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Give Me Ten

Exercise can help restore normal lung function

By DAVID NORRIE
Published April 1, 2005


We do it while working, while playing and even while we sleep.

We breathe. Our lungs distribute life-giving oxygen to all parts of our body 24 hours a day, 365 days a year until the moment we take our last breath.

When you stop to truly think about it, it's almost too immense to contemplate, this process that many of us take for granted. That is, until the day when life's most basic function is no longer basic. The day when taking a breath becomes laborious and requires effort.

More than 24-million adults have been diagnosed with impaired lung function, reports the U.S. Centers for Disease Control. Those diseases that affect our breathing include bronchitis, asthma, and emphysema. The U.S. Department of Health and Human Services lists chronic obstructive pulmonary disease as the fourth leading cause of death. Between 1980 and 2000, the death rate among women 45 and older tripled, while such deaths among men increased by 15 percent.

Symptoms include shortness of breath while performing simple everyday tasks, and increased mucus, or that phlegmy feeling. A Spirometry test is the best way to identify pulmonary disease. While the statistics are cause for alarm, the good news is chronic obstructive pulmonary disease is for the most part curable, if not totally avoidable through education and exercise.

Not surprisingly, 82 percent of pulmonary diseases are directly related to cigarette smoking. Despite the enormous antismoking campaign of recent years, more Americans die from lung cancer than from breast, prostate and colorectal cancers combined. And more than 85 percent of all diagnosed lung cancer is related to smoking, with some comparing nicotine to heroine in its addictive qualities.

"If you smoke until the age of 45, you have a 50 percent more likelihood of being dead by the age of 62," said Warren Rose, Critical Care Program Leader and Registered Respiratory Therapist at the James A. Haley Veterans Hospital. "Cigarettes are the only product you ever see that advertises not to use it. You don't see Mercedes saying, "call us and we will tell you why not to buy our product.' "

Working in the veterans hospital, Rose sees patients who grew up on cigarettes, unaware of the damage they were doing to their lungs. He says that while heart disease may still be the nation's leading cause of death, it may be easier to combat than pulmonary disease.

"I don't want to minimize cardiovascular disease," Rose said. "But which is easier, to take a cholesterol-lowering medication or kick smoking?"

While bronchitis and asthma aren't as directly related to smoking as emphysema is, they contribute to loss of lung function as well. People with lung disease typically require about 40 percent more energy to breathe at rest than a normal person. Labored breathing causes those afflicted with pulmonary disease to actively lift the chest wall to inhale, taxing the muscles in the shoulders, ribs and the neck.

"Your lungs are working so hard to distribute oxygen, it's like being a distance runner at rest," Rose said. "So you're never truly at rest."

The American Council on Exercise outlines specific exercise programs to help pulmonary patients restore their normal lung function.

STEP 1: Breath retraining. This requires placing a hand over the belly while allowing the stomach and chest to rise at the same time with the shoulders relaxed during inhale. Then simply exhale with pursed lips as if trying to whistle. Repeat this procedure for several minutes each day.

STEP 2: Walk test. Before starting an exercise program, measure the distance you can walk at a normal pace in six minutes. Then, begin exercising twice a week with supported arm exercises and cardiovascular work, either walking or riding a bicycle. You may need to start with short sessions of two to three minutes. Continue for 8 to 10 weeks for a total of 24 to 30 sessions, or an average of three times per week. Increase intensity and duration of exercise gradually, then test yourself again for six minutes to judge improvement.

STEP 3: Exercise. People suffering from pulmonary disease often have difficulty with trivial tasks such as tying their shoes or reaching for something above their heads. These movements cause odd distortions of the torso and increased pressure of the abdomen, resulting in more laborious breathing.

Doctors recommend exercises that support the arms as to put no additional pressure on the abdomen or lungs. If riding a stationary bike, support arms and elbows on the handlebars. The same goes for treadmill work. Always support the arms away from the body to open lung capacity.

Exercising in water is an excellent source of movement for pulmonary patients. Water is 1,000 times denser than air, and therefore provides resistance to develop muscular strength and endurance. The water also supports the arms and alleviates pressure around the core of the body.

Always consult a physician, take precautions during exercise and look for warning signs such as chest or arm pain, increased ankle swelling, nausea and excessive fatigue one to two hours after exercise.

For additional information go to the American Lung Association Web site at www.lungusa.org or contact the Pulmonary Rehabilitation Centers at either Tampa General or St. Joseph's Hospital.

David Norrie of Tampa is a freelance sports writer when he isn't helping people get in shape. He writes an occasional column about recreational sports and personal fitness. E-mail him at gimmie10@aol.com

[Last modified March 31, 2005, 08:54:10]


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