's rehab and cutting back on my fat intake. I was thrilled. I woke up feeling well rested this morning and had a good outlook on today's rehab exercises. I had a light breakfast along with my coffee. I was glad to have somewhere to go and a reason to get dressed and out the door.

I arrived early as usual and am beginning to know the routine. I checked in at the desk, located an empty locker for my purse and Helios, located my cannula and tubing and proceeded to hook myself up to their oxygen tank. I then sat down and waited on the Respiratory Therapist. She came by and took my blood pressure and oxygen saturation, asked how I was feeling and if I had any questions which I did not, and it was off to the races, or I should say the walking track for me. On the walking track I met up with a lady named Carol whom I had exercised with last week. We chatted briefly and it was good to see her. At least I'm not the only person who arrives early. Walking the track two times is part of the warm up, so I did not rush but walked at a steady pace and tried to maintain good posture since I tend to slouch. Standing straight instead of slouched over makes it easier to breathe, so I've learned something new today which is good. With head held high and back straight, I rounded the corner to the warm up area and did my stretching exercises. I can still really feel that back right hamstring pull when I stretch. It probably hasn't been stretched since 1985, so that explains it. But I'm not discouraged. I'm going to loosen up than hamstring bit by bit no matter how long it takes...but, very slowly as to avoid injury. I sanitized my hands and along with Carol, headed for the bicycle.

We were told to do the exercise we felt most difficult, first, so I climbed on a bike. I am still going by a card they gave me with the instructions as to how much exercise I am to do on what machine. My bike level stayed the same as last week since last week I had become short of breath, but today I did the full ten minutes keeping the level between 4 - 6 and did well with very little shortness of breath, much to my surprise. I could feel my muscles pulling in my legs, but that was alright since it did not hurt. They changed the second part of my bike exercise due to my right hand and arm which I will explain. I have arthritis in my right thumb and need a joint replacement, so I wear a hand splint which was given to me by my orthopedist. Also, this past July I pulled a muscle in my upper right arm, and it aches a lot when I try to reach or pick up things. They decided that I need to have that checked by my orthopedist before I do anything strenuous with it. So, today I didn't use my right hand much. I did only three minutes on part two of the bike exercise whereby my feet are on a steady, level place..not peddling, and I exercised my left arm and pulled the handlebars with only my left hand. About half way through the first portion of bike riding, they checked my blood pressure and oxygen saturation.

I like the Treadmill, but had trouble working it again today. I thought I had it figured out, and it seemed right, but then I noticed it was set for kilometers instead of miles per hour, so I got some help setting it up. I'm not good at mechanical things, and to me, this is mechanical. They upped me from level 1.6 to level 1.8 mph, and the time flew by with very little shortness of breath, plus I was able to watch the news on TV. They never turn the channel to soap operas or Foodnetwork or sports, so we get the news and that's all. My BP and oxygen was checked also while I was on the treadmill.

Besides Carol, I did see a lot of the same people there, but it seems to change day to day as to who comes when. I know they had said that if we have to rearrange our rehab schedule due to doctor's appointments or any reason, they would be happy to do that. It's a nice thing to know.

I sanitized my hands and walked at a relatively slow but steady pace around the walking track to cool down. I felt good today. I did my stretching exercises too and noticed a poster for a headband called Oxyband. There was a picture. Since I still get entangled in my oxygen tubing when sleeping, my eyes were glued to that poster. It was a plain white, somewhat wide headband (it looked stretchy) and the person wearing it had the cannula in her nose and the tubing ran along the side of her face and through slits of some type in the headband and around to the back. It looked good to me. I have tried wearing the tubing at the back but the front seems best for me although I do get tangled up and find myself awakening and tossing the tubing from left to right on the bed depending on which way I turn. So, I might look into that. I don't want to buy anything I won't use, so Thursday, I will take down the 1-800 number, and give them a call for information.

I put my rehab cannula in it's proper place along with the oxygen tank, collected my purse and Helios from the locker and proceeded to sit down and wait on the Respiratory Therapist. I also sanitized my hands again. My hands are probably going to dry up and wither away, but they stressed it so much that I do it a lot. I also purchased at the Dollar Store several more hand sanitizer bottles to carry with me and have at home.

My pulse rate was higher than last week, so they had me sit there about five extra minutes, but then it was fine, and my oxygen saturation was fine, so I left for the day. My oxygen stayed in the upper nineties the whole time I was at rehab which I'm glad of. I'm not sure why my pulse rate was a bit higher, but it went down.

After rehab, I had enough energy to go by my pharmacy to pick up my prescriptions and then went home. I really wasn't that tired today. Maybe because I slept well last night, but instead of taking a long two hour nap, I dozed on the sofa for about an hour and feel good now.

Thursday they are going to increase my Treadmill rate to 2 miles per hour. The Respiratory Therapist told me that most women walk about approximately 2 miles per hour, so that sounds good to me. Of course, they don't have me on an incline yet, but I'm sure that is to come. I think they are increasing my bicycle rate or level to 6 - 8 Thursday instead of 4 - 6, but cannot remember for sure. I'll let you know Thursday.

I can tell I have worked out today especially when I walk. I can feel it in my thigh muscles. My thighs are not what I would call sore, I just can feel the muscles pulling when I walk a certain way or step to the side. It makes me feel good because I know that these thigh muscles want and need this exercise so very much. It gives them oxygen and better circulation and strength. I have become more aware too of my poor posture which needs working on badly. I told the Respiratory Therapist that I felt that I should have been doing some type of exercises between last Thursday and today and asked if I could. She recommended that for now, I only do the stretching exercises which I've learned at rehab twice between Thursdays and Tuesdays. She also said that if the weather permitted that I could take a short walk twice. They really do want you to go slow, and I feel it's the best way too because I know me, and if I were really sore today, then on Thursday I might not try as hard or as much.

When Thursday comes, I'll be ready with bottled water in hand and determination in my heart and a big wish and hope that I haven't gained weight.

Until Thursday.....Joyce

[bobbioh]

WTG Joyce you are moving right along keep up the good work and attitude. And even losing weight you go girl. bobbioh

[Joyce7]

DAY 3 - PULMONARY REHABILITATION

everyone. I am moving along well so they tell me and much to my surprise, I am still not sore. Today was a strenuous day at rehab but a good one. When I say the word, strenuous, I mean that I worked hard at what I did. They never have pushed me in any way to increase my workout which is very much appreciated by me. We talk about the days workout and then decide together what the next rehab day's workout will entail. I felt good this morning, but did have to rush a little to get there on time since I had dilly dallied around the house a bit too long this morning. I was a bit out of breath when I arrived at rehab but that was my fault, so I sat down and rested before even checking in at the desk.

I checked in, exchanged by oxygen for theirs as usual and they took my stats. All was well, and off I went to the walking track. I could tell right away that even pulling the oxygen tank behind me that I was walking at a faster pace than before. It was comfortable to do that, and I really didn't think about it. I assumed I would become a bit tired after the first walk around (we walk twice around for our warm up), but I did not. This was another pleasant surprise. I thought to myself, "This exercise/rehab must be working." And, I do believe it is. I did my stretching exercises and noticed that when I did the one whereby I reach back with my right hand and grab my right foot and pull, I previously felt a real tightness in the right thigh muscle. Today, it did not feel anywhere near as tight. I was surprised. It felt the same as my left thigh. My right thigh must be becoming accustomed to the stretching exercises, walking and other exercises. It wasn't sore either. So, that was very nice and very positive.

I was given my card of exercises to do and sat at a bike next the man who had the lung transplant. He said he is doing well and feeling better. He said the healing process has been slow but well worth it for him even though he is on a lot of medication. I noticed that he did not seem short of breath. I could only think, "What a wonderful thing for this man." Research and trials are ongoing and there is hope beyond measure for us all, whether we have pulmonary problems, cardiac problems or both combined. He was beaming with a new lease on life. Bravo for him and also for all the people working on our behalf and those who give money for the research. I climbed on my bike and two minutes were added to my time. I did twelve minutes, instead of ten, on the bike and the level was maintained between 6 - 8. I pretty much stayed near the six today. I did get it up frequently to the 8, but I could tell that I was using my legs much more to push the pedals and since they have told us to always stay at a comfortable rate, 6 was the most comfortable for me. I was a little out of breath but not much when finished, but I could really feel it in my legs. Nothing hurt, and there was no pain, but my leg muscles were quite tired.....a good quite tired I must say. I think I have been expecting pain or exhaustion or something bad, but nothing at all about pulmonary rehab has been painful nor bad. I don't know why I had this in my mind. I just assumed it, and wrongly so. I also did two minutes of resting my legs and pushing the handles which was not difficult. My stats were taken midway through the bike ride as usual.

I would like to mention too that if we feel we can do one or two more minutes of any exercise, then we can, but they do request that we ask them first so they can document it.

My legs were pretty tired by the time I got to the Treadmill, but I got on and finally was able to set the machine (the Treadmill) correctly without help. I walked 10 minutes at a rate of 2 miles per hour today. I didn't have any problems doing this. Again today, I exercised with a lady named Carol, and she finds the Treadmill to be more difficult than the bike, and I am just the opposite. I am not sure why this is. What I do know is that each person is different with different needs and different problems and is on different meds. As we exercise we talk or listen to others talk about their meds, how they feel, and how copd has changed their lives. For many, rehab is one the happiest and brightest times of their week. I am one of those.

Today's rehab seemed to go by faster than usual. I noticed the time when I went to do my cool down walk on the walking track. I think it is because I now know the routine better and don't have to read my card at each point in time as to what to do when. I want to emphasize that although I didn't type this in previously today, I did sanitize my hands off and on throughout the exercises. It is very important to do this to protect ourselves from each other's germs. My cool down exercises went smoothly, and I replaced their oxygen with mine once again and seated myself in a chair to await the Respiratory Therapist.

My blood pressure and oxygen saturation was good today, prior to and after rehab. I decided not to weigh myself today but will weight myself on Tuesday. I'm still so happy about losing three pounds that if I have gained any, right now, I don't want to know it!

After talking with the Respiratory Therapist, she decided that my rates/levels stay the same for this coming Tuesday. She and I talked about my exercising this weekend, and her suggestion was that I make a point if possible to find a place to walk on Saturday or Sunday. She wants me to walk with my oxygen for ten minutes, two times. If I want to do this at one time, then I am to walk ten minutes, rest completely, and then walk the other ten minutes. My other option is to walk ten minutes on two different days. I will probably walk the ten and ten in one day and see how that feels. I'll post what I have done this weekend.

That was the end of my rehab today, and as usual, I was quite hungry. I am finding that after exercising, I am hungry but not starving and didn't feel the need to "stuff" myself or overeat as I normally do. Normally I would have stopped by a fast food restaurant and had a wonderfully delicious cheeseburger with french fries and a glass of sweet tea. Today, I drank from my water bottle while driving home, and when I got home, I satisfied my hunger with a piece of warmed up Mahi Mahi from last night's supper along with a lot of lettuce all rolled up in a tortilla shell with a small amount of light mayonnaise. I didn't have the craving for the normal good southern sweet tea but wanted and drank cold water with ice cubes in it....the colder the better. It quenched my thirst and I was full.

Today was another good day, and I look forward to this weekend for a good walk. I am eating supper out tonight with my daughter for her birthday celebration, and I don't feel as though I have the desire to stuff myself full or look forward to that feeling of being "full." I know I want a salad, and I know I want either pork chops or fish, but for some reason, not steak. And, we are going to a steak house It's possible that some of my tastes for foods is changing. It's a strange thing to me to not want a steak. There is nothing wrong with having a steak, but I just wanted to mention it since this change in my eating desires is brand new and might have something to do with the changes going on in my body with exercises. We shall see.

Until next time...Joyce

[bobbioh]

Way to go Joyce your doing great keep up the good work. bobbioh