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British Lung Foundation
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Exercise v breathlessness

We keep reading/hearing of surveys/research which advise exercise for a specified amount of time in order to get the best benefit from exercise and fresh air. I would be interested in hearing informed opinion on the fact that those with lung conditions become breathless much quicker than those without. At some stage trying to struggle to carry on for longer than is comfortable must surely put a strain on the heart and then that becomes a problem. Any thoughts?

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Hi

From the BLF exercise book.

When exercising try to say the following sentence.

This exercise programme is doing me good!.

If you can say the whole sentence without stopping you are not working hard enough!

If you can't speak at all , or can only one word at a time, you are working to hard.

If you can say the sentence with one or two stops, that's right.

Remember, it is not harmful for you to get out of breath when you exert yourself.

However, if you are too breathless to speak, slow down until your breathing improves. Try not to get so breathless that you have to stop suddenly. As you gradually increase your activity and exercise you should find you are able to do more without feeling quite so short of breath.

On the modified Borg scale for breathlessness, which goes 1/10 keep at around 4/5

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That's interesting - thanks. I knew there were so many knowledgeable people on here. I'll have to print this off and take it out with me! Recently, on getting near the end of a slightly uphill footpath I use regularly, I had indeed stopped to get my breath back and was approached by a young man coming the other way who actually said "You okay?" and I explained that just the last few yards were the last straw! I was quite impressed though that he enquired. Most people would just walk passed. I'll look up the Borg scale too - never heard of that. Many thanks.

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Hi

Modified Borg scale for breathlessness

regionalhealthprogramsww.co...

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on my way 2 the barbers i was so short of breath i stopped 4 a rest to get my breathing under control along comes a lady with a handfull of jehovas witness pamphlets she smiled asked how i was iwas so short of breath i could'nt speak at first so she began giving me a sermon in the meantime i got my breath back and apologised for not speaking explaining to her that i had a lung condition, she did'nt say another word just walked off

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Oh dear - she might have thought you stopped to hear her! But I guess they must get used to being ignored! We do collect some funny little tales along the way don't we?

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i think she probably thought i was close to meet my maker so she would rather try and convert the one's that might be around a bit longer into her own perception of religion

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Hi

If you oxygen levels are good, what reason is there for not exercising harder than 4/5?

Thanks,

Sinclair

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I push myself higher than 4/5 on the Borg scale. Before I did I had various checks on cardiac function etc before I did. I was given limits on what to take my blood pressure and pulse up to. Best advice would be to get a check over by your GP before starting any new strenuous exercise. Safety first.

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Yes, it was the extra strain on my heart that I was querying. How do I know what my oxygen levels are when I'm out walking? I'm off to the docs on Thursday so I'll bring this up. Thanks.

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Claudine I brought my own pulse oximeter. You can get a good one off eBay. I checked them after each part of my exercise programme.

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Forgot to add that you can get a 6 minute walk test app off play store. You put in you details and it works out the distance a normal person should be able to walk in that time.

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Hi

It’s not your oxygen levels, but your level of breathlessness. If you progressed to 10 you would be requiring a visit to A&E.

On the standard Borg Scale 1/20 is based on activity the higher the number the more you are pushing yourself. To monitor safety you use a heart rate monitor.

This is not suitable for people with a lung condition, so they use the modified Borg scale of breathlessness 1/10 and use breathlessness as a monitor. The sentence is a good guideline.

As we are all different there will be variables. You have to work within your limitations. It’s exercise endurance not exercise activity. Your aim it to tone your muscles to work more efficient within the constraints of your lung condition.

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Hi

I understand that it is your breathlessness and not oxygen levels but my question was why do you need to moderate your breathlessness to such a moderate level if your oxygen levels are ok? what damage do you risk doing by exerting yourself more? If your heart rate and oxygen levels stay at a good level, why not push yourself more?

Thanks,

Sinclair

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This is what scares me (it doesn't take much!). I don't know (a) what my heart rate should be and (b) what my oxygen levels should be. I need further research.

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Hi

Your maximum heart rate is 220 minus your aged.

50% is your lowest. 70% is your highest.

So you should exercise between the lowest and highest figures.

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Hi

You risk a uncontrollable breathing episode which may require medical attention. You can do more in respect of time or distance but you must be in control of your breathing rate.

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Aha. That is not something I have ever experienced or considered.

Thanks

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This is why I need the discussion with the doc. I don't want to go out wired up just for a walk but I would like to stretch myself sometimes to see what I'm capable of. Perhaps this time of year is not the best time! Just breathing in very cold air puts the whole body under stress.

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For example, up until November I used to go on 20 mins runs and would get very out of breath, as you would expect when running. I wasnt jogging but sprinting at certain points. I would check my oxygen and my heart rates and they never hit dangerous levels (go below 95 or higher than 160). When I cycle i would also have times when I really exert myself.

I havent done much for the last few months because I have been travelling and have hit a very lazy stage but without those periods of serious breathlessness I dont really feel I gain much and increase my fitness levels.

My heart is healthy and my FEV is in the high 80s, I see no reason why I shouldnt push myself a bit harder.

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I push myself as hard as I can, with medical approval, my legs are responsible for any slow down or stopping but all the same I regularly hit a 160 bpm probably a little higher on the hills. My at rest bpm being around 95. I definitely go to borg 5/6, unable to speak more than one or two words, I am under no distress though and in total control. (remember, at work I am used to spending 8 hours a day at borg 3, horses for courses). I have increased my lung function, got a lot, lot fitter and still lead and enjoy a better quality of life than when I was, supposedly, healthy.

Now had I imploded at diagnosis, I would have quit working, been scared silly to get out of breath or go outside the front door, sat on my backside getting brain numb on daytime TV and be in a state of ill health both physically and mentally.

Instead a real big bonus, I now hope to be fit enough to undergo surgery.....and be able to return to work afterwards. I shudder now, to think "if I HAD imploded"!

The thing is, we are all different, we all tolerate different levels of being uncomfortable, we all have different health related limitations. You can only get medical guidance and as long as you are within the given guidelines, the rest is all down to your own determination and will power. There are marathon runners with a lot less than half your function (no,not me).

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Thank you. Inspiring!

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Hi, Sinclair. This question might seem dumb, but with an Fev1 in the high 80s I'm inclined to ask at what point would you not even rate as having COPD? Running for 20 minutes is quite an accomplishment. I was just tested with an Fev1 of 71 percent and have been trying to jog a little during my prescribed 15 minute walks at the start of my pulmonary rehab sessions. I can jog exactly one lap. That's 1/10th of a mile. Now, I do other stuff as well, like stationary bike, rowing machine, etc. The nurses there do encouraged me to push myself, so I have been trying to make myself uncomfortable. I agree with just about everyone who had done it that rehab is very helpful.

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