Exercise tough but good for COPD patients

Dear Dr. Donohue: My wife’s mobility has been quite limited by her breathing difficulty from COPD — chronic obstructive pulmonary disease. Are there some measures you might suggest that could enable her to start very gradually on an exercise program to build some muscle strength, especially leg-muscle strength? — E.M.

Answer: Emphysema and chronic bronchitis are the two chronic obstructive pulmonary diseases. Most people with COPD have a touch of both illnesses. Emphysema is a destruction of the lung’s air sacs. Shortness of breath on slight activity is its hallmark symptom. Oxygen cannot get into the blood through damaged air sacs, so people are constantly short of breath. Chronic bronchitis is irritation of the airways, the bronchi. Cough with thick sputum is its major symptom.

Exercise isn’t easy for people with COPD, since they become breathless so quickly. Exercise is necessary for the very reason you state. COPD patients tend to sit most of the time. Their muscles become deconditioned, and that’s another impediment to these people being active. Interval exercise usually can be tolerated. On a stationary bike, interval exercise means pedaling somewhat quickly for only 20 seconds and then slowing down for the next 40 seconds.

Repeating these cycles as many times as possible builds muscle strength and helps COPD patients achieve mobility. The same kind of training can be done while walking or swimming. Breathing through pursed lips helps a person with COPD. These people should inhale through the nose to a count of four then exhale through pursed lips to a count of six. Pursed lips are lips held like one would do when whistling.

While exercising, COPD patients should lean slightly forward at the waist to give the lungs more room to expand.

Dear Dr. Donohue: I need to know what is considered normal when it comes to menstrual cycles. Please tell me. — R.K.

Answer: Most women have cycles that last from 21 to 35 days. For 90 percent of menstruating women, bleeding lasts seven days. A little more than 1 ounce of blood (30 to 35 ml) is lost with each cycle. That amount of bleeding requires three to five pads a day.