Dear Doctor, You asked me to do this!
I continually tell this same joke:
Patient: “Doctor, what’s the best exercise for me?”
Doctor: “One that you will actually do”
In my live Pulmonary Rehab classes, we do the “Big 4” exercises: treadmill, bike, arm bike, and weights. I have people who like all but the treadmill, and others who will do anything to avoid the bike. Everyone is different.
After you find the exercises that you will actually do, and enjoy, you may discover that you need to either start on oxygen with activity, or, if you are already on oxygen, you may need to turn up the liter flow with activity. This is NOT a bad thing.
Your body needs fuel to exercise. Fuel is a combination of food, water, and oxygen. Starving yourself of any of those 3 will cause you to slow down or stop. No one is ever excited to start using oxygen, but here is why you should keep your oxygen saturations above 90% with exercise:
The oxygen will help you exercise longer. The longer you can exercise, the more efficiently your muscles will use oxygen, resulting in less oxygen consumption in the long run. In other words, using oxygen now to get strong will likely get you strong enough to not need it later. Not using it, and allowing yourself to desaturate with activity, will never allow you to get any stronger.
Now the Doctor part: You, the patient, are about to embark on an exercise program. Which, if deemed necessary by your doctor, means you will need to start using oxygen with activity, or you will need more oxygen than what you are prescribed at rest. Those little B -tanks they deliver for your outings aren’t going to cut it anymore. Because you won’t just be riding in a car anymore, you will be out walking, doing errands, gardening, and going out to lunch. Parking in the farthest space and walking to the entrance is now your new normal, which means your tank’s demand system may not be enough to keep up with your new pace. You will need a full flow system. And lots of tanks to go where you go. Don’t worry, this is likely temporary.
As you build strength, and endurance, we may be able to taper off the oxygen. But back to my point: skimping on oxygen will only slow you down. DO NOT let your oxygen company tell you ‘you can only have this many tanks’. Or that you can only have one kind. Your doctor needs to be the one who prescribes this. This is where you tell your doctor, “You told me to get more exercise. Now I need the proper fuel. And you have to tell the oxygen company to give me all I need!”
Don’t take no for an answer. Remember, you will not gain any strength exercising with saturations in the 80’s. Insist on having enough tanks delivered each week to meet your needs. Especially the first 5 weeks of starting Pulmonary Rehab, COPD Success, or any exercise program. Here’s to getting STRONG!
