To Rehab or Not?

Hi.

I haven't posted or commented on here for a long time now but do check in from time to time to see what's happening.

I'll be honest, I'm looking for some advice please.

I am a young 62 year old, still working albeit now part time 4 days a week but at a very stressful, although sedentary job. My consultant has referred me to Rehab prior to referring me to the Royal Brompton - although he's not sure what they can do. My lung function is about 35% at the moment and reducing slowly - I was first diagnosed with COPD/Emphysema at the age of 36.

Ok, so I would value people's opinions who have completed, or not, Rehab. I went to the first one yesterday. There was a talk first about what is COPD etc and then an hours exercise. A whole hour of exercise is a lot for someone whose days are busy and doesn't put time aside for dedicated exercise. I didn't know what was expected or what was the norm but was pushed to keep going - which I managed, even being encouraged to use equipment that the other group members had never used.

When I left the physio commented that I would probably be sore tomorrow - I'm not.

But - after I left the group I sat in my car for ten minutes before I could drive off. I got home and the exhaustion was awful. I could hardly move for the rest of the day, went to bed and slept for 12 hours.

I feel that I can't do this twice a week for the next 6 weeks, it was just fortunate that it was a Friday - have today to recover but the next one is next Wednesday.

Do I explain to them next week that I can't do such intense exercise or do i say this is not for me until I've retired?

I don't want to stop going as I do understand the benefits but I feel I can't do this intensity twice a week for 6 weeks. I genuinely feel that a whole hours exercise is too much to begin with.

I would be grateful for advice/opinions please.

Thanks

19 Replies

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  • Hi - please go on Wednesday and explain what happened to you yesterday. I am sure the people running the course will adapt the exercises to suit your needs. When I did the course the members on the course had widely varying health/breathing and SATS were checked regularly. Some people took breaks between each exercise for example if it was felt that they needed them. Good luck and please let us know how you get on.

  • 100% agree. Just finished my course and it was brilliant but the staff tailored the exercises to each individual's needs. We all worked at different levels and everyone agreed that it had been a very positive experience and would like to do it again in the future. 😊😊😊

  • How about explaining how you feel on your next appt and ask wether a half hour regeme more often would be of benefit if that is an easier option for you.

  • I think you should go next time and speak to one of clinicians about your situation. I had to do this when I went to PR the first time. Exercises were then adapted more to suit me.

    For a variety of other reasons that PR wasn't great for me. But am waiting for second go in new authority. Hope I find it more successful this time round. But like you I still work so there is a limit to how far I can be pushed!

  • Why don't you ask them at rehab if you can reduce the amount of exercise in the hour you have to ds. They are usually very good and very understanding. Keep In touch. Xx Bernadette xx

  • Hi,

    Do go next week and explain how you felt.

    The course I attended last year included people with varying degrees of lung disease and varying abilities. While every one was encouraged to do as much as possible to gain the most benefit from the course, every one was also encouraged to use their own judgement in pacing themselves, resting as needed in between the different exercises and gradually building up what they could do over the length of the course. The only one's 'pushed' were the few who seemed to be making a token gesture at doing the exercises.

    Hopefully the course will help you to strengthen muscles not being used in a sedentary job and you will eventually feel some benefit.

    Good luck

  • Hi, it was bound to be exhausting at first - you just didnt have any way of knowing that. During the exercise part, did you have 3 minutes of exercise, then 1 1/2 minutes of rest with 10 different exercise stations? That is the usual routine though Im sure it varies around the country. That adds up to 30 minutes of exercise with 15 minutes rest interspersed, but of course many people can't get through the full 3 minutes of each different exercise when they start.

    It sounds like they pushed you because you looked like you were ok. If you talk to the physios they will work with you to establish something that is more realistic for you.

    Overall you've done pretty well since you were originally diagnosed at 36, but to keep progression to a minimum now you really do need to exercise regularly. It should get much easier as you continue, then when you finish you can probably work out convenient times to keep exercising which fits around your situation.

    I'm at a similar fev1 to yourself and found PR excellent but undoubtedly the first session was exhausting. Now I go to what they call a maintenance session each week. Copd is an exhausting condition - maybe this first session has surprised you just how much exercise affects you? But please don't give up - you will get stronger and it will get easier! :)

  • I'm 64, work full-time and have just completed my 7 week pulmonary rehabilitation course. I found it to be a very positive experience and my exercise tolerance levels have increased tremendously.......I can now run upstairs without getting breathless!

    My group comprised of people who were all at different stages ( some on oxygen) and we were all allowed to work to our own capabilities, and rest in between exercises if necessary. It was so gratifying seeing people improving week on week, and the pleasure and confidence they gained from being part of the programme. Yes, you should expect to get breathless......if you don't you're not working your lungs hard enough to gain any benefit, but no way should you be exhausted like you were.

    I would go on Wednesday and discuss your concerns with them, and I'm sure that they will be more than happy to tailor things to suit your needs.

    Good luck with it, and please let us know how you get on.

    Pam XXX

  • ac3399 , I'm nearly 68!

    I do remember those sessions. I couldn’t do it outright either. And one nurse shouted, come on! I was right out of breath and gasping.

    I think you can obtain a book of exercises to improve your lung function from either the NHS or the Lung foundation. Talk to them about it and about the fact that it is too intense for you, there’s no shame to it. Here’s their number: Our Helpline - 03000 030 555.

    Mind you, after having done the 6 weeks rehab, I asked them to sign me in for the gym. At the start, I was extremely slow and often short of breath. My lung function in 2003 – 2010 was 30 and declining! After a terrible bout of illness in 2010, I decided to go back to the gym, even with my oxygen bottle. I went 3 times a week. After 2 months, I did not need the oxygen. 5 years later, my function had climbed from 30% to 42%. My consultant told me I was transformed.

    I felt it too.

    OK it’s a slow process, but you can improve these 35% indeed.

    If you cannot face the gym 3 times a week, start with some Chinese 8 pieces of brocade. This is a set of exercises taken from the medical branch of Tai Chi. They will give you the necessary energy, after perhaps a few weeks, you might sign to the gym once a week.

    Why brocade? Brocade is made of silk which is supple, but sturdy. That’s the aim of the exercises.

    Here is the explanation:

    taichivillage.org/exercises...

    And here is a nice lady doing them for you!

    The emphasis of the exercises is to breathe fairly rhythmically when you do it. Adopt your breathing pattern while doing them.

    Like Rome, health is not built in one day. It needs patience and consistency. Start with one or two exercises. If you get short of breath, stop and wait till you recover. Then you may wish to do some more or not. The important bit is to decide that you will do this at a certain time every day. Then really keep at it. You will notice the increase in energy after a week already. It’s like a little bud, as you nurture it, it develops. But I guarantee you that you will find a new energy and better breathing.

    Keep this improvement in mind, you will do it!

    Best wishes for your improvement. Mic

  • Thanks for this Mic. I have decided to try and continue with the Rehab but I am interested in Tai Chi so may give this ago!

  • Explain all this to the physio and deninately don!'t do too much. There is also the talks and chances to ask questions and , the social aspect of talking to other suffers over tea and biscuits. So all round very useful.

  • Your experiences happened to me, in the summer. There was a heatwave going on at the time. I did the exercises with difficulty and with no enjoyment at all. And I was so exhausted afterwards. This was my experience for me at the time. There were people present who were getting a lot from doing the exercises.

  • I can echo Pam1952's reply, I have gained so much, despite the vascular problem in my legs, I complete mine on Mon. I too have a similar Fev% but my work (full time) is not sedentary by any means, so therein lies a clue I believe, you really need to do this more than I did. Just have a word with the nurse/therapist, it has only been your first time, they have to get to know your capabilities first.

  • Thanks to all for your advice and especially the encouragement! I will go Wednesday and speak to the physio at the start.

    I have to say it wasn't very organised and with a lack of guidance - really just ' this is what we want you to do - work your way round and do as much as you can' sort of thing with no advice about resting in between different exercises and if I stood still someone would appear and suggest I do this or that.

    I will continue tho - seems that most people seem to think it's well worth it!

  • That is seriously bizarre ac - I had thought there was a protocol as to how PR exercises should be done. Yours sounds shambolic. The resting in between is necessary as most of us have a tendency to hyperventilate and that means there is less and less room for new air to get into the lungs, and from there into the blood. The rest gives your lungs the time to let out some of the trapped air and to return to (your) normal, so you can continue with the new one afresh.

    Ours were timed so for the first week we did one minute's exercise and 3 1/2 minutes rest. Then each session the exercise time was increased and the rest times decreased until they reached 3 minutes for the exercise and 1 1/2 minutes rest in between. Sorry I didnt make that clear in my earlier reply.

  • Hi ac3399 ! - sorry to read your having problems - I'me on my second Rehab course in 6 years and a few years older than you ! - which I find has been very helpful - it is interesting how to see , or rather feel how far we can push ourselves , but if you find it too difficult - take a pause between exercises ! - I take my inhaler - and have a puff every now and again ,but if it is all too much for you, ask if you can be referred again sometime in the future .its all a balancing act - this exercise business ! , I suppose our bodies tell us if something is too much for us at any one time ..and of course we are all different , - see this course through if you can ,- just do what you can - telling the staff of your thoughts , I'me sure they'll understand - as will your body ! your job, which you describe as " Stressful" probably is'nt helping much , and perhaps when you retire from this , you will have more time to relax as a precursor to having another bash at Rehab at a later date - so good luck !

  • I did rehab about 2 years ago I found the course very helpful loads of information and you meet people at different levels. The exercise is good for you I now go swimming it get the hart rate going and gives your lungs a good work out.

    If you finish the course like I did you will be better off for it well worth the time

  • I have been on Pulmonary ReHab twice over a period of years (I have severe COPD) and was offered it again early last year.

    At my pre-assessment doing the 6 minute walk I mentioned to the Physio about my recent diagnosis of Unstable Angina. Immediately the assessment was stopped and I was told I couldn't do the course because of their criteria.

    I was also advised to not even do the very simple warm-up exercises (I still have the sheet of paper outlining them).

    As for my Angina, I haven't had an attack since October 2015 and I know it could be years before I have another.

    If any of you get the chance to go on a Pulmonary ReHab course then please accept it as you WILL find it beneficial.

    Thérèse

  • Good Evening

    I perfectly understand your situation ,but must agree with a lot of the advice already given which is to keep going

    I completed P R about two years ago and I must say it helped me so much after which they referred me to a exercise / breathing c!ass twice a week which I still enjoy ( I am retired )

    The P R class was made up of people with variable strengths and activity levels and the exercise was adjusted accordingly ,so if it's a struggle for you let them know

    But it is such a good opportunity and if you walked away a second chance may not be so readily available

    Best regards

    Graham

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