Pulmonary rehabilitation gave me the confidence to live life again
Tessa, 74, is a retired nurse living in Kent who has chronic obstructive pulmonary disease (COPD). Here she describeses how pulmonary rehabilitation (PR) helped her control her breathing and build up the strength and confidence to enjoy life again.
I always had problems with my lungs as a child and in my adult life. In my late fifties, I was diagnosed with adult-onset asthma, but about three years ago my feelings of breathlessness increased. It didn’t feel normal. I remember I went to the theatre with my friend in Canterbury. It was windy and cold. We started walking and all of a sudden, I panicked because I was so breathless. I thought I was going to pass out. I do suffer with anxiety a bit as well, so it was terrible. I had also begun to feel a pain in my left lung.
The following morning, I went to my doctor and said, ‘This breathlessness is not just my asthma - I’m not happy and I would like a chest X-ray.’ She sent me for an X-ray and was shocked when she got the results. She said, ‘You have COPD, Tessa’ and I could see that she was a little taken aback. I was just relieved to have a diagnosis.
I manage very well
When I was diagnosed with COPD, my medication was kept the same as my treatment for asthma. If I felt a bit breathless, I would take my reliever a lot. Recently, my nurse told me I don’t need to use my reliever so much - I was using it a lot when I felt breathless - and relying less on it has really helped me manage my condition because I am making sure I take my preventer regularly (twice a day) and properly (with a spacer).
My GP manages my medication, but occasionally I ask my community pharmacy, who are opposite my GP surgery, for help. I have known the chap working there for many years. When I first started getting my medication, it was all muddled up and the chemist sorted it out.
I had lost so much confidence
After my diagnosis and because of my breathlessness, I lost a lot of confidence. I didn’t want to go out with my family or friends, because when I went out and started having a massive coughing fit it made me feel very self-conscious. I used to cover up my breathlessness and pretend that I was too busy to take part in things people invited me to. I even stopped going on holiday – I have two very dear friends who were both divorced, and we would go on holiday together, but I was so afraid of putting myself out there that I drew away from everyone around me.
I kept thinking that because I can get in the car and get to the supermarket and use a trolley and walk about I was okay, but then I suddenly realised I had stopped doing lots of things. It was beginning to cause a little bit of aggravation within the family, because they had been used to seeing Mum do this, that and the other.
When I went back for my annual spirometry test, I asked to be referred to pulmonary rehabilitation (PR). My GP had mentioned it to me before but at the time we thought I was doing really well and didn’t need to go. But I got to the point where I wanted to give it a go and see if it helped my breathlessness. The GP referred me and, three months later, I attended my first class.
PR is wonderful, I wish everyone was offered it
The PR programme was over six weeks and there were 12 sessions. It involved an hour of exercising, then an hour of educational talks given by various people as well as Gillian the physiotherapist, who ran the sessions, which were wonderful.
I had lost an awful lot of confidence because I thought that I couldn’t go out because I would get out of breath. I felt a bit daft if I had to stop and lean against a wall. Now I know for me, bending over helps me get my breath back, while other people have different techniques they use to help them. I was shown this recovery technique in PR and now feel more comfortable when I am out and need to rest.
I also learnt to stretch my arms up and learn forward when I am in the shower and am feeling a bit breathless. PR shows you these techniques which are so helpful.
If I don’t do any exercise, I notice my chest feels tighter
I know now that it’s important to keep moving. Sometimes, I have days where I really don’t want to exercise. Fatigue is one of the things you get with COPD. You get terribly tired with it. But if I don’t do anything for a couple of days, I am very aware that my chest feels tighter.
At PR we would do some lifting of weights, press ups off the wall, and exercises like sit to stand, and we did a little bit of dancing around; that’s when we have fun. They advise that you do some form of exercise five days a week. If possible, I walk every day and I will do exercises with weights – I have weights at home. One of the things I really like to do, is doing press ups off the wall. For some reason for me, that’s a really good exercise. That’s all about strengthening upper body muscles.
I have an exercise bike now - the kids bought me that. If I don’t get out for whatever reason, I just sit on it and gently pedal around.
The benefits of doing PR are superb. It’s not just the physical benefit - it also helps you mentally. I enjoy being around people and, before the lockdown, I had started volunteering at the PR group, helping induct new patients.
I loved doing PR and keep up with the exercises at home now. It’s been a life saver and has given me confidence to take part in life again.
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.
Many face-to-face PR classes have been halted during the pandemic. The Taskforce advocates a menu-based approach, so that people are given options to access PR in the best way for them, including remote programmes.