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BETTER LIVING WITH EMPHYSEMA

Emphysema and other lung conditions cause shortness of breath that can interfere with normal life. This disease can affect you quite slowly, so you simply slow down and avoid activities that trouble you and you lose fitness and strength. It can eventually get you down to the point where your role in the family changes, or you can no longer go to your favourite sporting events. You may think it's your own fault because you have smoked- especially when friends, the doctor, or even your family may stress this point.

How important is it to stop smoking?

It is true there's no cure for emphysema. But if you stop smoking your cough will ease up, and your breathing function won't continue to worsen so quickly. If you can't stop smoking on your own, ask for help. Your doctor or a state Quit program can always help.

Can stress play a role?

Most people who have emphysema worry about their future, panic when they lose their breath, or feel frustration, irritability and depression about their poor physical performance and changing bodily image. These emotions can cause a lot of distress. However, if you can learn more about your lungs and why you become short of breath, it is possible to get rid of fear of the unknown and to cope better .

You need to know that it's normal to get stressed from time to time. When your body is under stress you might feel your heart pumping harder and faster, you tremble inside, you flush and perspire, you might even feel nauseous. This is a normal body reaction. If you let it get on top of you, a stage of fatigue and even fear sets in. Or you become angry, stubborn, or start to blame others.

Often this feeling seems to overwhelm you, but it can be turned to your advantage. If you know that feeling like this is normal you can learn how to relax and control your breathing, your mind can become a master of your body. Deliberately slow your breathing. Concentrate on using your diaphragm by expanding your stomach as you breathe in. When you breathe out, try pursing your lips to slow the rate of breathing. Put yourself in the most comfortable position you can, and make sure your arms are supported so your shoulder and chest muscles help your breathing. Close your eyes and imagine you are in your favourite place of relaxation. Each time you breathe out, imagine the tension also being breathed out. Practise positive thinking.

If you need further help with these stress-management techniques your doctor or health centre should be able to find help for you.

Which medicines are likely to help me?

Your doctors will usually prescribe medicines, often in the form of inhalers or puffers. These puffers either open the breathing tubes in your lungs (bronchi), or stop them from closing down. They are used for treating asthma, and can also help in emphysema.

In case you don't notice much immediate benefit from these medicines, don't be discouraged.

How important is exercise?

You might have noticed that your ability to carry on normal daily activities and chores has deteriorated. It's easy to give in to the feeling of breathlessness. After all, you probably feel quite well when you are resting. But this can lead to a vicious cycle of inactivity, so you lose fitness and muscle strength, and this makes exercising all that much harder.

So what can you do about it? Start with a short walk, counting your steps and the number of breaths- perhaps two slow steps as you breathing and four as you breathe out through pursed lips. Don't go too far: and stop to rest if your breathing starts to feel uncomfortable. Wait to recover, then walk on. Try this for 15 minutes every day. Measure the distance and set a realistic goal to better that distance next week. Don't rush it, just do it.

If the weather is bad, drive to a large shopping centre and walk there. As you improve you might even like to try a few steps on the stairs or escalators. Some people buy or hire a treadmill or an exercise bike. Whatever you do, make sure you enjoy it. Do it with your wife or husband, your children, grandchildren, confidence and fitness and strength to go to your favourite sport, or the movies or a theatre show. Or try a swing or two of the rusty golf clubs, or take out the dusty bowls.

Your breathing muscles also need a regular work-out. The lower ribs and upper abdomen help the diaphragm. The shoulder and upper chest muscles also add to breathing power. A simple set of exercises can be done to strengthen them.

Guidance can be given by some physiotherapists.

Is nutrition important?

If you are overweight it is hard to move around. Shifting extra Weight takes so much more energy you become more breathless. Excess weight also squashes you lungs, making the problem worse. Even though you might find it hard to exercise to burn off the excess weight, it is still possible to lose weight slowly if you watch what you eat. Eat smaller portions at each meal, reduce the amount of fat you eat, fill up on high fibre foods, don't snack between meals, and keep a good balance to your food.

If on the other hand you start to drop below your ideal weight your muscles lose strength. You need to keep up your nutrition, even if you don't feel hungry or you lose breath whenever you try to eat. It often helps to eat small snacks, and to eat more often. Maintain a good balance between food groups. Keep your fat intake low, but remember that proteins and carbohydrates are essential. Fresh vegetables and fruit maintain the carbohydrates as well as important vitamins. Fish contains plenty of protein and also important protective oils.

Your doctor, health centre or hospital will be able to point you towards good dietitian advice.

How could pulmonary rehabilitation help me?

All these treatments can be combined together in a team approach . Respiratory rehabilitation programs improve shortness of breath, give a feeling of control, ease both anxiety and depression, reduce fatigue, make exercise easier, and make overall quality of life better. A series of small group classes helps to improve your understanding about your lung condition and its treatment (including drugs and diet), about exercise and control of stress, and teaches new ways of doing normal chores with less stress or breathlessness. Working with others with similar problems helps you and them. You all try to solve the problems in your own ways. You might be able to help each other socially or with transport or shopping. Exercise classes are also included to help with your own individual goals.

There are respiratory rehabilitation programs in each state. Your doctor, hospital or health centre will be able to refer you. You will also be able to find these programs through patient support groups and the Australian Lung Foundation's LungNet. You can find out where your nearest patient support group is located by ringing LungNet on 1800 654 301 (toll free).

The methods mentioned above should help to set up a new way of living with your emphysema. With practise, your new habits will become second nature. But you need to keep up the practise or you will start to become worse again. You will probably benefit from discussion with your doctor, especially if you forget something you have been taught or shown. The physiotherapist, pharmacist, specialist nurse, counsellor, or a rehabilitation program could also help. It's a good idea to make sure you have regular appointments with your doctors so your health can be monitored, and so you won't forget what to do.

Above all, try not to hibernate. Go out and enjoy yourself. Keep up your exercise and maintain good eating habits. Support groups may be just the thing for you and your closest carer (wife, husband, etc.) as they encourage and assist people with emphysema, and often arrange regular meetings with experts, or trips to interesting places. If it's hard to get out, try to find some things you can do at home to occupy your time and add happiness to your life. Don't forget that there are patient support groups in each state: contact the Australian Lung Foundation 's LungNet on 1800 654 301 (toll free) for further information about these groups.

Please Note: This information is intended by The Australian Lung Foundation to be used as a guide only and is not an authoritative statement. Please consult your family doctor or specialist respiratory physician if you have further questions relating to the information provided here.