Pulmonary rehabilitation and exercise – If I can do it, you can do it, too
Rita is 91 years old and lives in a care home with her husband Eric, who is 100. Rita has Idiopathic Pulmonary Fibrosis (IPF), and shares her story of how exercise is key to living well with a lung condition.
I was relieved to get a diagnosis
I was diagnosed with IPF six years ago, when I was 85 years old. When I first received the results, I felt relieved, but rather puzzled, too, because I had never smoked and had never lived with people who smoked. Many people think that all lung diseases are caused by smoking, but that is not always the case. Since my diagnosis I have been told that IPF can be genetic. When I had a thorough health check-up upon joining the Civil Service in 1973, the doctors found a mild pulmonary disfunction. No one suspected I could have something like IPF, a life changing lung disease.
I had spent a long time wondering what was wrong with me. I loved walking and was part of an active walking group, but suddenly, I could only walk about five miles before I felt too physically tired and worn out to continue. And it wasn’t just walking – I had loved dancing, but this too had become difficult and challenging.
I also have heart problems and need a pacemaker and a stent, so my diagnosis journey was a little complicated. For a while, my doctor was convinced my feelings of breathlessness and my cough were an extension of my heart problems – I was sure that was not the case. Despite my protestations, I had to see a cardiologist, so that they could rule out my heart problems as a cause. A little while later, I had a breathing test and a scan of my chest. Overall, the diagnosis process took two years. It felt good to finally get some answers, so that I could learn to live well with my condition.
After six years of living with IPF I now understand my condition and know how to make sure I feel as well as the disease will allow me to. I am not on any medication, and I don’t use an inhaler or oxygen, but I know I am deteriorating quite fast as far as breathing is concerned.
Exercise is the key to me living well
Having found dancing and walking quite difficult, it was a bit of a surprise when my GP recommended that I start a gym routine, and my lung consultant referred me to Pulmonary Rehabilitation (PR). Exercise had never occurred to me as a solution before, but I started to make the effort to enjoy it. It has since proved to be the answer to my problems.
Now, I usually go to a gym near my care home, and a special Pulmonary Rehabilitation session. Pulmonary Rehabilitation is designed to specifically help people with lung conditions, so I have found it very useful. There are eight to fifteen of us in the class and it takes up an hour on a Tuesday.
In the PR class, led by an instructor, we start with a short warm-up session stood up. Because I am unsteady on my feet, I sit down to do this. We continue the class by doing twelve different arm and leg exercises with a large elastic band either standing or fixed to a chair. The instructor has a stopwatch to time us when to move on to the next exercise. I am now finding this class a bit difficult.
When I am at the gym, I prefer using my walker to help me move around, and I spend about an hour doing my set routine. I go on the bicycle for twenty minutes first, and then move on to the rower for ten minutes. To strengthen my arms, shoulder and chest muscles, I go on a machine which involves pulling on a handle. Then, to strengthen my legs, I place a big ball up against my back roll it up and down the wall.
Exercise has allowed me to manage my condition. It has kept me strong and ready to face the world. For instance, because of my exercise routine, I have strong arms and legs which means I can hop on a bus if I need to without any help. I believe exercise is the key to me living well.
I have vowed to follow my exercise plan
At the moment, I am shielding. It frustrates me that I cannot go the gym because it is closed, although I understand why this is the case. I have bought some exercise bands that I can use at home and I am using them to do strengthening exercises with my legs. I watch fitness videos on my laptop and do the exercises that I can manage sat down – usually the ones for my arms and chest. Nonetheless, I want to get back to the gym as soon as possible. I need the gym equipment so that I can feel strong again.
It almost seems counterintuitive, because when I’m going to the gym and doing exercise, I don’t cough, but when I talk to someone for a long time, my cough gets exacerbated. It’s a testament to how much keeping fit can help someone with a lung condition. That’s why I swear by exercise. It is important for me. Despite the fact that I can’t go to the gym right now, I have vowed to follow my exercise plan, regardless of the lockdown.
I feel better after exercise
My advice to others would be to ask your consultant to refer you to PR treatment and other forms of exercise. The consultants need to write to your GP to ask them to refer you to an exercise programme that is suitable for lung conditions. But is not always easy to find the right class. Call your hospital or GP to find out where the classes are. It is possible to find them. They are there. And do carry on and do what they recommend. Sometimes, I think “oh I don’t want to go today!”, but I do go, if reluctantly. I am not a person who always wants to go. But I go and I do feel better as a result. If I can do it, you can do it too.
If you would like to share your story with the Taskforce, please contact us at [email protected]
Making Pulmonary Rehabilitation (PR), more widely available than it is currently has significant benefits, including financial savings for the NHS and social care system.
The Taskforce for Lung Health recommends that access to PR is improved so that every person with a Medical Research Council (MRC) breathlessness score of grade 2 and above is identified, referred to, and has the opportunity to complete a programme.
Face-to-face PR classes have been halted during the pandemic. For those shielding or considered vulnerable to COVID-19, remote consultations and digital PR programmes should be offered and accessible to all who would clinically benefit.