Always short of breath? Diagnosed with COPD? There are treatment options beyond inhalers!

If you have been diagnosed with COPD, emphysema, chronic bronchitis or otherwise suffer from persistent shortness of breath and you’ve visited your doctor about your concerns, chances are you left the office with a prescription for one or more rescue inhalers, antibiotics and/or a pamphlet on smoking cessation (for those who currently smoke).

Now it’s true that rescue inhalers do provide short-term relief from shortness of breath attacks (events pulmonologists call “dyspnea” or “exacerbations” depending on the severity of the attacks), but alone rescue inhalers do nothing to reduce shortness of breath, improve lung function or physical conditioning over the long-term.

It’s also true that antibiotics can relieve short-term symptoms associated with upper respiratory infections (shortness of breath, persistent cough and/or sputum secretion), but again over the long term antibiotics do not deliver lasting conditioning/breathing benefits for those with COPD or persistent breathlessness.

And clearly, if you are a current smoker, quitting smoking delivers huge and lasting health benefits and that’s why doctors discuss smoking cessation with patients who suffer from chronic breathlessness. But the reality is that quitting smoking is extremely tough for most people. Of the 43 million smokers in the U.S., approximately 70% express a desire to quit smoking each year, but only about 40% actually try, and of the 40% who try only about 10% of people successfully abstain for at least one year. It is further estimated that the average current smoker will try to quit 8-10 times before achieving permanent cessation.

So what do you do if you want to do more for yourself than wait for the next dyspnea or exacerbation event to occur?

What if you’d like to proactively take steps to reduce shortness of breath, improve your physical conditioning, and improve your quality of life over the long term? What if you’re a current smoker and you have not been able to quit or you are not ready to try again right now – what other options do you have to feel better now?

Are you aware there is a proven COPD treatment for people who suffer from chronic shortness of breath that has over three decades worth of peer reviewed research standing behind its effectiveness in a variety of measures?

  • reducing shortness of breath
  • improving physical conditioning
  • reducing hospital admissions due to exacerbations
  • improving your ability to take on more activities and lead a more fulfilling life
  • slowing down the progression of lung disease

Pulmonary Rehabilitation – It works!

It’s called pulmonary rehabilitation (PR). In short pulmonary rehab combines guided/observed aerobic exercise and strength training, nutrition counseling, breathing technique training, airway clearing technique training and other forms of counseling. For a more robust description of pulmonary rehabilitation and a sampling of research studies demonstrating its effectiveness, click here to visit the “What is Pulmonary Rehab?” page of our website.

PR programs typically run 8-12 weeks in an outpatient clinic setting with patients attending 2-3 times each week over the course of the program for 1-2 hours each session, with the majority of time spent on the aerobic exercise and strength training.

But guess what? Even if you wanted to apply for admission into a local pulmonary rehabilitation outpatient program in your area, you have less than a 1% chance of being admitted! It’s a ridiculous and shameful circumstance. Click here to learn why.

Exercise as Medicine for COPD patients and smokers

For people who are largely sedentary, have low mobility and/or poor balance, find it difficult to walk up a single flight of stairs or otherwise find it difficult to do simple household tasks without needing to rest, the prospect of beginning an exercise program can seem daunting.

But kid yourself not, beyond prolonged exposure to cigarette smoke, the number two risk factor contributing to persistent breathlessness is physical inactivity followed by poor nutritional intake/key nutrient depletion caused by cigarette smoke and poor diet.

So if you want to do more than reach for your inhaler whenever you feel breathless, if you want to stop feeling so tired, and stop feeling frustrated you can’t do simple every-day tasks, we recommend you consider purchasing our Breathe Better for Life guidebook and CD-ROM.

The Breathe Better for Life guidebook provides you specific recommendations on how to start and maintain a better breathing program including exercise and nutrition. It’s patterned on our research of the highly effective COPD treatment called pulmonary rehabilitation and our own deep knowledge of nutrition science. To learn more about the guide and CD contents, please click here to visit the “What’s in the Guide?” section of our website.

If you believe there is more to your ability to live a more fulfilling life than inhalers, antibiotics and oxygen therapy, you owe it yourself to investigate pulmonary rehabilitation. And to be clear, if you can gain entry to a local PR program in your area, we highly endorse your participation. But if you’re one of the 99% of COPD patients that can’t access a PR program we strongly urge you to buy and read our Breathe Better for Life guide and companion CD-ROM. Whether you follow our recommendations or not (in consultation with your physician), starting and maintaining a regular, ongoing exercise program and improving your nutritional intake (through foods and nutritional supplements) are excellent steps you can take on your own to improve how you feel and live!

For some complimentary healthy living tips you can put into action today, read our “Quick Healthy Living Tips for COPD Patients and Smokers” box below. We hope you find these quick tips useful in your pursuit of better breathing.

Quick Healthy Living Tips for COPD patients and smokers:

Beyond quitting smoking, the three simple things you can do on your own to improve how you feel and live right now are:

  1. Walk at least 3 days each week for 30-60 minutes – to achieve the most meaningful physical conditioning benefits, we strongly recommend a pulmonary rehab style exercise program combining aerobic exercise and strength training. That said you can still derive some health benefits by simply starting a regular walking program. A recent study showed that COPD patients who walked at least 20 minutes a day, 3 days a week over a 7 week period improved walking endurance, experienced reduced shortness of breath and reported improved sense of well being. In starting a walking program choose a course (indoors or outdoors) with a flat walking surface and ample seating options in the event you need to stop and rest. For those with poor balance, seek walking courses that offer railings or other forms of hand support.
  2. Eat more nutritious foods and complement your diet with key nutritional supplements that contain potent antioxidants - one puff of cigarette smoke contains approximately 10,000,000,000,000,000 free radical molecules and there is no way the average pack-a-day smoker can consume or produce enough antioxidants to offset the damage done by these pro-oxidative free radicals. New research studies on a range of antioxidants for COPD patients and smokers reveal a direct correlation between tissue/blood antioxidant levels and airway inflammation – a significant contributing factor driving chronic breathlessness.
  3. Get outside in direct sunlight for at least 30 minutes each day – with multiple areas of your skin exposed to the sunlight and do NOT wear sun block that prevents UVB rays from penetrating your skin. Vitamin D deficiency is highly prevalent among COPD patients, asthmatics and smokers. Researchers believe there is a direct correlation between Vitamin D deficiency and airway inflammation. If you can’t get out in the sunlight for 30 minutes each day, consider bolstering your diet with foods that have high concentrations of Vitamin D and/or complement your diet with the nutritional supplement Vitamin D3 (in the form of cholecalciferol).

To learn more about the latest research studies on each of the above healthy living tips, we recommend you visit our Breathe Better Blog by clicking here. You can search our archive of postings on these and other COPD treatment topics by entering key terms such as “antioxidants”, “vitamin D”, “walking”, or other topics that interest you in the convenient “Search This Blog” box on the left hand column of each blog page. Alternatively, you can click on each month of the “Blog Archive” section to scan all of our past postings.

Why is it so hard to gain entry to a pulmonary rehab program?

Several reasons…

Medicare and insurance reimbursement limitations — the Medicare and insurance rules that govern admission into pulmonary rehab programs only provide reimbursement for people with moderate to severe COPD (pulmonologists categorize moderate COPD patients as Stage II and severe COPD patients as Stage III). This means that if you’re just beginning to notice shortness of breath symptoms or if you have been diagnosed with Stage I COPD (considered mild by pulmonology professionals), you will unlikely be admitted to a PR program (unless you are willing to self-pay and the program is willing to admit a patient whose condition is less severe than other potential applicants with more severe COPD). And this is despite clear research findings that demonstrate that pulmonary rehab is valuable for people of any age, physical condition or level of current breathlessness!

Smoking cessation requirement — In addition, even if you have a Stage II or Stage III COPD diagnosis, most PR programs in the U.S. will not admit you if you are currently smoking. Many programs require you to complete a smoking cessation program prior to entry, while others require you to agree to participate in a smoking cessation program during the PR program. Again, these restrictions exist despite clear research evidence that shows that current smokers gain valuable health benefits from pulmonary rehab…not as much as former smokers or never smokers, but still significant benefits. In fact, there is also emerging evidence that participating in a pulmonary rehab program may help increase smoking cessation success rates!

Shortage of outpatient pulmonary rehab programs — Further, there is a growing shortage of outpatient PR programs across the U.S. and those that do exist are primarily centered in large urban and suburban areas where there is enough concentrated population to operate a viable clinic. The primary driver for the shortage of outpatient programs is rooted in economics – hospitals have more profitable outpatient program options they can offer their communities. What do you do if you live in a rural area and there is no PR program around you? What is your option when your local hospital, even in an urban or suburban area, either offers no PR program or has severe limitations on its ability to serve their communities’ full COPD population due to budgetary constraints?

Under-diagnosis & mis-diagnosis — Further still, many people suffering from chronic shortness of breath are unaware they have COPD or have been misdiagnosed and therefore never hear about pulmonary rehab as a treatment option. It is estimated by pulmonology researchers that over 12 million people in the U.S. have COPD but do not have a confirmed diagnosis – that’s a number equal to the total number of confirmed COPD diagnoses…meaning 50% of the people with COPD in our country have no idea they have COPD! Why is this? Three really big reasons:

  1. Many people don’t want to admit they have a breathing problem, don’t visit or talk to their doctor about their symptoms, and don’t discover they have COPD until they land in a hospital due to an acute exacerbation.
  2. Those people who do visit their doctor related to shortness of breath symptoms most often first see their general practitioner. Most GP’s do not screen patients for COPD using a diagnostic test called spirometry and do not refer patients who report shortness of breath symptoms to pulmonologists. Instead, most GP’s prescribe antibiotics, rescue inhalers, discuss smoking cessation and send you on your way. In fact, a number of recent research studies have shown that 30-70% of people who visit their GP with COPD-like symptoms do not receive confirmed diagnoses from their GP (i.e. GPs’ miss a huge percentage of people with COPD). This means that many people with early stage COPD don’t find out they have the disease until they are either Stage II or Stage III.
  3. Spirometry, the gold standard diagnostic test used to diagnose COPD, is often poorly administered and/or poorly interpreted (even by pulmonology professionals). As a result, recent studies have shown that even when spirometry tests are applied, over 30% of people whose spirometry results did not confirm COPD are later shown to have the disease.

For all of the above reasons, there are way too few COPD patients , current smokers/former smokers, and others who suffer from chronic breathlessness who know about pulmonary rehab, what it can do for you, and fewer still that are actually getting into programs.

Oh, and by the way, for the lucky few who do get admitted to a program, the program lasts 8-12 weeks and then they are expected to continue the principles and practices to maintain the benefits gained in the program…but they are often NOT provided adequate materials and support do so on their own and so many “PR graduates” don’t continue their exercise programs post-rehab and lose the benefits gained within one year!
 

Why I created the Breathe Better for Life guidebook:

My name is Kevin Donoghue and I’ve spent the majority of my professional career publishing hard-to-find healthy living advice for people who believe they can do more for themselves than simply take medications prescribed during all-too-often rushed doctor office visits.

I began on this journey to help people who suffer from chronic shortness of breath because when I first learned about pulmonary rehabilitation (PR) and what it can do for people I was absolutely stunned so few people can access an outpatient PR program. Then when I learned the reasons why most people with persistent breathlessness don’t hear of pulmonary rehab, and further learned why it is so hard to gain entry to such a program, I was compelled to write the Breathe Better for Life guidebook and to pair with the companion CD-ROM.

You see it really hit home for me because my 71 year-old father has COPD and when I talked to him about what I’d been researching, he told me that no doctor he had ever seen for his lung conditions ever mentioned pulmonary rehab! Keep in mind my Dad smoked for 40 years before he finally quit in his mid-50’s, had multiple lung surgeries between the ages of 27 and 55, has been diagnosed with emphysema, Stage II COPD, and bronchiolitis obliterans, has a battery of rescue inhalers and standing antibiotic prescriptions …and NOT ONE DOCTOR, NURSE OR THERAPIST ever considered discussing pulmonary rehab with him over the last 30 years? Are you kidding me??? It’s outrageous.

In writing Breathe Better for Life, I spent months reading pulmonology research studies and respiratory medicine textbooks, speaking with the leading researchers and practitioners in the field, attending respiratory medicine conferences to glean the latest treatment developments, and visiting pulmonary rehab clinics around the country to see practice and patients in action first hand.

I’ve instilled my learning into the Breathe Better for Life guidebook and CD-ROM so that you can learn for yourself the secrets of pulmonary rehab. Whether you use this knowledge to demand entry to a local PR program in your area, of whether you use the guide/CD to start a better breathing program of your own at home or at a local fitness center, I believe you will find the information I’ve synthesized on your behalf to be an invaluable resource.

In the guide, I created an aerobic exercise and strength training program based on pulmonary rehab guidelines established by the American Thoracic Society and the European Respiratory Society, exercise guidelines for people with chronic respiratory conditions established by the American College of Sports Medicine, and observations I made of successful program elements drawn from over 100 published pulmonary rehab studies I’ve reviewed over the past year. I then took my guide and asked two prominent pulmonology professionals to review the guide and offer their improvements. The finished Breathe Better for Life guide represents their feedback and improvements.

Please keep in mind that though I’ve developed these recommendations based on the very best medical guidelines and research on pulmonary rehab, you should still consult your physician prior to beginning any exercise program to ensure it is appropriate for your particular situation.

Yours in Good Health,

Kevin P. Donoghue
Publisher,
Breathe Better for Life