John's diagnosis hasn't stopped him and his wife from doing all the things they love; life with COPD just looks a little different. In this episode, we learn why diet, exercise, quitting smoking, and other good habits are important to managing COPD. We also chat about pulmonary rehab, which has been life-changing for Jan and others. As always, we share resources to help you live your life on your terms.
For links to resources and information covered in this series, visit our website at HealthUnmuted.com/resources
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Disclaimer: The content provided in this podcast is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast. Reliance on any information provided by this podcast or its guests is solely at your own risk.
[00:00:00] John Linnell: I certainly wish I had not been diagnosed, but I have a very full life. I help people, and I enjoy that so much.
[00:00:11] Jean Rommes: It takes the spontaneity out of things, in a lot of ways. The other part of that, though, is if you get organized, and if you take the time, you can go and do the things that you really want to do.
[00:00:27] Micaela Arneson: Chronic obstructive pulmonary disease is different for everyone. Some cases are more severe than others. But for people like John and Jean, COPD doesn't get in the way of life. It just means life looks a little different.
[00:00:39] Dr. David Mannino: Certainly, if you go back 20 years in time, there was a great deal of negativism that surrounded COPD. And I can say that that has changed. We have better therapies, we have better interventions for not only COPD, but also the diseases that travel along with COPD. Patients are able to live much better and fuller lives.
[00:01:02] Micaela Arneson: This is the COPD Podcast. In this episode, we'll talk about some of the challenges of living well with COPD as well as the lifestyle changes that help people carry on doing the things they love and reduce the risk of more serious illness. As always, we'll share resources at the end where you can learn more. I'm your host, Micaela Arneson.
Keeping healthy with COPD can be challenging in part because it often occurs alongside other illnesses.
[00:01:30] Kelly Becker: I absolutely see overlap with other chronic conditions.
[00:01:33] Micaela Arneson: That's Kelly Becker, a family nurse practitioner in rural Michigan.
[00:01:38] Kelly Becker: What we've learned with a lot of chronic conditions is it comes down to inflammation.
[00:01:43] Micaela Arneson: Inflammation is our immune response to invaders, like germs and physical irritants such as smoke particles, so normally it's a good thing, but long term inflammation can damage healthy cells too and put people at risk for multiple health problems.
[00:01:57] Kelly Becker: Some people will develop issues or may already have issues with obesity or lack of activity tolerance. Cardiac disease also can have to do with inflammation in the blood vessels and put people at higher risk for heart disease and stroke and other issues with veins and vascular health.
[00:02:16] Micaela Arneson: Cardiovascular disease is one of the most common comorbidities of COPD. Diabetes and osteoporosis are also frequent bedfellows, as are sleep disorders and depression.
[00:02:27] Kelly Becker: So if it's difficult to breathe and it's difficult to get out in public, it may be more difficult to get more physical activity and this is a snowball effect. What we often see with this and other chronic diseases is a feeling of isolation, shame and a high percentage of people with depression.
[00:02:48] Micaela Arneson: So what does all of this mean for managing COPD? We asked pulmonologist Dr. Mina Pirzadeh.
[00:02:55] Dr. Mina Pirzadeh: Dietary changes, healthy lifestyle, exercise become super important. Weight loss actually is huge because weight loss will help not only improve your breathing, but also for patients who have sleep apnea, they can actually potentially completely get rid of their sleep apnea if they are able to lose enough weight. And of course, following up with their primary care providers to make sure that all their other health screenings are done.
[00:03:21] Micaela Arneson: And our customary plea, you should always consult a qualified healthcare provider with questions about COPD management or anything else related to your health. This show is not a substitute for formal medical advice, diagnosis, or treatment. It was created for educational purposes only.
Dr. Pirzadeh’s healthy lifestyle tips apply to all of us, but for people with COPD, things like eating and exercise require a bit more thought and planning.
[00:03:48] Stephanie Williams: With COPD, the lungs expand, pushing the diaphragm down into the abdomen.
[00:03:54] Micaela Arneson: Stephanie Williams is a respiratory therapist. And she says many dietary changes are necessary because some foods can make symptoms worse and force the body to use too much energy during digestion.
[00:04:06] Stephanie Williams: You don't want them to eat foods that cause a lot of gas in the stomach because that's going to push up on the diaphragm, causing those feelings of shortness of breath. We also need to avoid foods that are heavy in simple carbohydrates. So things that are sugary or really starchy. Things that don't break down well. Those foods build carbon dioxide up in the blood that just makes them have to work harder to exhale that carbon dioxide out. So what we encourage people to do is to eat multiple small meals throughout the day.
[00:04:40] Micaela Arneson: As Kelly and Dr. Pirzadeh said, nutrition is important because some people with COPD struggle with being overweight. But others have the opposite problem.
[00:04:49] Mike Hess: We see sometimes people losing weight inappropriately. People who are too tired during the eating process. By the time you do the shopping and the food prep, you're simply too tired to eat. And then there are folks that simply can't get enough calories because when you're working that hard to breathe all the time, your metabolism can sometimes accelerate a little bit.
[00:05:09] Micaela Arneson: Mike Hess is also a respiratory therapist, and he recommends people consult their health care provider to figure out a nutritional plan that works best for them. But, in general, a good diet includes a few basic things.
[00:05:21] Mike Hess: Some general rules of thumb are to eat things that are relatively dense in good nutrients. Protein, healthy fats. The healthier kinds of peanut butter have some good fats and they're relatively easy to eat and to digest.
[00:05:33] Micaela Arneson: The COPD Foundation also recommends avoiding lactose, processed foods, and fatty foods.
[00:05:41] Jean Rommes: I pretty much changed the way that I cooked and that I grocery shopped.
[00:05:48] Micaela Arneson: Jean Rommes was diagnosed in 2000, but it wasn't until a couple years later when she was hospitalized with a flare up that she decided things really needed to change.
[00:05:58] Jean Rommes: When I got out of the hospital three days later, I decided I will do a diet. I have been heavy all my life, and I had never been very successful, ever. I learned to use ground turkey, lots of vegetables, lots of low-fat meats, fruit. I started with the diet, and about a week into it, I realized I gotta do more than this. I need to exercise.
[00:06:22] Micaela Arneson: An exercise regimen, like a diet, should be designed with a person's unique needs and abilities in mind. But any program will include a couple key components.
[00:06:31] Mike Hess: A good exercise program is always going to start with stretching. It gets your muscles ready, plus it avoids injury in your joints. We want to improve aerobic capacity so that you're able to do the things that you enjoy for longer. Finally, we want to work your muscles because the stronger your muscles are, the more efficiently they're able to process oxygen.
[00:06:51] Micaela Arneson: If you're someone with COPD and you haven't done much exercise in a while, it can feel a little intimidating to get started. Breaking your program down into manageable steps and finding a strong motivator can help.
[00:07:02] Mike Hess: With any exercise program, it's important to set some goals. Like, I want to go check my mail and come back without hitting my rescue inhaler a half dozen times. I want to be able to go see my grandchild's wedding in a couple of months. It's really important to have that thing that you're striving for.
[00:07:18] Micaela Arneson: After her exacerbation, Jean felt really motivated to push herself to lose weight. So she consulted her doctor.
[00:07:25] Jean Rommes: They said, look, the only thing you need to do is make sure that your oxygen saturation levels are 95 or better. When you're exercising, you don't have any heart problems and you don't have any arthritis, there's no reason why you can't exercise as hard as you want to.
[00:07:41] Micaela Arneson: Jean started to do aerobic exercise and strength training, and she soon found that her body was capable of more than she thought.
[00:07:48] Jean Rommes: I had an exercise bike, so I would use that 20 minutes in the morning, and then 20 minutes after I got home. I decided I needed a treadmill. So I got a treadmill, I'd be on the treadmill at 5:30, and I'd walk for 45 minutes, 45 minutes in the afternoon, and then, usually, three times a week, I would do some weight kinds of things. After 18 months, I'd lost well over 100 pounds and I was probably in the best shape I'd been in since I was maybe 25.
[00:08:20] Micaela Arneson: Breathing also became a little easier, as Jean's lung function improved to roughly the level she was at before she was diagnosed. While Jean's regimen has since changed, exercise is still crucial to doing the things she loves.
[00:08:33] Jean Rommes: The Des Moines Metro Opera had their summer season. I hadn't been in so long and it was kind of scary. We had to drive down to Indianola. I have to find a parking place. I have to walk. I got short of breath walking up the steps. It was a little frightening. There were some things that I wasn't really thrilled with, but I did it and it worked just fine.
[00:08:55] Mike Hess: A lot of times we get caught up in the notion that exercise has to be on a treadmill, on an exercise bike, and obviously sometimes those things are a little bit out of reach for folks who have these breathing problems. Exercise can be very simple as well.
[00:09:10] Micaela Arneson: Really, it's most important to just stay active because the less you do, the less you're able to do. John Linnell and Jan Cotton have figured out programs that work best for them.
[00:09:20] John Linnell: I'm not one to hop on the treadmill all the time, but we have pets. I'll walk my dog. That's exercise.
[00:09:29] Jan Cotton: Each day, no matter what, if it's only 10 minutes, I'm going to do my weights, or I'm going to do something for the bottom half of my body with legs, arms, or whatever it takes.
[00:09:39] Micaela Arneson: If you're on oxygen therapy, talk to your doctor about how you should be using oxygen when you exercise. And as always:
[00:09:46] Mike Hess: Listen to your body. You really don't want to overextend yourself. And if you do run into some trouble, never hesitate to contact your clinician.
[00:09:55] Micaela Arneson: People with COPD also have to be very careful about contracting illness. This is because germs and viruses can cause lung infections or exacerbations, a sudden worsening of symptoms like the one Jean had.
[00:10:07] Jean Rommes: You take your medications and you get your vaccines and you stay away from people with bugs. And if you do get something, you get to your doctor as quickly as possible and get some treatment.
[00:10:21] Mike Hess: Annual vaccinations are an essential part of trying to avoid exacerbations. Get your flu shot, get your pneumonia shot, get your COVID 19 shot, get everything you can to avoid getting sick in other ways, which can bring on COPD flares.
[00:10:39] Micaela Arneson: Life for people like Jan was hard enough before the COVID 19 pandemic, but the need for hand sanitizers and masks increased dramatically. And having a lung disease during that time was paralyzing for her.
[00:10:51] Jan Cotton: I was so afraid. I didn't know what to do. I couldn't go out of my house. I was afraid to let anybody in the house. And because of the stresses of COVID, I had several exacerbations and had to end up in the hospital. And that's exactly where I didn't want to end up.
[00:11:06] Micaela Arneson: The virus also made it difficult for Jan and others to keep up with their exercise, diets, and other wellness routines. And like many of us who turned to familiar habits to cope with the stress of the pandemic, some people with COPD picked up smoking again.
[00:11:20] Jan Cotton: COVID really did hit hard for COPDers. No exercise, didn't care about nutrition. People said that COVID had just really made them just stop dead in their tracks.
[00:11:34] Micaela Arneson: If you or someone you love is struggling with fear and anxiety, talking to a mental health professional can really help. After all, living well with COPD is about more than just your physical health.
[00:11:45] Jan Cotton: Thankfully, I had a counselor that I could talk to, so they helped me through some things, and I'm just getting back to where I used to be.
[00:11:54] Jean Rommes: I'm extremely lucky in that I have a therapeutic relationship with a clinical neuropsychologist that I have known for the last 25 years. That is really critical to my functioning, knowing that I have a place where I can talk about anything I want and it's safe.
[00:12:13] Micaela Arneson: In episode one, Mike Hess also recommended a few other practices that can help reduce stress and anxiety, not only for people with COPD, but for loved ones and caregivers.
[00:12:24] Mike Hess: Exercise and stretching, taking some time to relax, maybe doing a little meditation, listening to some good music, and also make sure that you're talking to friends, families, caregivers, counselors, peers, whoever it is. Make sure that you're maintaining those lines of communication and support.
[00:12:41] Micaela Arneson: And Stephanie says that learning about your condition can make you feel empowered and in control of your health.
[00:12:46] Stephanie Williams: Get a lot of education and information for yourself. The more you know, the better questions you can ask, the more involved you can become in your treatment. That really will help your healthcare team find the best treatment or combinations of treatments for you.
[00:13:02] Micaela Arneson: That's a perfect segue to talking about resources. You can find links to them and more at our website, healthunmuted.com/resources. Firstly, the COPD Foundation has a free document called the My COPD Action Plan, which helps people keep track of changes in their condition, remember when to take their medication, and what to do in the event of an exacerbation. Having that information written down in one place is also helpful for a person's loved ones and care team.
[00:13:29] Jan Cotton: It's all there for my doctor to see. What questions do I need to ask him? Everybody needs an action plan. You cannot live with COPD and be on the edge 24/7.
[00:13:42] Micaela Arneson: The COPD Foundation also has a smartphone app called the Pocket Consultant Guide, with exercises for a wide range of abilities. If you're interested in pulmonary rehab, a structured, monitored exercise program that we talked about in an earlier episode, talk to your healthcare provider. And for more on nutrition, the Cleveland Clinic and Temple Health have excellent tips on what foods to eat and what foods to avoid. Finally, if you need some extra support, check out COPD 360 Social run by the COPD foundation or any of their free monthly support groups, which cover a variety of topics. And remember they're not just for people with a diagnosis. Loved ones, caregivers, and really anyone affected by lung disease are welcome.
This is the COPD Podcast hosted by me, Micaela Arneson. This show is part of the Health UNMUTED audio library by Mission Based Media and created in collaboration with the COPD Foundation. To listen and learn more, visit healthunmuted.com and follow our show on your favorite podcast player. There are still many questions to answer about COPD, so please do keep listening.