Get Thee to Rehab

My rehab boy Dick was back yesterday. It was so good to look at him yet he was a long way from being well. He still felt horrible and was struggling with no stamina but he was there to slowly work out. He said he decided that he would die sitting on his couch if he didn't get moving.

I know that when we are not breathing well, we don't want to push ourselves. I bumped into this article below while searching for portable oxygen systems yesterday. It explains the importance of pulmonary rehab and for those of us with a lung disease to fight to be fit. I thought it was interesting. Get moving. Go to a rehab program. Taking a walk is not enough.

Dear Dr. Bauer, Why is it that I feel so short of breath when my oximeter is reading in the low 90s? It’s confusing.

Dana A., Ormond Beach, FL

Many of my patients with advanced lung disease have asked me why they are still so short of breath even when their oxygen level's in an acceptable range of 90% or better. There are complex reasons for this. It is true that low oxygen levels (below 88%) can be a strong signal to the brain to make us sense air hunger and dyspnea (the medical term for short of breath). Many additional factors also result in the sensation of dyspnea.

We lung doctors often check pulmonary function tests. W e typically measure the Vital Capacity (how much air from the beginning to the end of a breath) and the FEV1 (how much air you can forcefully exhale in one second). Even when your oxygen level is good, when these numbers are low, the body senses dyspnea. The respiratory muscles need to work in overdrive and the brain just gets that feeling of “I’m not getting enough air”. This is why inhalers can be so effective in improving breathing symptoms. They often immediately improve the Vital Capacity and FEV1.

Patients with lung disease are often just not physically fit. This situation comes hand in hand with medical illness as well as advancing age. Walking up the stairs or vacuuming is likely to cause shortness of breath in anyone who has not been used to exercise or is overweight. Exercising and pulmonary rehabilitation are the key here.

Low blood counts (anemia), heart disease (congestive heart failure or irregular heart rhythms) and advanced kidney disease are common conditions that may cause shortness of breath even when lungs are working well. Your doctor tries to make sure all these situations are optimally treated.