Author Archives: Jackie Aim

What will I do at the class?

Breathless not helpless image: Breathing control - Exercise - Education

  • Classes may be one to two hours long.
  • There is an exercise session which will include exercises to improve your flexibility, strength and fitness. The exercise session also includes breathing control and pacing to be able to gain the most from the class.
  • An information or advice session will follow. This will cover all aspects of living with lung disease from medical issues to practical day-to-day tips. This session is your chance to ask questions, share experiences or thoughts and get the answers you need.
  • The combination of exercise and information will help you to manage your COPD and improve your well being.
  • You will learn that you may be breathless but you are not helpless!

Where are they held?

A group of people exercising in a fitness studio

© Crown Copyright 2009

  • Pulmonary rehabilitation can happen in many different places. Some may be run in hospital, but increasingly they will be run in a local venue. This is to try to make them as close to home as possible.
  • Leisure centres, gyms, community centres, church halls and sheltered housing common rooms have all been used for pulmonary rehabilitation.
  • In some rural areas classes may be delivered by a televised link – this is where classes being held in one location are broadcast to other locations. This enables more people to join in without having to travel a long way.

Who will be there

Every programme is organised and coordinated by a healthcare professional. This will usually be a nurse or a physiotherapist. These will be the core staff who will be at all your pulmonary rehabilitation sessions.
Pulmonary rehabilitation programmes vary, and may also involve other health care professionals for the education sessions.

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Select the staff members below to find out more about their involvement in Pulmonary rehab.

  • Physiotherapist – The physiotherapist will show you exercises to suit your ability, and provide advice and tips for fitness and breathing
  • Nurse – The nurse will perform health checks, advice, help to stop smoking and discussions
  • Occupational therapist – The occupational therapist will provide advice on pacing, dealing with anxiety, as well as equipment you may need
  • Dietician – The dietician will provide advice on weight loss or weight gain, healthy eating and tips to try if you are breathless when eating
  • Psychologist – The psychologist will provide advice on how to deal with the emotional aspects of COPD
  • Pharmacists – The pharmacist will provide advice and information about your inhalers and medicines
  • Social worker – The social worker will provide advice about benefits and services in the community
  • Doctor – The doctor will provide advice about medical causes and treatments of your COPD
  • Other people who have graduated from the rehab programmeOther people who have graduated from the rehab programme can be a great source of support, fun and companionship and give you tips which have worked for them

How often would I attend?

A female therapist working with a male patient

© Crown Copyright 2009

Pulmonary Rehabilitation programmes vary:

  • Some ask you to attend twice a week for around 6 weeks.
  • Some ask you to attend once a week for around 10 weeks.
  •  The exercises will be tailored to your abilities and you will be supervised and encouraged by the team on what you can achieve.
  • You will be advised to you carry out the pulmonary rehabilitation exercises 3 times a week. This means you will need to do some exercises at home. When you do this, you will feel yourself getting stronger and feeling less breathless.

Self management tip

To get the full benefit from pulmonary rehabilitation you should commit to attending the whole programme.

What is pulmonary rehabilitation?

Two female doing warm up exercises

© Crown copyright 2009

Pulmonary Rehabilitation is a free programme of exercises and information for people living with COPD. It helps by supporting you to learn ways that help to control your symptoms and improve your general well being.

You may be surprised at how much more you will be able to do by the end of the pulmonary rehab programme.

  • Pulmonary = your lungs.
  • Rehabilitation = to improve your health.

How can Pulmonary Rehabilitation help you?

  • Pulmonary Rehabilitation has been proven to improve the lives of people living with COPD by showing you how to control your symptoms and improve your lifestyle.
  • Feeling short of breath can be frightening. As time goes on, you may feel you can do less and less. This can lead to anxiety, anger, frustration and even isolation. Pulmonary Rehab can help you to overcome these feelings through a combination of breathing control, methods for coping and exercise.
  • You will be able to do more by the end of the programme, for example walking further, managing the stairs more comfortably, keeping up with your grand children or doing the housework.
  • You will meet others like you who know exactly what it is like to have COPD and you can share helpful experiences and advice.
  • During all the sessions you will be carefully supervised by a health care professional and exercises can be adapted to meet your level of breathlessness.

Amber – what to do

To see an enlarged version of the amber traffic light page select the image above.

To see an enlarged version of the amber traffic light page select the image above.

These changes may mean that you are developing an infection or exacerbation.

  • You should increase use of your short acting inhaler, usually a blue inhaler.
  • Rest while you can.
  • Use your breathing techniques.
  • Use your chest clearance exercises.
  • Drink plenty of fluids, don’t get dehydrated.
  • Eat small amounts often.
  • Keep monitoring how you feel in case you are having a flare up.

If you have an agreed action plan you will know what to look out for as the trigger for starting a course of antibiotics and / or prednisolone. If you do not have this arrangement it would be worth speaking to your GP/Practice nurse – they will want to teach you to monitor your symptoms and will also give you a contact telephone number so that you can talk things over. Later on they will want to check that you are able to start these treatments at the right time. It is only safe for you to continue if your health team is confident you are using these treatments safely.

Click on the amber traffic light for more information.

Dietician advice

Remember, If you are struggling with your diet you may wish to contact your GP practice to discuss if a referral to a dietician would be beneficial for nutritional supplements or more detailed dietary advice.

If you are struggling to eat enough you may also be given nutritional supplement drinks to try. These ready made products provide you with energy, protein, vitamins and minerals. They are designed to boost your intake in between meals, they are not designed to be a meal replacement. There are a range of products available in different styles/ flavours. A health care professional like a Dietician would be best placed to assess you for this and how much was required per day.

If you notice any weight gain , weight loss or increased thirst , seek medical attention due to possible diabetic complications with some treatments.

Seasoning suggestions

When thinking of different ways to start seasoning food, its important not to increase the salt in your diet. Many people have too much salt in their diet. Salt can raise blood pressure and this increases the risk for stroke and heart disease. The recommended daily amount for adults is 6 grammes or less (the equivalent of 1 teaspoon a day. Salt can easily be hidden in processed foods, bread, breakfast cereal and ready meals. Check food labels when you are shopping. See Chest Heart & Stroke Scotland fact sheet on salt.

Alternative flavourings to salt;

  • Pepper, mustard, onions, garlic, vinegar, lemon juice.
  • Herbs (e.g. mint, parsley, basil, bay leaves).
  • Spices (e.g. chilli, nutmeg, paprika and ginger).

Consider:

Fish Beef Lamb Pork Chicken
Fish

  • Bay leaf
  • dill
  • lemon
  • tarragon
 Highland cow

  • Mustard powder
  • tomatoes
 Lamb

  • Rosemary
  • oregano
  • basil
  • mint
  • cumin
  • chilli
 Pig

  • Apple
  • sage
  • thyme
  • coriander
  • lime
  • orange
 Chicken

  • Lemon
  • marjoram
  • tarragon
  • garlic
  • ginger
Potatoes Rice Tomatoes Peas Pasta
Potatoes

  • Paprika
  • nutmeg
  • parsley
  • pepper
 Bowl of rice

  • Coriander
  • saffron
  • onion
 Tomatoes

  • Basil
  • marjoram
  • oregano
 Peas in a pod

  • Mint
  • parsley
 pasta

  • Garlic
  • basil
  • pepper
  • tomato

For more information on daily salt, sugar and fat levels:

Tips to try if your sense of taste has changed

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If you are struggling with taste changes the following may help:

  • If you are using a steroid inhaler always rinse your mouth and gargle with water after use, this helps to prevent oral thrush.
  • Regularly clean teeth/ dentures, use mouth wash and try and floss if possible.
  • Don’t be afraid to try new foods.
  • Try sharp or spicy foods that have stronger flavour.
  • Experiment with seasoning (suggestions on next page).
  • If you have gone off a particular food, re-try it again after a couple of weeks as your taste may have changed again.

Tips if you have a dry mouth

You may find you have a dry mouth from time to time. Using oxygen, nebulisers and inhalers can sometimes cause this. It can make it difficult to chew and swallow foods. Some medicines can also give you a dry mouth. Check with your GP if this is a problem for you.

If you are struggling with a dry mouth the following may help:

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  • Choose softer/ moist foods.
  • Suck fruit sweets, ice cubes made with fruit juice/ squash and chew sugar free gum.
  • Your doctor can prescribe pastilles or saliva sprays if this is an on-going or persistent issue.