Empowerment Via Self-Care And Service
|Vijai P. Sharma, Ph.D.
I talk everywhere I can with people with COPD and their friends and families how we can empower ourselves to take care of the COPD/Emphysema. We must increase COPD awareness and encourage early detection, self care and treatment. My "special" message is to draw attention to the emotional burden and stress that COPD brings in our lives. Self-care is as important as medical care. Emotional support and support from friends, family and loved ones, exercise, nutrition, healthy diet and knowledge of the disease are important for our health and well being. Emotional stress is as harmful as the physical stress and in fact they can't be separated. People may even need more encouragement and support to address their emotional symptoms than their physical ones!
Around 1994, I found myself becoming increasingly breathless, even during mild exertion. Determined to increase my stamina, I decided to try jogging. But after repeated efforts, I found I could not jog slowly for even 5 minutes without feeling uncomfortably out of breath.
But as I had to increase my medications to deal with breathlessness from just moving around the house, my usual optimism was overcome by pessimism, then depression. My use of bronchodilators increased from two or three puffs two or three times a day to three to four puffs four times a day. I did treatments as many as five times a day on a "bad" day. Cold, heat, humidity, dryness, pollen or anything even slightly disagreeable in the environment bothered my "hyper-responsive" airways.
Being a psychologist, I could recognize how much my psychological "demons"--depression, anger, frustration, worries, anxiety, loss of control, and lowered self-esteem--directly affected my breathing. Fortunately, I also got help from Larry and Michelle Ingram, two friends of mine, trained as respiratory therapists who came to visit us.
Their parting words--"Think about pulmonary rehabilitation"--led to a turning point in my life. There was no pulmonary rehabilitation program near where I lived, so I read everything I could find in libraries and via the Internet and patient groups. Thanks to a background in self-care stemming from practicing yoga, I recognized that I was the "leader" of my treatment and rehabilitation team. I also recognized that helping others was one of the best ways to help myself!
My personal program includes slowly but steadily increasing the duration of my walking and selecting specific exercises to strengthen my arms, legs, abdomen, and chest. I especially focus on making my diaphragm and ribcage more flexible and strong,, and on yoga postures and breathing exercise I had abandoned to avoid exertion. I lift light weights, and work out at the local YMCA to have access to different types of treadmills and muscle strengthening machines.
The first time I went on treadmill was the longest 3 minutes I have ever spent. But I persisted for 5 minutes, in spite of leg fatigue and shortness of breath. In just a few days, I was up to 15 minutes, and in a couple of months, to 30 or 35 minutes. I made an interesting discovery about endurance and stamina that I don't recall reading anywhere: the first 5 "warm-up" minutes are the hardest. So don't give up! "Listen" to the breath, so you know when to slow down so as not to run out of breath. Perform difference exercises so you don't get bored!
In my quest to assume as much responsibility as possible for my own care, I studied extensively to understand my disease, medication and treatment options. For example, I learned the most efficient way of using bronchodilators so I could get the most from my puff. I learned to recognize the beginning of an acute exacerbation of COPD symptoms and seek medical treatment as soon as possible. Even on a bad day, I have options. I can spend the day being sick and complaining or focus on regulating my breathing and doing light stretching and lots of relaxation exercises to get some relief from symptoms.
I also exercise options related to "obstructions" in my emotional health. I rarely get depressed or angry about why I had to get emphysema or why I didn't take better care of myself. I prefer to focus my energy on looking for answers and solutions to practical problems of everyday life. Fortunately, I don't have other medical problems, such as heart disease, high blood pressure, or diabetes, to compound my problems.
I try to practice breath management "24/7" to reduce symptoms and prevent exacerbations. This means I pace my breathing so I can perform an activity longer. I exert according to how strong or weak I feel while exercising, walking or engaging in any other type of exertion and effort. I focus on stabilizing my breath and to alleviate a 'breathing attack" before it starts to escalate. Before I assumed responsibility for my own health care management and improvement, I was in denial, hoping that if I ignored my symptoms, they would go away, letting an infection "brew" in the silent areas of my chest. I learned the hard way that I was harming my lungs by delaying the treatment
Relaxation exercises, which are now being recognized as effective treatment for many conditions, are mandatory for me: I do mini-relaxation sessions, 5 minutes each time, at least three or four times a day. I do at least two 15 to 20-minute relaxation sessions a day. In relaxation sessions, I physically and mentally relax for 10-15 minutes and then do 5-10 minutes of smooth, relaxed, slow and deep breathing. When I can't sleep at night, I stay in bed and try to do my relaxation session as long as needed until I fall off to sleep. When sleep does not come, relaxation becomes an all night affair.
I created the COPD DVDs ("Stretching and Breathing Exercises Adapted for People with Severe COPD and "Stretching and Breathing Exercises Adapted for People with COPD at All Levels") and a Workbook (COPD Workbook I for the severely challenged 'copders' and their families and caregivers). You can view more details of my works by visiting my website www.mindpub.com/copdhome.htm
I utilize my website and my works to share with other COPD/Emphysema friends regarding what I have learned. I spend 3 to 4 hours every day on different self-help tools such as walking, breathing exercises, flexibility and strength training, weights and meditation. When my symptoms worsen, I spend as much time necessary-even all of my waking hours--to relieve my symptoms.
Empower yourself and others!
Copyright 2007, Mind Publications