In researching topics for the current edition of our e-letters, we ran across a review article examining the how to make pulmonary rehabilitation a greater success component of COPD disease management.
As readers of our blog, e-letters, and buyers of our Breathe Better for Life guide/CD know, we are emphatic supporters of the value of pulmonary rehabilitation. This treatment option has been shown in three decades worth of research studies to reduce breathlessness, improve physical conditioning, improve patient quality of life, reduce exacerbations and associated hospital stays/health care costs.
For those who are unaware, the cornerstone element of pulmonary rehabilitation is observed guided exercise (aerobic and strength training). Other elements of pulmonary rehab include training of breathing and airway clearing techniques, and counseling on nutrition, smoking cessation, and proper use of medications.
In any event, in describing ways to expand access to pulmonary rehabilitation for a wider range of COPD patients, and ways to encourage continued participation in an ongoing exercise program after rehab, the article author included a chart on self-management strategies for COPD patients (Bourbeau J, Making pulmonary rehabilitation a success in COPD. Swiss Medical Weekly. 2010;140:w13067)
We thought the chart was worth summarizing for you (see below). If your doctor has not discussed these strategies with you, or if you have not yet seen your doctor about your shortness of breath concerns, we recommend using this list as a guide to discuss your own “better breathing program” with your doctor. Alternatively, we suggest you consider purchasing our Breathe Better for Life guide/CD, www.breathebetterforlife.com, to find specific suggestions and strategies for many of the topics highlighted in the below list, including exercise, nutrition, breathing techniques, conserving energy, managing stress, and maintaining intimacy among others.
Self-management skills and healthy behaviors for COPD self-management (Table 3 in referenced review article):
1. Live in a smoke free environment - Quit smoking, remain non-smoker and avoid second-hand smoke.
2. Comply with your medication - Take medication as prescribed on a regular basis and use proper inhalation techniques.
3. Manage to maintain comfortable breathing, use according to directives:
– the pursed-lip breathing technique
– the forward body positions
4. Conserve your energy - Prioritize your activities, plan your schedule and pace yourself.
5. Manage your stress and anxiety - Use your relaxation and breathing techniques, try to solve one problem at a time, talk about your problems and do not hesitate to ask for help and maintain a positive attitude.
6. Prevention and early treatment of COPD exacerbations - Get your flu shot every year and your vaccine for pneumonia. Identify and avoid factors that can worsen your symptoms. Use your Plan of Action according to the directives (recognition of symptom deterioration and actions to perform).Contact your resource person when needed.
7. Maintain an active life style - Maintain physical activities (activities of daily living, walking, climbing stairs, etc.). Exercise regularly (according to a prescribed home exercise program).
8. Keep a healthy diet - Maintain a healthy weight, eat food high in protein and eat smaller meals more often (5–6 meals/day).
9. Have good sleep habits - Maintain a routine, avoid heavy meals and stimulants before bedtime and relax before bedtime.
10. Maintain a satisfying sex life - Use positions that require less energy. Share your feelings with your partner. Do not limit yourself to intercourse, create a romantic atmosphere. Use your breathing, relaxation and coughing techniques.
11. Get involved in leisure - Choose leisure activities that you enjoy.
12. Activities - choose environments where your symptoms will not be aggravated. Pace yourself through the activities while using your breathing techniques. Respect your strengths and limitations.
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