Thursday, May 31, 2007

Lower Extremity Exercises

Welcome To My Little Corner Of The World... here on this beautiful sunny, yet slightly breezy day in Lehigh Acres, Florida!!

I'd like to talk about your lower extremity muscles, which are the Quadriceps Muscles. These are on the front of your thighs and run between your knees and hips. These muscles are very important because they stabilize the knee, and are essential to enable safe walking and getting up out of a chair. Quadriceps deterioration happens very rapidly in people confined to bed. Restoring their strength is a crucial step in preparing to get our of bed to a chair, and to walk safely.

The Quadriceps may be exercised by having your legs flat in bed, and then tensing the upper leg muscles firmly for five second, then relaxing for five seconds, and then repeating the cycle for two or three times. As in the previous POST, build up this exercise as your strength improves.

Another lower extremity exercise is to strengthen the muscles about your hips and lower abdomen. Have your legs flat in bed, press your heels firmly into the mattress for five seconds, relax for five seconds, then raise your heels an inch or two off the mattress for five seconds, then relax for five seconds, repeat the cycle tow or three times. Again, build up this exercise s your strength improves.

If you have been confined to a bed for some time, or feel weak, you should never attempt to get out of bed without assistance. Professional supervision by a Nurse or Physical Therapist is preferred.
Your initial chair should be a firm plain wood chair with a high back, with side arms. A Walker device for additional arm support should also be used for the transfer from bed to chair. Preferably two caregivers should be on hand to help you. Wearing a stout Safety Belt until you are well mobilized is recommended.

When you are ready for the move, do not attempt to directly stand on the floor. Many weak patients develop Postural Hypotension, where your blood pressure quickly falls on standing up. This can lead to dizziness, fainting or falling. You should first, dangle your legs for a couple of minutes, if no dizziness is felt, then place your feet on the floor for a minute or two. If you feel the slightest hint of dizziness or exessive weakness, you can easily be slid back into bed. Do not get discouraged if you don't succeed on your first try. Progress to the chair only when you feel able to do so. Recommendation spending no more than five or ten minuts in the chair for the first time.

As your strength improves and your caregivers gain confidence in your capabilities, you may spend more time in the wooden chair, and then move into an easy more comfortable chair. Getting out of a deeper easy chair may be more difficult, so be sure your standing up strength and skills are adequate.

Well folks.... I think I have given you plenty of information to think about today.

Until we meet again... 1 2 3 Inhale ... 1 2 3 4 Exhale


Thursday, May 24, 2007

Beginning exercise for the frail person with COPD

Hello again, and I hope everyone is having a lovely day!

Some persons with severe COPD are so severly debilitated and weakened they are confined to bed, or so weakened they have great difficulty getting into a chair. Ideally such patients should have initial professional help from a Visiting Nurse service, who in turn, may be able to arrange for a temporary visiting Physical Therapist.

Even if bedridden, the patient can and should begin their rehabilitation with chest mobilization and corrective breathing training, as well as developing Pursed Lip Breathing skills. This should provide some dyspnea relief, and having some breathig control skills will be helpful later when exerting and needing more ventilation.

Exercises that anyone can do are called "Isometric Exercises." This is simply tensing muscle groups against one another. This type of exercise can be done by anyone, even those with severe arthritis problems, as there is little or no movement of joints involved.

For now, I will get you started with the Upper Extremity Exercises.
Upper extremity exercises for those confined to bed, may be done by clasping your hands in front of you, next to the chest. Then press your hands together, and maintain this tension to the count of five. Repeat this cycle two or three times until you can do this exercise fairly easily. This will strengthen your shoulder muscles.
Do this exercise (and all of the other exercises) at least every two hours, and preferably every hour. Then build up your strength by a combination of stronger pressures, longer times of applying pressure, and more cycle repetitions. You have to decide what is best for you, but initially stay with pressure times of about five seconds until you are stronger.
Another shoulder muscle exercise is to place your hands by your side, palms down, next to your hips, then press your hands firmly into the bed to the count of five, relax to the count of five, and then repeat the cycle two or three times. Extend this exercise in a manner noted above as you get stronger.

Good luck my friends, I know exercise is not easy when your feeling poorly, but believe me... it will help you.

Enjoy your day,


1 2 3... Inhale ... 1 2 3 4 Exhale

Friday, May 18, 2007

A Popular Home Exercise Device

Good Morning & Good Day To All!!

I would like to continue with my Activity & Exercise mini-series. If you are considering a home exercise device I would recommend one of the simpler and less expensive Stationary Bicycles. These devices are generally stable, and there is minimal danger of falling. Also if you become "short of breath" you are already seated. All you have to do is simply stop peddling, and brace your arms on the handles for rescue breathing control. As you first begin on the bicycle, adjust the tension so you can peddle with only minimal effort, and be able to maintain that peddling effort continuously for about two minutes. As you get stronger, try to gradually extend your peddling time to five minutes. When you can achieve that level of activity, then try applying slight increase in peddling tension. As you become more comfortable, try to gradually work up to ten minutes of continuous peddling, and do this preferably twice a day. A perfect place to put your exercise device would be in a room with a television or stereo to listen to music or news. This will avoid boredom while exercising. And it's always fun to exercise to music!!!

I feel that learning the proper breathing techniques are important with exercise, so I am going to go on to explain the "tricks" to breathing & exercise.

As with all exercise programs, the "trick" to progressive exercise success is learning how to recognize your dyspnea level that you know you can control with slow / deep breathing, or Pursed Lip Breathing. When you reach that point you should stop, regain your breathing comfort, and then continue with your exercise activity. If you continue beyond this breathing control point to levels of severe dyspnea, this makes it difficult to conrol and re-gain your breathing comfort. Be patient, this may take time, and sound very scarey... but gradually push your breathing control point to further effort. As your peripheral muscle strength improves you will find that you are capable of more exertion. This increased exertion capability will be done within dyspnea levels that you know you can control. If you have the skills to exert yourself, and be able to recognize your particular dyspnea control level, and then be able to manager your dyspnea, you will have the confidence to become progressively more active in whatever activity your are doing. This will be a wonderful feeling for you and a major step forward!

A few devices I would not recommend are treadmills or stepping devices for home use because of the danger of falling. Definately the minature trampoline devices are dangerous and should be avoided. As to arm weight training, avoid heavy weights. A pair of dumb-bells for upper extremity exercises is convenient, but they should not weigh more than five pounds, and one or two pounds is adequate for most individuals. Remember, you are basically not training for strength, but mainly for reconditioning and endurance.

I hope that I have given you some valuable information. That info that I pass on to you is all of my own life experiences in my day to day life with COPD/Emphysema.

Until next time my friends.... "Live Well & Breathe Well"

1 2 3... Inhale ... 1 2 3 4.... Exhale,

Tuesday, May 8, 2007

Spiriva Capsules

Good day to all!!!
I was just thinking about a problem I have had with Spiriva Capsules on more than one occasion and wanted to share it with all of you and would also like to know if anyone else has had this problem.

I have encountered empty capsules in my prescription. When I punctured the capsule and tried to inhale the powder, there was nothing there, you could not hear anything...usually the capsule vibrates when you inhale the powder, and you know when the capsule is empty because you do not hear the sound.

I called Boehringer Ingelheim to complain and their response was that "they could not do anything as I was the only person who has complained." Now I know for a fact that there are others who have had the same problem with the capsules. They also complained to B/I and received no satisfaction.

Please respond if you've also had the same problem!! I'm curious to know how many this has happened to.

1 2 3 ... Inhale ... 1 2 3 4 Exhale

"Live for the Moment"

Thursday, May 3, 2007

Structured Home Exercise

Good afternoon and what a beautiful day it is!

This post will talk about a home exercise without using any type of exercise device. We will get to those type of devices in a later post. Enjoy!!!

A structured home exercise that I would recommend is Yoga training. Yoga Training videos developed by Dr. Vijai Sharma are excellent. Dr. Sharma is a Clinical Psychologist and credential Yoga teacher with a special interest in COPD. I also need to mention that Dr. Sharma has Emphysema himself. Dr. Sharma has developed two training videos "Stretching Breathing Exercises adapted for people with severe COPD" and "Stretching Breathing for COPD for all levels of fitness." These videos are carefully designed to first provide safe training for a frail person with severe COPD, and secondly to provide more strenuous exercise for less disabled individuals.

The Yoga movements provide excellent stretching and posture maneuvers to mobilize the spine and chest wall,and improved general coordination and balance training exercises. Yoga is intimately related to breathing exercises, and there are good breathing instructions directed to COPD needs. Teaching coordination of breathing with general body movements is well done, and this provides a bridge to more efficient movement for performance of activities of daily living. Dr. Sharma has a website with many topics of interest for COPD patients and you may purchase these videos from his site at:

Smile, breathe and go slowly. - Thich Nhat Hanh

1 2 3...Inhale ... 1 2 3 4...Exhale

Wednesday, May 2, 2007

Breathing Control Skills

Today I would like to continue our "mini-series" and talk about the effective alternatives to the formal exercise programs and for long term follow-up exercise.

This is based on a simple technique that if you have breathing control skills and can control your exertion dyspnea, than you will not be afraid of becoming short of breath. And.... if you are not afraid of developing uncontrolled dyspnea you will become more active, because you want to become more active and therefore you will do the many desirable things that you previously could not do. You may be thinking.... "well, it's easier said than done!!" But as you regain your ability to do more and more activities of daily living, you will develop more and more strength doing these activities. You will become stronger in body and mind, feeling more sure of yourself and also feeling much better about yourself.

Be proud... you worked hard in your pulmonary rehabilitation program. And then you continued and took it a step further... you learned "breathing control skills".

Many home bound people with COPD find that with reconditioning and improving breathing control skills they can participate in family activities, or climb stairs once again. And with further progress they can begin activities outside of the home such as; visiting friends or going shopping. But all of this involves progressive exercise, which is a natural part of simply becoming more active. And a tip to "brighten your day"... this form of exercise is usually neither boring or unpleasant!!

I am going to leave you with that bit of knowledge for today.
Please check in tomorrow as I will talk about "Structured Home Exercise - Yoga Training".

I would like to encourage you all to please post and tell us about your exercise program, or send in any questions that you may have. I am sure we have many "exercise friends" who can share their stories.

Breathe well tonight my friends... 1 2 3 Inhale ... 1 2 3 4 Exhale