Lovego weekly report-Pulmonary rehabilitatio

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Weekly report

Pulmonary rehabilitation 

Pulmonary rehabilitation is an integral part of the clinical management and health maintenance of those patients with chronic respiratory disease who remain symptomatic or continue to have decreased function despite standard medical treatment. Especially, it is widely advocated for people with chronic obstructive pulmonary disease (COPD) to reduce breathlessness, improve exercise capacity, symptoms, and quality of life. 

Pulmonary rehabilitation includes two parts, excercise training and patients education. Of course,other support like psychosocial/nutrition advices will be provided as well.

For the patients education, the related organizations or societies will plan some classes to teach you about the lung, about the COPD, about how to take the mideicine propertly,how to do exercise, how to reduce the shorts of breathness, how to cope with the negative feelings and fight with the desease ect. What’s more, during the education, you will meet the people with similar problems, you can get a social support.

Unlike the education, the exercise will be took more time and need your insist during your daily life. It is the most important part of any program.When you’re in the Pulmonary Rehabilitation Program, you will get a detail plan for the daily excercises( both the arms and legs), which contains the lower limb endurance exercise training/ home exercise program and other trainings(like Upper limb endurance and strength/ Lower limb strength ect)

The Program will help you live a much better life. If you have the change,pls go ahead.

If you don’t have the chance,then you can try some excersice by yourself, quit smoking,learn about the COPD, exercising regularly. Such walking,which is one of the most important exercise.  Pls review below self-plan:

“Begin walking slowly at a very comfortable pace for a period of time (say 5 to 10 minutes daily), 3 to 5 days a week. Do not increase the time you are walking until you can walk the entire time without stopping. When you can walk without stopping to rest, increase the time you are walking by 1 to 2 minutes each week. For example, if you can walk nonstop for 5 minutes a day for five days in one week, increase your walking to 7 minutes each day. Many people with severe lung disease can reach the goal of walking 30 minutes without stopping. Some people with lung problems require oxygen during exercise. If you have been prescribed oxygen for regular use, be sure to use it with exercise. If you aren't sure about using oxygen, talk with your health care provider. Some of the resources listed below may help you either find a program or provide you with more information about lung conditions.”

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Lovego weekly report-Diaphragmatic breathing

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Diaphragmatic breathing

Last week, we talked about the Pursed lip breathing, which is the most common breathing excersise to control the short of breath. Besides the Pursed lip breathing,the other technique that your doctor may teach you is diaphragmatic breathing.

Diaphragmatic breathing is done by contracting the diaphragm, a muscle located horizontally between the chest cavity and stomach cavity. Air enters the lungs and the belly expands during this type of breathing.This deep breathing is marked by expansion of the abdomen rather than the chest when breathing. It is considered by some to be a healthier way to breathe, and is considered by some a useful form of complementary and alternative treatment.

To practice this technique, you can lie down or sit on the chair/sofa

• Lying down on the bed or floor

1. Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe. 

2. Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible. 

3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see "Pursed Lip Breathing Technique").The hand on your upper chest must remain as still as possible.

                        

• Sitting on the chair

1. Sit comfortably, with your knees bent and your shoulders, head and neck relaxed.
2. Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
3. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
4. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see "Pursed Lip Breathing Technique"). The hand on your upper chest must remain as still as possible.

For prictising this techque,suggest 3-4 times per day,and each time for 5-10 minutes.

Below is a video from youtube introduing how to do it

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Tel:86-0755-23733851
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Lovego Weekly report--Pursed-Lip Breathing for COPD

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Weekly report

Pursed-Lip Breathing for COPD

When suffering from the COPD,shortness of breath is a main syptom and maybe happen everyday.To control it,the breathing excersise will be helpful.

One of the most common and simple way is pursed lip breathing.By doing it,you will breath more fresh air and reduce your anxiety,Also,It provides a quick and easy way to slow the pace of breathing, then making each breath more effective.

The following steps are how this way is done:

1.Relax your neck and shoulder muscles.
2.Breathe in through your nose while counting to three.Keeping mouth closed and don't take a deep breath,a normal breath will do.
3.Pucker or "purse" your lips as if you were going to whistle or gently flicker the flame of a candle.
Breathe out (exhale) slowly and gently through your pursed lips while counting to four. It may help to count to yourself: exhale, one, two, three, four.

Exhale

Pucker or purse

Inhale

With regular practice, this technique will seem natural to you.Of course below tip shall be kept in mind while practising:

Do not force the air out.
Always breathe out for longer than you breathe in.
Breathe slowly, easily, and relaxed ... in and out ... until you are in complete control.

Here recommending a video made by Michael Riser,pls review

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Lovego Weekly report--Coping with COPD Depression and Anxiety

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Weekly report

Coping with COPD Depression and Anxiety

Depression and anxiety are the common psychological characteristics for people who suffer from the COPD. Studies show depression and anxiety can increase the number of flare-ups you experience and increase your risk of requiring hospital treatment for your COPD. And the percentage of COPD patients are 10%-96% for anxiety, 16%-88% for depression. They are obviously higher than normal people.

As high COPD incidence and high mortality, longer duration, heavy economic burden on patients, seriously affect the ability of patients to work and quality life of patients, these make the patient been negative easily. They will become worry or panic. We know for COPD patients,almost any activity can lead to breathlessness—walking, socializing with friends, even eating—these further add to depression and anxiety.

These two negative feeling always worsen the syptoms of COPD, to feel better,pls try to take the following steps:

Get medical help. Both depression and anxiety can be treated. When you feel anxiety or depression, you can go and talk to your doctor how you are feeling.
From the doctors,they may prescribe an antidepressant for you, it will be helpful; Some patients may have took it;
From the psychotherapist, they will help you to gain an understanding of how to respond to things that allows you to cope better with depression;
From the behavioral therapist, they also can teach important relaxation and breathing techniques to you.People with COPD tend to breathe shallowly, which can lead to rapid breathing, lightheadedness and anxiety. But you can learn to breathe more deeply by inhaling, letting the belly fill, expanding the diaphragm, then exhaling, relaxing the stomach.

Join Support groups. There are many groups which offer education of the desease and provide access to others with the same situation. Everyone diagnosed COPD will have a bad time some day, bad feeling, losing hope, not confident with the life, ect. Join the groups such as in the real life,on the facebook, some forums, you can see how others battle with the COPD,how they share the daily life,ect. You can gain courage from them

Pulmonary rehabilitation and exercise. Pulmonary rehabilitation sessions can offer both exercise and information. An expert said, “We talk to patients about thinking creatively about what they can and can’t do.For instance, if a patient loves to garden, he could have a family member help build the garden off the ground so he won’t have to bend over, which can limit breathing. “It’s part of reframing your response to COPD.We will introduce more in the following reports.

Exercising regularly. Working with your exercise trainer who familiar with COPD. Creat a plan to do the exercise, insists on it. After a couple of months, you will feel better

Do things you enjoy. Even though your COPD symptoms may make it harder to participate in many activities, it is important to find things you can do that you enjoy. Taking time out for yourself can help lift your mood.

For a self test the depression and anxiety,you can take Hospital Anxiety and Depression Scale (HADS),Pls visit the last blog.

If you are experiencing any of the following thoughts and symptoms, you may be depressed as well :

· Sadness

· Anxiety

· Emptiness

· Guilt

· Worthlessness

· Helplessness

· Hopelessness

· Irritability

· Disinterest in activities that were once enjoyable

· Fatigue

· Trouble concentrating

· Sleep problems

· Appetite changes

· Thoughts about death or suicide

· Unexplained physical symptoms

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Tel:86-0755-23733851
Add: Building B, LC Hi-tech Park, Longhua District, Shenzhen, China

Hospital Anxiety and Depression Scale (HADS)

Hospital Anxiety and Depression Scale (HADS)

Patients are asked to choose one response from the four given for each interview. They should give an immediate response and be dissuaded from thinking too long about their answers. The questions relating to anxiety are marked "A", and to depression "D". The score for each answer is given in the right column. Instruct the patient to answer how it currently describes their feelings.

A I feel tense or 'wound up': 

Most of the time                                     3 

A lot of the time                                     2
From time to time, occasionally            1
Not at all                                                0

D I still enjoy the things I used to enjoy: 

Definitely as much                                0
Not quite so much                                 1
Only a little                                           2
Hardly at all                                          3

A I get a sort of frightened feeling as if something awful is about to happen: 

Very definitely and quite badly           3
Yes, but not too badly                          2
A little, but it doesn't worry me           1
Not at all                                              0

D I can laugh and see the funny side of things: 

As much as I always could                   0
Not quite so much now                         1
Definitely not so much now                  2
Not at all                                               3

A Worrying thoughts go through my mind: 

A great deal of the time                         3
A lot of the time                                    2
From time to time, but not too often     1
Only occasionally                                 0

D I feel cheerful: 

Not at all                                                3
Not often                                                2
Sometimes                                             1
Most of the time                                    0

A I can sit at ease and feel relaxed: 

Definitely                                             0
Usually                                                 1
Not Often                                             2
Not at all                                              3


D I feel as if I am slowed down:

Nearly all the time                            3
Very often                                         2
Sometimes                                        1
Not at all                                           0

A I get a sort of frightened feeling like 'butterflies' in the stomach:

Not at all                                         0
Occasionally                                   1
Quite Often                                     2
Very Often                                      3

D I have lost interest in my appearance:

Definitely                                                 3
I don't take as much care as I should       2
I may not take quite as much care           1
I take just as much care as ever               0


A I feel restless as I have to be on the move:

Very much indeed                                  3
Quite a lot                                              2
Not very much                                       1
Not at all                                                0


D  I look forward with enjoyment to things: 

As much as I ever did                          0
Rather less than I used to                    1
Definitely less than I used to               2
Hardly at all                                         3


A I get sudden feelings of panic: 

Very often indeed                                3
Quite often                                          2
Not very often                                     1
Not at all                                             0


D I can enjoy a good book or radio or TV program:

Often                                                 0
Sometimes                                        1
Not often                                          2
Very seldom                                     3



Scoring (add the As = Anxiety. Add the Ds = Depression). The norms below will give you an idea of the level of Anxiety and Depression.

0-7 = Normal

8-10 = Borderline abnormal

11-21 = Abnormal