Exercise

Colleen Regan - Lake Mary, FL

Dear Colleen:

Seven years, I received the same question from a reader and my answer remains the same! I am a firm believer that exercise is good for both the college athlete as well as the patient with advanced lung disease who may have difficulties performing routine activities of daily living. Pulmonary rehabilitation may mean different things to different people. A pulmonary rehabilitation program might consist of formal courses with medical evaluation and exercise prescriptions under the supervision of a dedicated team of rehabilitation specialists; it may occur on a one to one basis with a patient and his physician or it may even occur after a patient reads an informative article in a book or journal. Regardless of how it occurs, rehabilitation efforts should have certain goals and the benefits of sustained rehabilitation have been proven over and over again.

An important part of rehabilitation is its educational component. Patients with lung disease need to have proper skills in breathing techniques. This makes breathing efforts more effective and efficient. Patients should be taught breathing relaxation exercises, energy and work simplification techniques and simple ways to manage the stresses of coping with their disease. No matter how bad your lung disease may be, almost any patient can benefit from exercise! Regular exercise can improve muscular conditioning, especially in the large muscle groups, in your arms and legs. This means you can perform activities more efficiently and your muscular needs for oxygen are actually reduced. When this occurs, your exercise capacity can actually improve with less sensation of shortness of breath during activities. Exercise prescriptions can consist of aerobic training (stationary bicycles, treadmills, walking, swimming, etc.) flexibility training and muscle strength training. These are the same training principles that all athletes are concerned about. In my opinion, efforts of rehabilitation clearly improve patient’s quality of life. What does this mean? To me, it means that patients feel less short of breath, they have more energy and their general emotional outlet improves. Living with your lung disease becomes somewhat easier as you sense that you have some control and the potential to reverse what might otherwise be a downhill course for your illness. Good luck!

Flying with Oxygen

Marilyn Sundt, Colorado

It is not surprising that you may be experiencing more shortness of breath at higher elevations even though you are using oxygen. At higher altitudes, the air becomes “thinner.” Inhaling this air results in decreased blood oxygen levels, even in those of us without lung disease. Individuals with lung disease, especially those who need oxygen all the time, are even more stressed at altitudes and commonly experience breathing problems. Modest altitudes such as Denver, Colorado (5000 feet above sea level) are usually not a problem. Jet travel in commercial airlines is now typically pressurized to altitudes between 5000-8000 feet. This is usually well tolerated by most people with lung disease. Elevations above 10,000 feet seen in many of the mountain ranges in the western U.S. can result in very low oxygen levels, even when supplemental oxygen is used. The best treatment for this condition is to get in your car and drive to lower elevations as quickly as possible.

Mycobacterium Tuberculosis

DA, Orlando, FL

A diagnosis of “atypical TB” does not usually imply a significant risk of infection to others. Typical mycobacterium tuberculosis can be a very infectious disease especially when coughing patients are in enclosed spaces. Atypical mycobacterial infection is caused by a very different germ. There are many different types of atypical mycobacterium that can cause a variety of infections. These germs are commonly found in the environment and usually only cause a problem in a lung that already has prior scars from an old infection. People with very impaired immune status, such as those with AIDS, may also be prone to this type of disease.