7. Pulmonary Rehabilitation for COPD
Although not a medication, pulmonary rehabilitation can be very helpful for people with COPD. It is a program that has been designed to help all people with breathing difficulties – those with COPD, sarcoidosis, pulmonary fibrosis, and cystic fibrosis, for example.
Pulmonary rehabilitation is not a replacement for medications that may have been prescribed. Rather, it may be prescribed by a physician and then utilized in conjunction with medical therapy.
Here are some things you may learn in pulmonary rehabilitation:
- Exercises to strengthen your lungs.
- The fundamentals of nutrition to help prevent exacerbations.
- Education about your specific lung condition and how to manage it.
- Tactics on how to conserve energy.
- Breathing strategies.
- Counseling and/or group support.
Pulmonary rehabilitation typically involves a team of practitioners. You may work with nurses, dietitians, doctors, respiratory therapists, physical therapists, occupational therapists, psychologists, and social workers.
It is also important to note that pulmonary rehabilitation is a long-term commitment – which is what makes it effective. This long-term commitment is an outpatient program, and it is individualized to each individual. Your pulmonary rehabilitation treatment program will likely be different than another person’s because each of you has different needs.
Not only will your program meet weekly with the disciplines that we have discussed, but you will have exercises and different lifestyle changes that you will carry out at home, as prescribed by these disciplines.
The goal of pulmonary rehabilitation is to improve your functioning and your quality of life, as well as relieve some of your breathing problems.
The benefits of pulmonary rehabilitation are multifaceted. According to the National Heart, Lung, and Blood Institute, benefits include:
- A possible reduction in anxiety and depression
- An improvement in the quality of life
- Better functioning in daily life
- An increase in the ability to exercise
- A reduction in symptoms of COPD
There is little risk to pulmonary rehabilitation, but if you have a heart condition, you should ensure that your physician has recommended pulmonary rehabilitation and has cleared you for exercise first.
Can Diet Help your COPD Symptoms and Prevent Exacerbations?
And what about making dietary changes? Can changing what you eat to improve your COPD symptoms?
Well, the answer is yes – and no.
No, changing what you eat each day won’t necessarily magically improve your breathing (wouldn’t that be amazing though?) However, it is well established that food is fuel. We need fuel in order to do everything that we do on a daily basis – walk down the hallway, prepare our medications, hug our grandchildren, drive our cars, and even breathe.
The specific foods that you eat provide your body with nutrients (macronutrients include carbohydrates, fats, and proteins) – at a very basic level, these macronutrients aid in cellular metabolism, which produces energy. This energy is what powers the body.
In addition, proper nutrition also helps the body to prevent and fight infections, which people with COPD are prone to developing.
A healthy diet can also help to maintain weight. Being overweight means that the heart and lungs must work harder in order for breathing to occur. Being underweight can also make you more prone to infections.
So, what constitutes a proper diet for someone with COPD? You should discuss this with your physician and a registered dietitian (RD), but here are some general guidelines:
- Discuss your calorie needs. If you are overweight, you may need to lose weight. If you are overweight, you may need to gain weight. Due to the exertion of breathing, you use more energy. In fact, people with COPD may require up to 10 times – yes, ten times! – as many calories as someone without COPD. An RD can help you figure out how to obtain all of your necessary calories so as to maintain your pulmonary muscles.
- Stay hydrated. Unless your physician has told you otherwise, you should consume six to eight glasses of non-caffeinated beverages daily. Staying hydrated keeps mucus secretions thinner and easier to cough up. Caffeine should be limited because it may interact with certain medications.
- Foods that are rich in fiber should be consumed. A general guideline is 20 to 25 grams per day. Examples of fiber-rich foods include fruits, vegetables, legumes, and whole grains. Why is fiber so important? For multiple reasons – it can help to control glucose levels, help move food through the digestive tract, and may even reduce blood cholesterol levels.
- Curtail your sodium intake. I know, I know – I love the salt shaker too! But too much salt can cause fluid retention, and fluid retention can make it more difficult to breathe. Experts recommend removing the salt shaker from your home completely! You can replace the salt shaker with fresh herbs, salt substitutes, and ensure that when you purchase foods, that you’re not buying anything that has over 300mg of sodium.
For more in-depth recommendations, you should meet with your physician and an RD.
Emergency Treatment for COPD Exacerbations
What if you’ve taken all of your medications as prescribed, you’re in pulmonary rehabilitation, you eat a healthy diet – and you think you’re in the midst of a COPD exacerbation? What should you do?
First, you should know the symptoms of a COPD exacerbation. Symptoms include:
- Breathing that is fast and shallow
- Shortness of breath with minimal activity
- Excessive sleepiness
- Coughing that is powerful
- Confusion
- Having oxygen saturation levels that are lower than normal
- An uptick in mucus production
- An increase in wheezing
If you notice these symptoms, you should notify your physician right away. Your physician can assess your symptoms and decide if the symptoms are treatable at home, or if you must seek emergency medical attention.
If you have any doubts about waiting to speak with your physician, you should always seek emergency medical attention.
It is not uncommon for someone to require hospitalization for a COPD exacerbation. This will depend on the severity of the exacerbation, as well as the cause. In extreme circumstances, someone with a COPD exacerbation may require ventilatory support until the inflammation in the lungs has improved.
Prevention of exacerbations is important; taking all medications as prescribed is one of the most important things you can do to prevent exacerbations. Here are some other tips on preventing exacerbations:
- If you are still smoking, quit now!
- Stay up-to-date on vaccinations. Influenza and pneumonia are particularly dangerous for people with COPD.
- Perform hand hygiene diligently. Proper hand hygiene can prevent viral and bacterial infections from occurring. This can be in the form of soap and water or hand sanitizer.
- Get plenty of sleep – well-rested people are less likely to get ill.
- Avoid COPD triggers, such as pollutants and irritants.
- Stay away from people who are ill, especially during cold and flu season.
The Bottom Line
Unfortunately, due to the unpredictability of COPD, it can be a tricky disease to treat. Fortunately, there are a variety of COPD treatment options available.
