Effects of exercise on Pulmonary Function

[jmrommes]

I was diagnosed with COPD five years ago.  In the last 18 months I've lost nearly 90 pounds (with about 40-45 still to go). My current exercise routine includes walking at least two miles a day on the treadmill(about 45 minutes), resistance workouts of about 25 minutes usually every three days or so and 20 minutes on the exercise bike daily, or some combination of the above.  I get about 5 aerobic points in per day.  In March of 2003, my FEV1 was 16% pre-bronch; 22% post-bronch.  In Sept of 2004, it was 28% pre-bronch and 41% post-bronch.  Obviously, I've worked up to my current level of exercise over time, and plan to continue the exercise routine, though I don't know how much I can increase the intensity.  My question really is, how much more improvement might I expect to see?  I'm 60 and smoked for 30 years before quitting in 1992.  I'm on combivent (use it only before exercise), pulmicort turbohaler 2X day and oxygen (1.5 liter) at night with my C-Pap machine.  I also have a nebulizer that I use sometimes before exercise instead of the combivent.  I'd really like to get off the oxygen and have a sleep test scheduled in hopes it will show acceptable levels of desaturation at night.

[National Jewish]

Your efforts to improve your own health are outstanding.  There is still room for improvement in your pulmonary function with medicine and exercise.  Yours is a terrific exercise program.  The pre-exercise use of Combivent® Inhalation Aerosol (ipratropium bromide and albuterol sulfate) is fine.  There is a very good chance that you could experience even greater improvement, not only in your lung function, which appears to be significantly reversible, but in your exercise capacity as well.  The need for nighttime oxygen may or may not change.

You would almost certainly benefit by adding a long-acting inhaled bronchodilator, such as Spiriva® HandiHaler® (tiotropium bromide inhalation powder), Serevent® Inhalation Aerosol (salmeterol xinafoate), or Foradil® Aerolizer™ (formoterol fumarate inhalation powder).  A combination of Spiriva® HandiHaler® (tiotropium bromide inhalation powder) with Serevent® Inhalation Aerosol (salmeterol xinafoate) or Foradil® Aerolizer™ (formoterol fumarate inhalation powder) would also help.  This is assuming that there is no medical reason for you to avoid these medicines.

As long as it is your lung and not your heart that is limiting your exercise program, you should also be able to increase the intensity of exercise.  This should be done only after talking with your doctor about the safety of doing so.  Ultimately, the exercise level must be strenuous, with some shortness of breath, but not exhausting or debilitating.

If you have never engaged in a pulmonary rehabilitation program, you should do so.  Participation would provide a complete evaluation of your exercise program.  Also you would be able to set safe parameters for exercise.